RESUMO
Although dynamic resistance training (DRT) and isometric handgrip training (IHT) may decrease blood pressure (BP) in hypertensives, the effects of these types of training have not been directly compared, and a possible additive effect of combining IHT to DRT (combined resistance training-CRT), has not been investigated. Thus, this study compared the effects of DRT, IHT and CRT on BP, systemic hemodynamics, vascular function, and cardiovascular autonomic modulation. Sixty-two middle-aged men with treated hypertension were randomly allocated among four groups: DRT (8 exercises, 50% of 1RM, 3 sets until moderate fatigue), IHT (30% of MVC, 4 sets of 2 min), CRT (DRT + IHT) and control (CON - stretching). In all groups, the interventions were administered 3 times/week for 10 weeks. Pre- and post-interventions, BP, systemic hemodynamics, vascular function and cardiovascular autonomic modulation were assessed. ANOVAs and ANCOVAs adjusted for pre-intervention values were employed for analysis. Systolic BP decreased similarly with DRT and CRT (125 ± 11 vs. 119 ± 12 and 128 ± 12 vs. 119 ± 12 mmHg, respectively; P < 0.05), while peak blood flow during reactive hyperaemia (a marker of microvascular function) increased similarly in these groups (774 ± 377 vs. 1067 ± 461 and 654 ± 321 vs. 954 ± 464 mL/min, respectively, P < 0.05). DRT and CRT did not change systemic hemodynamics, flow-mediated dilation, and cardiovascular autonomic modulation. In addition, none of the variables were changed by IHT. In conclusion, DRT, but not IHT, improved BP and microvascular function in treated hypertensive men. CRT did not have any additional effect in comparison with DRT alone.
Assuntos
Hipertensão , Treinamento Resistido , Masculino , Pessoa de Meia-Idade , Humanos , Pressão Sanguínea/fisiologia , Força da Mão/fisiologia , Hipertensão/terapia , Hemodinâmica/fisiologiaRESUMO
PURPOSE OF REVIEW: The aim of this systematic review and meta-analysis was to investigate the effect of resistance training on arterial stiffness (AS) in healthy subjects. Two electronic databases (PubMed and Scielo) were searched for randomized controlled trials comparing the effect of dynamic and/or isometric resistance training stand-alone versus non-exercise control group on AS assessed by pulse wave velocity (PWV) in healthy subjects. Random-effects modeling was employed to compare delta changes (post-pre-intervention) in AS between the resistance training and control group. Data were reported as weighted mean difference (MD) and its 95% confidence intervals (CI). Statistical significance was set at 5%. RECENT FINDINGS: A total of 10 studies involving 310 participants (46.5% female; resistance training groups, n = 194; control groups, n = 116) were included in the meta-analysis. Comparing changes from pre- to post-resistance training groups versus control groups, no differences were observed in PWV (MD - 1.33 cm/s (95% CI - 34.58 to 31.91), p = 0.94, I2 = 91%). Resistance training stand-alone does not elicit changes (i.e., improvement or impairment) on AS in healthy subjects, but the high heterogeneity suggests influence of training protocol and/or personal characteristics that should be investigated in the future.
Assuntos
Hipertensão , Treinamento Resistido , Rigidez Vascular , Feminino , Humanos , Masculino , Análise de Onda de PulsoRESUMO
AIMS: This study's aim is to compare the ability of two ECG criteria to differentiate ventricular (VT) from supraventricular tachycardia (SVT): Brugada et al. [horizontal plane (HP) leads] and Vereckei et al. [frontal plane (FP), specifically aVR lead], having electrophysiological study (EPS) as gold standard. After comparing, suggestions for better diagnosis of wide QRS-complex tachycardia (WCT) in emergency situations were made. METHODS AND RESULTS: Fifty-one consecutive patients with 12-lead ECG registered during EPS-induced regular WCT were selected. Each ECG was split into two parts: HP (V1-V6) and FP (D1-D3, aVR, aVL, and aVF), randomly distributed to three observers, blinded for EPS diagnosis and complementary ECG plane, resulting in total 306 ECG analyses. Observers followed the four steps of both algorithms, counting time-to-diagnosis. Global sensitivity, specificity, percentage of incorrect diagnoses, and step-by-step positive/negative likelihood ratios (+LR and -LR) were calculated. Kaplan-Meier curve was plotted for final time-to-diagnosis. Inter-observer agreement was assessed with kappa-statistic. Global sensitivity was similarly high in FP and HP algorithms (89.2 vs. 90.1%), and incorrect classifications were 27.4 vs. 24.7%. Forty-eight correct analyses by Vereckei criteria took 9.13 s to diagnose VT in the first step, showing that first step was fast, with high +LR, generating nearly conclusive pre- (72.6%) to post-test (98.0%) changes for VT probability. CONCLUSION: Both algorithms as a whole are similar for diagnosis of WTC; however, the first step of Vereckei (initial R in aVR) is a simple, reproducible, accurate, and fast tool to use. The negativity of this step requires a 'holistic' approach to distinguish VT from SVT.
Assuntos
Algoritmos , Eletrocardiografia , Ventrículos do Coração/fisiopatologia , Taquicardia Supraventricular/diagnóstico , Taquicardia Ventricular/diagnóstico , Diagnóstico Diferencial , Humanos , Estudos Prospectivos , Sensibilidade e EspecificidadeRESUMO
Introdução: A criança com seqüêcia de Moebius pode apresentar paralisia de vários pares cranianos, entre os quais: III, IV, V, VI, VII, VIII, IX, X e XII. Essas anomalias comprometem funções motoras e sensoriais nobres. Associam-se defeitos em pés e mãos, como equinovarus, sindactilia e artrogripose. O uso de misoprostol na gestação tem sido confirmado por muitas mães. Forma do estudo: C1ínico prospectivo. Objetivos: Avaliar as manifestaçoes clínicas e a acuidade auditiva em crianças portadoras da anomalia e detectar possíveis fatores etiológicos. Material e método: Foram realizadas avaliações otorrinolaringológicas e da acuidade auditiva em cinco crianças portadoras da sequência de Moebius, seguidas na Faculdade de Medicina de Botucatu - Unesp. As alterações faciais e as limitações funcionais foram registradas. As avaliações da acuidade auditiva foram realizadas através de testes comportamentais, audiometria tonal, imitanciometria e potenciais evocados do tronco encefálico. Resultados: Foram avaliados três meninos e duas meninas. As alterações que mais se destacaram no exame físico foram: paralisia facial, atrofia do masseter, má oclusão dentária, retração de membrana timpânica, equinovarus, fenda palpetoral oblíqua e atrofia de hemilíngua. Hipoacusia condutiva foi detectada em três crianças; e mista, em uma. O uso de misoprostol na gestação foi confirmado por quatro mães. Conclusões: Nas crianças avaliadas com sequência de Moebius, observou-se comprometimento, principalmente dos pares cranianos V, VII e XII, entre outros, responsáveis por limitações motoras e sensoriais. A obstrução tubária associada à hipoacusia condutiva foi achado frequente do exame físico. O uso de misoprostol na gestação foi relatado pela maioria das mães, indicando possível fator etiológico