Papers by Luiz Carlos de Abreu
IFMBE Proceedings, 2015
Background: Few studies evaluated cardiac autonomic responses induced by hemodialysis. We aimed t... more Background: Few studies evaluated cardiac autonomic responses induced by hemodialysis. We aimed to evaluate cardiac autonomic regulation during hemodialysis in haemodynamically stable patients with chronic renal disease. Method: Heart rate variability (HRV) was analyzed in the time and frequency domains in the following periods: Pre-dialysis (10 minutes before); Hemodialysis (240 minutes). Results: The standard deviation of all normal RR intervals (SDNN) increased 60-90min after hemodialysis compared to pre-hemodialysis (29.77±12ms vs. 51.70±41.6ms-p<0.05). The percentage of adjacent RR intervals with a difference of duration greater than 50ms (pNN50) also raised 180-210 min after hemodialysis compared to 0-30 min after hemodialysis (1.29±3.5 vs. 4.37±7.8-p<0.05). Low frequency (LF) (ms 2) increased 150-180 min after hemodialysis compared to pre-hemodialysis (168.2±179.8 ms 2 vs. 562.6±455.7 ms 2 : p<0.05) and high frequency (HF) (ms 2) band raised 150-180min and 180-210 after hemodialysis compared to pre-hemodialysis (59.3±70.78 ms 2 vs. 212.5±304.9 ms 2 vs. 186.3±335.1 ms 2 : p<0.05). Conclusion: Hemodialysis acutely increased HRV, raising the parasympathetic component of HRV.
Medicine, May 28, 2021
Abstract Among the main types of neoplasms in the female population, breast and cervical cancers ... more Abstract Among the main types of neoplasms in the female population, breast and cervical cancers are the most important due to their high morbidity and mortality rates. The mortality has been proportionally higher in developing countries. Analysis of the trend of cancer mortality in Brazil revealed a considerable difference in the pattern of deaths between the regions. To analyze the trend of mortality due to breast and cervical cancers in women. Retrospective study of a series of death cases, using secondary data from the mortality information system (SIM) of the Ministry of Health. The deaths were identified as the underlying cause of breast and cervical cancers, including malignant neoplasms of the uterus without other specifications, occurring from 1980 to 2014. Thus, the annual standardized age-specific mortality rates by the world population were applied. For trend analysis, regression models were utilized in which the mortality rates were considered dependent variables and years the independent variable. Polynomial regression models and a Prais–Winsten regression model were adopted. Cervical cancer presented a mortality rate ranging from 2.15 to 10.69 per 100,000 women from 1980 to 2014, with a tendency for stability. Breast cancer mortality rate varied from 3.81 to 11.47 per 100,000 women from 1981 to 2014, indicating a growing trend. There is a significant increase in the mortality rate for breast cancer and stability of cervical cancers in the State of Acre from 1980 to 2014, evidencing a concern in their care and monitoring. Above all, guaranteed access, especially to the population of women at social risk, and the search for effective screening should be emphasized in the formation of the care line and the Health Care Network in the State of Acre.
International Archives of Medicine, 2016
Introduction: Abdominal fat and the proportion of lean body mass have both been independently con... more Introduction: Abdominal fat and the proportion of lean body mass have both been independently considered as risk factors leading to insulin resistance and to an increased risk of developing chronic diseases later in life. Objective: To analyse the relationship between the waist-to-height ratio (WHtR) and other body composition indicators in children aged 2-6 years at public childcare centres. Methods: This study consisted of a random, probabilistic cluster sampling of 9 of the 59 existing childcare centres (Taubaté-SP, Brazil), resulting in the evaluation of 950 preschool children. The body mass index z-score (zBMI) and internationally accepted cutoff points were used to evaluate their nutritional status. The z-score for the arm muscle area (zAMA) and arm fat area (zAFA) and the WHtR were used to evaluate their body composition. Analyses were performed using the parameters of central tendency, dispersion, proportions and correlations, adopting a significance level of 5%. Results: The data indicated a direct correlation between the WHtR and zBMI (r P = 0.78), zAMA (r P = 0.52), zAFA (r P = 0.66) and the percentage of AFA (r P =0.54), with p <0.0001. There was an inverse correlation between the WHtR and the percentage of AMA (r P =-0.54), with p <0.0001. Conclusion: In preschool children, as the WHtR increases, the amounts of both lean body mass and body fat mass also increase. However, an increase in the waist circumference is accompanied by a disproportionately greater increase in fat mass compared to lean mass, which could indicate an additional risk factor for future chronic diseases.
International Journal of Environmental Research and Public Health
Background: High blood pressure is an important public health problem due to its high prevalence,... more Background: High blood pressure is an important public health problem due to its high prevalence, the difficulty to control it, and its high contribution to morbidity. A series of changes may be linked to the aging process, compromising cardiac conduction, and reducing cardiovascular baroreceptor function. Advancing age promotes a decline in heart rate variability and this decrease can increase the probability of cardiovascular disease. The aim of this study was to analyze the autonomic modulation of heart rate in hypertensive elderly individuals during and after a session of aerobic exercise, and to compare it with elderly individuals without cardiovascular or metabolic disease. Our study was a non-randomized controlled study with hypertensive elderly (HBP group) and elderly without cardiovascular and/or metabolic diseases (control group). Data on blood pressure and heart rate variability (HRV) were collected before, during, and after 30 min of aerobic physical exercise on a treadm...
Translational Pediatrics, 2021
Background: The cardiovascular system is directly influenced by the autonomic nervous system (ANS... more Background: The cardiovascular system is directly influenced by the autonomic nervous system (ANS); its changes affect heart rate variability (HRV) and are sensitive indicators of physiological changes. Autonomic dysfunction (AD) is manifested in up to 60% of patients with cirrhosis. Therefore, we aim to analyze the indexes of HRV pre-and post-surgery of children submitted for liver transplantation (LT). Methods: HRV, in children of both genders from 6 months of age to 10 years, that attended at the pediatric surgery clinic in the queue for LT at the Children's Institute were analyzed. To access HRV we analyzed indexes such as standard deviation of the RR intervals (SDNN), root-mean-square of the successive normal sinus RR interval difference (RMSSD), low frequency (LF), high frequency (HF), and LF/HF. Results: The analysis of the behavior of cardiac autonomic modulation, in the period prior to LT and after surgery, showed an increase in HRV linear parameters SDNN, TINN (triangular interpolation of NN interval histogram), HFms 2. In the time domain, there was also an increase in the HFms 2 index. Conclusions: The analysis of the period preceding LT and two months after surgery showed an increase in the HRV linear parameters representing a global HRV improvement. In the time domain, there was also an increase in the HFms 2 index, parasympathetic tone of the HRV.
Medical Express, 2017
Rest arterial pressure has been shown to be associated with cardiovascular mortality. Autonomic h... more Rest arterial pressure has been shown to be associated with cardiovascular mortality. Autonomic heart rate control during recovery from exercise is estimated to detect changes in cardiovascular system, which may lead to cardiovascular diseases. We assessed the involvement of rest diastolic arterial pressure (DAP) on heart rate dynamics after exercise in normotensive physically active men. METHOD: We evaluated healthy physically active men aged 18 to 22 years old divided into two unequal groups: G1-rest DAP between 80 and 90 mmHg (N=11) and G2-rest DAP < 80mmHg (N=24). