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Systemic arterial hypertension is accompanied by autonomic impairments that, if not contained, promotes cardiac functional and morphological damages. Pyridostigmine bromide (PYR) treatment results in positive effects on autonomic control and beneficial cardiac remodeling. These findings were also observed after aerobic physical training (APT). However, little is known about PYR effects on left ventricular contractility, mainly when it is combined with APT. We aimed to investigate the effects of chronic acetylcholinesterase inhibition on cardiac autonomic tone balance, coronary bed reactivity, and left ventricular contractility in spontaneously hypertensive rats (SHR) submitted to APT. Male SHR (18 weeks) were divided into two groups (N = 16): untrained and submitted to APT for 14 weeks (18th to 32nd week). Half of each group was treated with PYR (15 mg/kg/day) for two weeks (31st to 32nd week). The experimental protocol consisted of recording hemodynamic parameters, double autonomic blockade with atropine and propranolol, and assessment of coronary bed reactivity and ventricular contractility in isolated hearts using the Langendorff technique. PYR and APT reduced blood pressure, heart rate, and sympathetic influence on the heart. The Langendorff technique showed that APT increased coronary perfusion pressure and left ventricle contractility in response to coronary flow and ß-agonist administration. However, treatment with PYR annulled the effects of APT. In conclusion, although chronic treatment with PYR reduces cardiac sympathetic tonic influence, it does not favor coronary bed reactivity and cardiac contractility gains. PYR treatment in the trained SHR group nullified the coronary vascular reactivity and cardiac contractility gains.

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The treatment of hypertensive patients with losartan is very common. Despite the reduction in blood pressure, its effects on cardiac contractility and sympathetic autonomic drive are still controversial. In turn, aerobic physical training (APT) also presents an important therapeutic option, providing significant improvements in cardiovascular autonomic control, however little is known about its effects on cardiac contractility, especially when associated with losartan. Therefore, we investigated in spontaneously hypertensive rats (SHR) the effects of losartan and APT on cardiac hemodynamics and functionality, with emphasis on autonomic tonic balance and cardiac contractility. Sixty-four SHR (18 weeks old) were divided into four groups (N = 16): vehicle; vehicle submitted to APT through swimming for 12 weeks; treated with losartan (5 mg·kg-1·d-1) for 12 weeks; and treated with losartan associated with APT. The groups were submitted to cardiac morphological and functional analysis by echocardiography; double blockade of cardiac autonomic receptors with atropine and propranolol; and coronary bed reactivity and left ventricular contractility analyses by the Langendorff technique. APT improved functional parameters and autonomic balance by reducing sympathetic drive and/or increasing vagal drive. In contrast, it promoted a concentric remodeling of the left ventricle (LV). Treatment with losartan reduced sympathetic autonomic drive and cardiac morphological parameters, but there were no significant gains in cardiac functionality and contractility. When combined, the concentric remodeling of the LV to APT was abolished and gains in cardiac functionality and contractility were observed. Our findings suggest that the effects of losartan and APT are complementary and should be applied together in the treatment of hypertension. In spontaneously hypertensive rats, the combination of aerobic physical training with losartan treatment was crucial to greater blood pressure reductions and an increase in left ventricular contractility. Furthermore, losartan treatment prevented the concentric left ventricular remodeling caused by aerobic physical training.

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BACKGROUND: Hypertension treatment with renin-angiotensin system inhibitors (RASi) presents contradictions about the recovery of damage in cardiovascular autonomic modulation characterized by reduced heart rate variability (HRV) and increased blood pressure variability (BPV). Conversely, the association of RASi with physical training can influence achievements in cardiovascular autonomic modulation. OBJECTIVE: To investigate the effects of aerobic physical training on hemodynamics and cardiovascular autonomic modulation in hypertensive volunteers untreated and treated with RASi. METHODS: A non-randomized controlled trial in which 54 men (≅ 40-60 years old) with a history of hypertension for >2 years were allocated in accordance with their characteristics into three groups: untreated (Control; n=16), treated with type 1 angiotensin II (AT1) receptor blocker (losartan; n=21), and treated with angiotensin-converting enzyme inhibitor (enalapril; n=17). All participants underwent hemodynamic, metabolic, and cardiovascular autonomic evaluation using baroreflex sensitivity (BRS) and spectral analysis of HRV and BPV, before and after 16 weeks of supervised aerobic physical training. RESULTS: The volunteers treated with RASi had lower BPV and HRV, both in the supine position and in the tilt test, with the losartan group having the lowest values. Aerobic physical training increased HRV and BRS in all groups. However, the association of enalapril with physical training appears to be more prominent. CONCLUSION: Long-term treatment with enalapril and losartan may harm the autonomic modulation of HRV and BRS. Aerobic physical training is essential to promote positive adjustments in the autonomic modulation of HRV and BRS in hypertensive patients treated with RASi, especially with enalapril.

