RESUMO
The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms. Exercise training has been recommended as non-pharmacological treatment for patients with different chronic cardiopulmonary diseases. In this respect, previous studies have reported improvements in ventilatory efficiency after aerobic exercise training in patients with heart disease. Against this background, the primary objective of the present review was to discuss the pathophysiological mechanisms involved in abnormal ventilatory response to exercise, with an emphasis on both patients with heart failure syndrome and coronary artery disease. Secondly, special focus was dedicated to the role of aerobic exercise training in improving indices of ventilatory efficiency among these patients, as well as to the underlying mechanisms involved.
Assuntos
Doença da Artéria Coronariana/fisiopatologia , Exercício Físico/fisiologia , Insuficiência Cardíaca/fisiopatologia , Ventilação Pulmonar/fisiologia , Doença da Artéria Coronariana/reabilitação , Teste de Esforço , Terapia por Exercício/métodos , Feminino , Insuficiência Cardíaca/reabilitação , Humanos , Masculino , Consumo de Oxigênio/fisiologia , Troca Gasosa Pulmonar/fisiologia , Fatores de TempoRESUMO
The oxygen uptake efficiency slope (OUES) is a submaximal index incorporating cardiovascular, peripheral, and pulmonary factors that determine the ventilatory response to exercise. The purpose of this study was to evaluate the effects of continuous exercise training and interval exercise training on the OUES in patients with coronary artery disease. Thirty-five patients (59.3±1.8 years old; 28 men, 7 women) with coronary artery disease were randomly divided into two groups: continuous exercise training (n=18) and interval exercise training (n=17). All patients performed graded exercise tests with respiratory gas analysis before and 3 months after the exercise-training program to determine ventilatory anaerobic threshold (VAT), respiratory compensation point, and peak oxygen consumption (peak VO2). The OUES was assessed based on data from the second minute of exercise until exhaustion by calculating the slope of the linear relation between oxygen uptake and the logarithm of total ventilation. After the interventions, both groups showed increased aerobic fitness (P<0.05). In addition, both the continuous exercise and interval exercise training groups demonstrated an increase in OUES (P<0.05). Significant associations were observed in both groups: 1) continuous exercise training (OUES and peak VO2 r=0.57; OUES and VO2 VAT r=0.57); 2) interval exercise training (OUES and peak VO2 r=0.80; OUES and VO2 VAT r=0.67). Continuous and interval exercise training resulted in a similar increase in OUES among patients with coronary artery disease. These findings suggest that improvements in OUES among CAD patients after aerobic exercise training may be dependent on peripheral and central mechanisms.
Assuntos
Doença da Artéria Coronariana/metabolismo , Terapia por Exercício/métodos , Exercício Físico/fisiologia , Consumo de Oxigênio/fisiologia , Limiar Anaeróbio/fisiologia , Análise de Variância , Índice de Massa Corporal , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana/reabilitação , Teste de Esforço/métodos , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Condicionamento Físico Humano/métodos , Esforço Físico/fisiologia , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Função Ventricular EsquerdaRESUMO
The oxygen uptake efficiency slope (OUES) is a submaximal index incorporating cardiovascular, peripheral, and pulmonary factors that determine the ventilatory response to exercise. The purpose of this study was to evaluate the effects of continuous exercise training and interval exercise training on the OUES in patients with coronary artery disease. Thirty-five patients (59.3±1.8 years old; 28 men, 7 women) with coronary artery disease were randomly divided into two groups: continuous exercise training (n=18) and interval exercise training (n=17). All patients performed graded exercise tests with respiratory gas analysis before and 3 months after the exercise-training program to determine ventilatory anaerobic threshold (VAT), respiratory compensation point, and peak oxygen consumption (peak VO2). The OUES was assessed based on data from the second minute of exercise until exhaustion by calculating the slope of the linear relation between oxygen uptake and the logarithm of total ventilation. After the interventions, both groups showed increased aerobic fitness (P<0.05). In addition, both the continuous exercise and interval exercise training groups demonstrated an increase in OUES (P<0.05). Significant associations were observed in both groups: 1) continuous exercise training (OUES and peak VO2 r=0.57; OUES and VO2 VAT r=0.57); 2) interval exercise training (OUES and peak VO2 r=0.80; OUES and VO2 VAT r=0.67). Continuous and interval exercise training resulted in a similar increase in OUES among patients with coronary artery disease. These findings suggest that improvements in OUES among CAD patients after aerobic exercise training may be dependent on peripheral and central mechanisms.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Consumo de Oxigênio/fisiologia , Doença da Artéria Coronariana/metabolismo , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana/reabilitação , Limiar Anaeróbio/fisiologia , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Índice de Massa Corporal , Análise de Variância , Função Ventricular Esquerda , Teste de Esforço/métodos , Esforço Físico/fisiologia , Condicionamento Físico Humano/métodos , Hipertensão/fisiopatologiaRESUMO
The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms. Exercise training has been recommended as non-pharmacological treatment for patients with different chronic cardiopulmonary diseases. In this respect, previous studies have reported improvements in ventilatory efficiency after aerobic exercise training in patients with heart disease. Against this background, the primary objective of the present review was to discuss the pathophysiological mechanisms involved in abnormal ventilatory response to exercise, with an emphasis on both patients with heart failure syndrome and coronary artery disease. Secondly, special focus was dedicated to the role of aerobic exercise training in improving indices of ventilatory efficiency among these patients, as well as to the underlying mechanisms involved.
Assuntos
Humanos , Masculino , Feminino , Doença da Artéria Coronariana/fisiopatologia , Exercício Físico/fisiologia , Insuficiência Cardíaca/fisiopatologia , Ventilação Pulmonar/fisiologia , Doença da Artéria Coronariana/reabilitação , Teste de Esforço , Terapia por Exercício/métodos , Insuficiência Cardíaca/reabilitação , Consumo de Oxigênio/fisiologia , Troca Gasosa Pulmonar/fisiologia , Fatores de TempoRESUMO
AIM: To verify the muscular force and resistance to the movement of the flexor and extensor muscles of the knee of patients with spasticity after treatment with neuromuscular electrical stimulation (NMES) and isotonic exercises. PATIENTS AND METHODS: The patients this study were divided into group 1 (NMES) and group 2 (isotonic exercises). Their muscular torque and resistance to the movement of the flexor and extensor knee muscles were measured by the isokinetic dynamometer and the degree of spasticity by the modified Ashworth scale before and after ten sessions. RESULTS: Alterations in the scores of the modified Ashworth scale were not observed. An increase in the flexor torque in group 1 (p = 0.041) and in group 2 (p = 0.001) was verified. In the passive mode, group 1 presented a reduction of resistance to the flexion movement (p = 0.026), while in group 2, a reduction of resistance to both the flexion (p = 0,029) and extension movements (p = 0.019) was verified. CONCLUSIONS: The two therapeutical resources had their efficiency proven only for the increase of the force of the flexor muscles. The resistance to movement, the isotonic exercises were more effective because they promoted a reduction in the resistance of the flexor and extensor knee muscles.
Assuntos
Terapia por Estimulação Elétrica , Terapia por Exercício , Hemiplegia/reabilitação , Feminino , Humanos , Joelho , Masculino , Pessoa de Meia-Idade , Músculo EsqueléticoRESUMO
OBJECTIVES: The aim of this work was to identify the presence of atherosclerotic plaque in the human carotid artery using near infrared Raman spectroscopy. BACKGROUND DATA: Atherosclerosis is the most common and serious pathology of the cardiovascular system. Raman spectroscopy is an analytical tool that can be used to gather information about both the morphology and chemical composition of tissues. METHODS: A Ti:sapphire laser operating at the near-infrared wavelength of 830 nm pumped by an argon laser was used for excitation of the samples, and the Raman scattering was detected by an optical spectrometer with a liquid-nitrogen-cooled CCD detector. Carotid artery samples were classified into five groups: normal, intimal thickening, fatty plaque, fibrous-fatty plaque, and fibrous-calcified plaque. RESULTS: It was observed that the Raman spectrum of atheromatous plaque was different that that of normal tissue. The spectra of atheromatous plaques had bands due to the presence of cholesterol and its esters, with major bands at 1439 and 1663 cm(1), respectively. In normal tissues a peak related to C-H bending appears at 1451 cm(1). Calcified atheromatous plaques had primary bands at 961 and 1071 cm(1), which were due to the presence of phosphate and carbonate in the accumulated calcium. Peaks were seen at 1451 and 1655 cm(1) in the non-atherosclerotic tissue, which were shifted to 1439 and 1663 cm(1) in the atherosclerotic plaque. CONCLUSIONS: Our results indicate that this technique could be used to detect the presence of atherosclerotic plaques in carotid arterial tissue.
