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Disturbed Blood Flow Acutely Increases Endothelial Microparticles and Decreases Flow Mediated Dilation in Patients With Heart Failure With Reduced Ejection Fraction

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Autor(es):
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Silva, Thiago O. C. [1] ; Sales, Allan R. K. [1, 2] ; Araujo, Gustavo S. M. [1] ; Fonseca, Guilherme W. P. [1] ; Braga, Pedro G. S. [1] ; Faria, Diego [2] ; Rocha, Helena N. M. [3] ; Rocha, Natalia G. [3] ; Lima, Marta F. [1] ; Mady, Charles [1] ; Negrao, Carlos E. [4, 1] ; Alves, Maria Janieire N. N. [1]
Número total de Autores: 12
Afiliação do(s) autor(es):
[1] Univ Sao Paulo, Sch Med, Inst Heart, Sao Paulo - Brazil
[2] Dor Inst Res & Educ, Sao Paulo - Brazil
[3] Fluminense Fed Univ, Dept Physiol & Pharmacol, Niteroi, RJ - Brazil
[4] Univ Sao Paulo, Sch Phys Educ & Sport, Sao Paulo - Brazil
Número total de Afiliações: 4
Tipo de documento: Artigo Científico
Fonte: FRONTIERS IN PHYSIOLOGY; v. 12, MAR 11 2021.
Citações Web of Science: 0
Resumo

Introduction Disturbed blood flow, characterized by high retrograde and oscillatory shear rate (SR), is associated with a proatherogenic phenotype. The impact of disturbed blood flow in patients with heart failure with reduced ejection fraction (HFrEF) remains unknown. We tested the hypothesis that acute elevation to retrograde and oscillatory SR provoked by local circulatory occlusion would increase endothelial microparticles (EMPs) and decrease brachial artery flow-mediated dilation (FMD) in patients with HFrEF. Methods Eighteen patients with HFrEF aged 55 +/- 2 years, with left ventricular ejection fraction (LVEF) 26 +/- 1%, and 14 control subjects aged 49 +/- 2 years with LVEF 65 +/- 1 randomly underwent experimental and control sessions. Brachial artery FMD (Doppler) was evaluated before and after 30 min of disturbed forearm blood flow provoked by pneumatic cuff (Hokanson) inflation to 75 mm Hg. Venous blood samples were collected at rest, after 15 and 30 min of disturbed blood flow to assess circulating EMP levels (CD42b-/CD31+; flow cytometry). Results At rest, FMD was lower in patients with HFrEF compared with control subjects (P < 0.001), but blood flow patterns and EMPs had no differences (P > 0.05). The cuff inflation provoked a greater retrograde SR both groups (P < 0.0001). EMPs responses to disturbed blood flow significantly increased in patients with HFrEF (P = 0.03). No changes in EMPs were found in control subjects (P > 0.05). Disturbed blood flow decreased FMD both groups. No changes occurred in control condition. Conclusion Collectively, our findings suggest that disturbed blood flow acutely decreases FMD and increases EMP levels in patients with HFrEF, which may indicate that this set of patients are vulnerable to blood flow disturbances. (AU)

Processo FAPESP: 15/22814-5 - Câncer e coração: novos paradigmas de diagnóstico e tratamento
Beneficiário:Carlos Eduardo Negrão
Linha de fomento: Auxílio à Pesquisa - Temático
Processo FAPESP: 14/11671-6 - Efeito do treinamento intervalado de alta intensidade versus moderado contínuo nos mecanismos reflexos periféricos de controle da atividade simpática em pacientes com insuficiência cardíaca
Beneficiário:Allan Robson Kluser Sales
Linha de fomento: Bolsas no Brasil - Pós-Doutorado
Processo FAPESP: 17/25613-6 - Exercício aeróbico habitual diminui endotelina 1 e restaura a vasodilatação induzida por insulina em pacientes com diabetes tipo 2: o papel do shear stress
Beneficiário:Allan Robson Kluser Sales
Linha de fomento: Bolsas no Exterior - Estágio de Pesquisa - Pós-Doutorado