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Background: Moderate-intensity continuous training (MICT) is strongly recommended for polycystic ovarian syndrome (PCOS) treatment. However, recent studies have suggested that high-intensity interval training (HIIT) would promote great benefits for cardiac autonomic control. Therefore, we investigated whether the benefits of HIIT related to cardiovascular autonomic control were greater than those of MICT in women with PCOS. Methods: Women with PCOS were randomly allocated through a blind draw into three groups: control, MICT, and HIIT. The control group did not undergo exercise, whereas those in the MICT and HIIT groups underwent 16 weeks of aerobic physical training. All groups were evaluated before and after the 16 weeks of intervention in the following aspects: quantification of serum lipids, testosterone, fasting insulin and blood glucose; physical fitness through cardiopulmonary testing; analysis of heart rate variability (HRV) by linear (time domain and frequency domain) and non-linear (symbolic analysis) methods, analysis of blood pressure variability (BPV) and spontaneous baroreflex sensitivity (BRS). Results: The final analysis, each group comprised 25 individuals. All groups had similar baseline parameters. After 16 weeks, intragroup comparison showed that the MICT and HIIT groups had a reduction in baseline heart rate (P < 0.001; P < 0.001, respectively) and testosterone levels P < 0.037; P < 0.012, respectively) associated with an increase in VO2peak (MICT, P < 0.001; HIIT, P < 0.001). The MICT (P < 0.36) and HIIT (P < 0.17) groups also showed an increase in cardiac vagal modulation, however only observed in the non-linear analysis. The intergroup comparison showed no differences between the MICT and HIIT groups in any of the hormonal, metabolic and autonomic parameters evaluated, including testosterone, peak oxygen uptake (VO2peak), HRV, BPV and BRS. Conclusion: HIIT and MICT showed similar results for the different parameters evaluated. This suggests that both training protocols can be recommended for the treatment of PCOS. Brazilian Clinical Trials Registry (RBR-78qtwy).

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ABSTRACT Objective: We investigated the effects of aerobic training on adipokine concentrations in women with polycystic ovary syndrome (PCOS). Subjects and methods: 120 women, including 60 with PCOS and 60 without PCOS, were divided into six groups (n = 20) based on body fat percentages of 22%-27%, 28%-32%, and 33%-37%. All groups were submitted the same evaluations before and after 16 weeks of aerobic training. These included anthropometric and hemodynamic analyses, cardiopulmonary tests, and laboratory tests. Two-way analysis of variance was performed to evaluate the differences between women with and without PCOS, effect of the body fat percentage, and effect of aerobic training. Results: Body fat and PCOS were associated with high values of blood glucose, insulin, and testosterone. Body fat also reduced adiponectin levels and increased leptin, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). In contrast, the PCOS increased only TNF-α and IL-6 levels. In the PCOS group, aerobic training reduced insulin, triglycerides, leptin, and IL-6 levels. It also promoted an increase in adiponectin and high-density lipoprotein levels. However, aerobic training did not alter TNF-α concentrations. Conclusion: The body fat potentiates metabolic impairments that may be harmful to women with PCOS. Aerobic training appears to promote an important beneficial effect on the metabolic regulation of adipokines, except TNF-α.

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Objective: We investigated the effects of aerobic training on adipokine concentrations in women with polycystic ovary syndrome (PCOS). Subjects and methods: 120 women, including 60 with PCOS and 60 without PCOS, were divided into six groups (n = 20) based on body fat percentages of 22%-27%, 28%-32%, and 33%-37%. All groups were submitted the same evaluations before and after 16 weeks of aerobic training. These included anthropometric and hemodynamic analyses, cardiopulmonary tests, and laboratory tests. Two-way analysis of variance was performed to evaluate the differences between women with and without PCOS, effect of the body fat percentage, and effect of aerobic training. Results: Body fat and PCOS were associated with high values of blood glucose, insulin, and testosterone. Body fat also reduced adiponectin levels and increased leptin, tumor necrosis factoralpha (TNF-α), and interleukin-6 (IL-6). In contrast, the PCOS increased only TNF-α and IL-6 levels. In the PCOS group, aerobic training reduced insulin, triglycerides, leptin, and IL-6 levels. It also promoted an increase in adiponectin and high-density lipoprotein levels. However, aerobic training did not alter TNF-α concentrations. Conclusion: The body fat potentiates metabolic impairments that may be harmful to women with PCOS. Aerobic training appears to promote an important beneficial effect on the metabolic regulation of adipokines, except TNF-α.

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Metabolic and hormonal outcomes of polycystic ovary syndrome (PCOS) have implications on telomere biology and physical activity may prevent telomere erosion. We sought to observe the effects of continuous (CAT) and intermittent (IAT) aerobic training on telomere length, inflammatory biomarkers, and its correlation with metabolic, hormonal, and anthropometric parameters of PCOS. This randomized controlled clinical trial study included 87 PCOS randomly stratified according to body mass index (BMI) in CAT (n = 28), IAT (n = 29) and non-training control group (CG, n = 30). The exercises were carried out on a treadmill, three times per week for 16 weeks. The participants' anthropometric characteristics and biochemical and hormonal concentrations were measured before and after aerobic training or observation period, as the telomere length that was evaluated using quantitative real-time PCR. Four months of aerobic exercises (CAT or IAT) did not alter telomere length and inflammatory biomarkers in PCOS women. Obesity index as BMI and waist circumference (WC), and inflammatory biomarkers negatively affect telomeres. The hyper-andro-genism measured by testosterone levels was reduced after both exercises (CAT, p ≤ 0.001; IAT, p = 0.019). In particular, the CAT reduced WC (p = 0.045), hip circumference (p = 0.032), serum cholesterol (p ≤ 0.001), and low-density lipoprotein (p = 0.030). Whereas, the IAT decreased WC (p = 0.014), waist-to-hip ratio (p = 0.012), free androgen index (FAI) (p = 0.037). WC (p = 0.049) and body fat (p = 0.015) increased in the non-training group while total cholesterol was reduced (p = 0.010). Booth exercises reduced obesity indices and hyperandrogenism on PCOS women without changes in telomere length or inflammatory biomarkers.

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O treinamento físico aeróbio (TFA) tem sido cada vez mais recomendado para a prevenção e tratamento de comorbidades, que podem ter em comum a resistência periférica à insulina (RI), como o diabetes tipo 2 (DM2) ea obesidade. Caracterizada pelo acúmulo excessivo de tecido adiposo, a obesidade também implica a disfunção endócrina desse tecido. Leptina e adiponectina são hormônios secretados pelos adipócitos que desempenham importante função no metabolismo energético, cujo desequilíbrio está fortemente relacionado à obesidade e à RI. Fisiologicamente, mulheres apresentam maiores níveis de leptina e adiponectina comparados aos de homens. Contudo, em condições como a obesidade e/ou DM2 esses níveis diminuem, deixando o organismo de fêmeas sem os efeitos protetores dessas adipocinas. Assim, o presente estudo teve como objetivo investigar os efeitos do TFA sobre as características morfofuncionais de TAB e pâncreas de camundongos fêmeas com deficiência de leptina. Para isso, camundongos fêmeas com oitosemanas de idade C57BL/J6 selvagem (C57) ou com deficiência de leptina ob/ob (Lepob) foram separadas nos grupos sedentárias (S) e treinadas (T): C57S (n=6), C57T (n=6), LepobS (n=5) e LepobT (n=8). O TFA foi realizadodurante oito semanas, com corrida a 60% da capacidade máxima, 1h/dia, 5x/semana. Água e ração foram administradas ad libitum. Os procedimentos foram aprovados pelo CEUA da EACH-USP (#001/2017). O acompanhamento do peso corporal e consumo de ração foi realizado semanalmente. Na 7ª semana de protocolo foram realizados os testesde tolerância àglicose (TTG) e à insulina (TTI). Ao final do protocolode treinamento foram avaliados parâmetros metabólicos de repouso e de esforço através da calorimetria indireta. A eutanásia dos animais foi realizada cominjeção intraperitoneal de anestésico e, em seguida, foram coletados os tecidos adiposos branco (TAB) subcutâneo e retroperitoneal e a porção esplênica do pâncreas, utilizados, posteriormente, para análises morfológicas. A determinação de adiponectinasérica foi realizada através de kit ELISA. Os resultados foram analisados por ANOVA de duas vias mais o teste post-hoc de Bonferroni. O protocolo de TFA não foi eficaz em reduzir a adiposidade e hiperfagia dos animais LepobS e LepobT, contudo o grupo LepobT apresentou tamanho reduzido de adipócitos doTAB-SC comparado ao grupo LepobS.O TFA não afetouo metabolismo glicêmico dos animais. Os parâmetros metabólicos derepouso não apresentaram alteração, contudo, noteste de esforço físico máximo, o grupo LepobT apresentou maiores tempo em teste até a exaustão e iVO2 comparado ao grupo LepobS. Por fim, embora o TFA não tenha aumentadoa secreção de adiponectina, o que poderia regular positivamente o metabolismo glicêmico de camundongos deficientes em leptina, melhorou a condição metabólica desses animais e reduziu a hipertrofia dos adipócitos do TAB-SC