Assuntos
Artérias Carótidas/química , Doenças das Artérias Carótidas/diagnóstico , Espectroscopia de Luz Próxima ao Infravermelho , Análise Espectral Raman , HumanosRESUMO
OBJECTIVE: This study investigated the effect of photodynamic therapy (PDT) with toluidine blue O (TBO) and a light-emitting diode (LED) on the viability of Streptococcus mutans cells in a planktonic culture. BACKGROUND DATA: Growth of Streptococcus mutans is the first step in the development of tooth decay. The use of light and dyes promotes cellular death in a noninvasive way, reducing treatment time. METHODS: The LED used in this study had output power of 116 mW, its energy was 21 J, and the fluency was 2.18 J/cm(2). Samples were prepared and divided into five groups: (1) control group (-); (2) control group (+); (3) TBO; (4) LED; and (5) LED + TBO. RESULTS: One hundred percent of the bacteria were killed following irradiation with LED and TBO. The biofilm that formed on the glass surfaces was analyzed by SEM and colony count. CONCLUSIONS: It was demonstrated that PDT was efficient at killing microorganisms and preventing the formation of biofilms.
Assuntos
Biofilmes/efeitos da radiação , Lasers Semicondutores , Fotoquimioterapia , Fototerapia/métodos , Streptococcus mutans/efeitos da radiação , Biofilmes/crescimento & desenvolvimento , Sobrevivência Celular/efeitos da radiação , Corantes , Microscopia Eletrônica de Varredura , Streptococcus mutans/fisiologia , Cloreto de TolônioRESUMO
Bone fractures are lesions of different etiology; may be associated or not to bone losses; and have different options for treatment, such as the use of biomaterials, guided bone regeneration, techniques considered effective on improving bone repair. Laser therapy has also been shown to improve bone healing on several models. The association of these three techniques has been well documented by our group using different models. This study aimed to assess, through Raman spectroscopy, the incorporation of calcium hydroxyapatite (CHA approximately 958 cm(-1)) on the repair of complete tibial fractures in rabbits treated with wire osteosynthesis (WO); treated or not with laser therapy; and associated or not with the use of BMPs and/or Guided Bone Regeneration. Complete tibial fractures were created in 12 animals that were divided into four groups: WO; WO+BMPs; WO+laser therapy; and WO+BMPs+laser therapy. Irradiation started immediately after surgery; was repeated at every other day during 2 weeks; and was carried out with lambda 790 nm laser light (4 J/cm(2) per point, 40 mW, phi approximately 0.5 cm(2), 16J per session). Animal death occurred after 30 days. Raman spectroscopy was performed at both the surface and the depth of the fracture site. Statistical analysis showed significant difference on the concentrations of CHA between surface and depth. The analysis in each of the areas showed at the depth of the fracture significant differences between all treatment groups (p<0.0001). Significant differences were also seen between WO+BMPs+laser therapy and WO (p<0.001) and WO+laser therapy (p<0.001). At the surface, significant difference was seen only between the treatment groups and the non-fractured subjects (p=0.0001). However, no significant difference was seen between the treatment groups (p=0.14). It is concluded that the use of NIR laser therapy associated to BMPs and GBR was effective in improving bone healing on the fractured bones as a result of the increasing deposition of CHA measured by Raman spectroscopy.