Aerobic physical training (APT) has become an important strategy for the prevention and treatment of comorbidities, which may have in common the peripheral resistance to insulin(RI), such as type 2 diabetes and obesity. Characterized by the excessive accumulation of adipose tissue, obesity also implies endocrine dysfunction of this tissue.Leptin and adiponectin are hormones secreted by adipocytes that play an important role in energy metabolism, whose imbalance is strongly related to obesity and RI. Physiologically, women have higher levels of leptin and adiponectin compared to men.However,in conditions such as obesity and/or type 2 diabetes these levels decrease, leaving the body of females without the protective effects of these adipokines.Thus, the present study aimed to investigate the effects of APTon the morphofunctional characteristics of white adipose tissue (WAT)and pancreas in leptin-deficientfemale mice. For this, 8-week-old wild C57BL/J6 (C57) or leptin-deficient ob/ob (Lepob) female mice were separated into the groups sedentary (S) and trained (T): C57S (n = 6), C57T (n = 6), LepobS (n = 5) and LepobT (n = 8). Mice were housed in a temperature-controlled (22 ± 2°C) and 12-h light/12-h dark cycle, with free access to tap water and food ad libitum. The APT was performed for 1 h/day at 60% of maximal velocity achieved in the running capacity test, five times per week for eight weeks. The procedures were performed in accordance with the guidelines of the Brazilian College for Animal Experimentation and were approved by the Ethics Committee of the School of Arts, Sciences and Humanities of University of Sao Paulo (Process number001/2017). Body weight and feed intake were evaluated weekly. In the 7th week of protocol, the glucose and insulin tolerance tests (GTT and ITT) were performed. At the end of the training protocol, metabolic parameters of resting and maximal exertion were evaluated through indirect calorimetry. The euthanasia of the animals was performed by intraperitoneal injection of anaesthetic and thenthe subcutaneous and retroperitoneal WAT and the splenic portion of the pancreas were collected, and subsequentlyused for morphological analysis. Serum adiponectin quantification was performed by ELISA kit. The results were analyzed by two-way ANOVA plus the Bonferroni post-hoc test. The APT protocol was not effective in reducing the adiposity and hyperphagia of the animals LepobS and LepobT, however the LepobT group presented a reduced size of WAT-SC adipocytes compared to the LepobS group. Also, APT did not affectthe glycemic metabolism of theseanimals. Although the resting metabolic parameters were not different, in the maximal physical exercise test, the LepobT group had longer time to exhaustion test and iVO2 compared to the LepobS group.Finally, although APTdid not increase adiponectin plasma concentration, which could positively regulate the glycemic metabolism of leptin-deficient mice, it improved the metabolic condition of these animals and reduced the adipocyte hypertrophy of WAT-SC

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Fundamento: Caracterizada por perda súbita e transitória da consciência e do tônus postural, com recuperação rápida e espontânea, a síncope é causada por uma redução aguda da pressão arterial sistêmica e, por conseguinte, do fluxo sanguíneo cerebral. Os resultados insatisfatórios com o uso de fármacos permitiu que o tratamento não farmacológico da síncope neurocardiogênica fosse contemplado como primeira opção terapêutica. Objetivos: Comparar, em pacientes com síncope neurocardiogênica, o impacto do Treinamento Físico Aeróbico (TFA) de moderada intensidade e de uma intervenção controle, na positividade do Teste de Inclinação Passiva (TIP) e no tempo de tolerância ortostática. Métodos: Foram estudados 21 pacientes com história de síncope neurocardiogênica recorrente e TIP positivo. Esses foram aleatorizados em: Grupo Treinado (GT), n = 11, e Grupo Controle (GC), n = 10. O GT foi submetido a 12 semanas de TFA supervisionado, em cicloergômetro, e o GC, a um procedimento controle que consistia na realização de 15 minutos de alongamentos e 15 minutos de caminhada leve. Resultados: O GT apresentou efeito positivo ao treinamento físico, com aumento significativo do consumo de oxigênio-pico. Já o GC não apresentou nenhuma mudança estatisticamente significante, antes e após a intervenção. Após o período de intervenção, 72,7% da amostra do GT apresentou resultado negativo ao TIP, não apresentando síncope na reavaliação. Conclusão: O programa de treinamento físico aeróbico supervisionado por 12 semanas foi capaz de reduzir o número de TIP positivos, assim como foi capaz de aumentar o tempo de tolerância na posição ortostática ...