Assuntos
Regeneração Óssea/efeitos da radiação , Fixação Interna de Fraturas/métodos , Consolidação da Fratura/efeitos da radiação , Regeneração Tecidual Guiada , Terapia a Laser , Fraturas da Tíbia/terapia , Animais , Proteínas Morfogenéticas Ósseas/uso terapêutico , Durapatita/metabolismo , Consolidação da Fratura/efeitos dos fármacos , Masculino , Coelhos , Análise Espectral RamanRESUMO
OBJECTIVE: The aim of this study was to investigate if low-level laser therapy (LLLT) can modulate formation of hemorrhagic lesions induced by immune complex. BACKGROUND DATA: There is a lack of information on LLLT effects in hemorrhagic injuries of high perfusion organs, and the relative efficacy of LLLT compared to anti-inflammatory drugs. METHODS: A controlled animal study was undertaken with 49 male Wistar rats randomly divided into seven groups. Bovine serum albumin (BSA) i.v. was injected through the trachea to induce an immune complex lung injury. The study compared the effect of irradiation by a 650-nm Ga-Al-As laser with LLLT doses of 2.6 Joules/cm(2) to celecoxib, dexamethasone, and control groups for hemorrhagic index (HI) and myeloperoxide activity (MPO) at 24 h after injury. RESULTS: The HI for the control group was 4.0 (95% CI, 3.7-4.3). Celecoxib, LLLT, and dexamethasone all induced significantly (p < 0.01) lower HI than control animals at 2.5 (95% CI, 1.9-3.1), 1.8 (95% CI, 1.2-2.4), and 1.5 (95% CI, 0.9-2.1), respectively, for all comparisons to control. Dexamethasone, but not celecoxib, induced a slightly, but significantly lower HI than LLLT (p = 0.04). MPO activity was significantly decreased in groups receiving celecoxib at 0.87 (95% CI, 0.63-1.11), dexamethasone at 0.50 (95% CI, 0.24-0.76), and LLLT at 0.7 (95% CI, 0.44-0.96) when compared to the control group, at 1.6 (95% CI, 1.34-1.96; p < 0.01), but there were no significant differences between any of the active treatments. CONCLUSION: LLLT at a dose of 2.6 Joules/cm(2) induces a reduction of HI levels and MPO activity in hemorrhagic injury that is not significantly different from celecoxib. Dexamethasone is slightly more effective than LLLT in reducing HI, but not MPO activity.
Assuntos
Hemorragia/radioterapia , Doenças do Complexo Imune/complicações , Terapia com Luz de Baixa Intensidade , Pneumopatias/radioterapia , Animais , Anti-Inflamatórios/farmacologia , Celecoxib , Dexametasona/farmacologia , Hemorragia/tratamento farmacológico , Hemorragia/etiologia , Pneumopatias/tratamento farmacológico , Pneumopatias/etiologia , Masculino , Pirazóis/farmacologia , Ratos , Ratos Wistar , Sulfonamidas/farmacologiaRESUMO
Our objective was to investigate if low-level laser therapy (LLLT) could improve respiratory function and inhibit tumor necrosis factor (TNF-alpha) release into the diaphragm muscle of rats after an intravenous injection of lipopolysaccharide (LPS) (5 mg/kg). We randomly divided Wistar rats in a control group without LPS injection, and LPS groups receiving either (a) no therapy, (b) four sessions in 24 h with diode Ga-AsI-Al laser of 650 nm and a total dose of 5.2 J/cm2, or (c) an intravenous injection (1.25 mg/kg) of the TNF-alpha inhibitor chlorpromazine (CPZ). LPS injection reduced maximal force by electrical stimulation of diaphragm muscle from 24.15+/-0.87 N in controls, but the addition of LLLT partly inhibited this reduction (LPS only: 15.01+/-1.1 N vs LPS+LLLT: 18.84+/-0.73 N, P<0.05). In addition, this dose of LLLT and CPZ significantly (P<0.05 and P<0.01, respectively) reduced TNF-alpha concentrations in diaphragm muscle when compared to the untreated control group.