Background: Characterized as a sudden and temporary loss of consciousness and postural tone, with quick and spontaneous recovery, syncope is caused by an acute reduction of systemic arterial pressure and, therefore, of cerebral blood flow. Unsatisfactory results with the use of drugs allowed the nonpharmacological treatment of neurocardiogenic syncope was contemplated as the first therapeutic option. Objectives: To compare, in patients with neurocardiogenic syncope, the impact of a moderate intensity aerobic physical training (AFT) and a control intervention on the positivity of head-up tilting test (HUT) and orthostatic tolerance time. Methods: Were studied 21 patients with a history of recurrent neurocardiogenic syncope and HUT. The patients were randomized into: trained group (TG), n = 11, and control group (CG), n = 10. The TG was submitted to 12 weeks of AFT supervised, in cycle ergometer, and the CG to a control procedure that consisted in 15 minutes of stretching and 15 minutes of light walk. Results: The TG had a positive effect to physical training, with a significant increase in peak oxygen consumption. The CG did not show any statistically significant change before and after the intervention. After the intervention period, 72.7% of the TG sample had negative results to the HUT, not having syncope in the revaluation. Conclusion: The program of supervised aerobic physical training for 12 weeks was able to reduce the number of positive HUT, as it was able to increase tolerance time in orthostatic position during the HUT after the intervention period. .

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The objective of this work was to study the effect of the aerobic physical training and the cafeteria diet introduced after weaning of Wistar rats and on the morphology of the main salivary glands (parotid, submandibular, sublingual). Male rats after weaning were subjected to the cafeteria diet or the standard rodent chow, and either performed aerobic physical training in a treadmill for 100 days, or did not performed any physical activity. Analyses were done considering the response in body weight, adipose tissues and salivary glands, and the data were submitted to statistical treatment (p < 0.05). The morphological and morphometric analyses of the salivary glands were performed through histological sections stained with hematoxylin and eosin. Despite the normophagic behavior, the rodents fed with the cafeteria diet became obese, with repercussions on parotid gland weight. However, this obesity and/or physical training did not influence the histological organization of the salivary glands. The morphometric analysis of the submandibular glands pointed out a reduction in the levels of serous acinar cells as an effect of the diet and physical training. In conclusion, the parotid and the submandibular glands alter themselves due to the nature and consistency of food present in the cafeteria diet as well as due to the aerobic physical training.

O objetivo deste trabalho foi avaliar as características morfológicas das glândulas salivares (parótida, submandibular, sublingual) apresentadas por ratos submetidos a treinamento físico aeróbio e dieta de cafeteria após o período de lactação. Ratos machos após a lactação consumiram dieta de cafeteria ou ração-padrão para roedores e realizaram treinamento físico aeróbio em esteira rolante por um período de 100 dias, ou não realizaram nenhuma atividade física. Foram feitas análises sobre a resposta do peso corporal, dos tecidos adiposos e das glândulas salivares e os dados submetidos a tratamento estatístico (p < 0,05). A análise morfológica e morfométrica das glândulas salivares foi realizada a partir de cortes histológicos corados com Hematoxilina e Eosina. Apesar do comportamento normofágico, os roedores alimentados com dieta de cafeteria apresentaram maior quantidade de gordura corporal, com repercussão sobre o peso da glândula parótida. A análise morfométrica das glândulas submandibulares indicou redução na proporção dos ácinos serosos como efeito da dieta de cafeteria e do treinamento físico. No entanto, excesso de gordura corporal, dieta de cafeteria e/ou treinamento físico não influenciou a organização histológica das glândulas salivares. Concluiu-se que as glândulas parótidas e submandibulares são mais influenciáveis em função da natureza e consistência dos alimentos presentes na dieta de cafeteria, assim como do treinamento físico aeróbio.

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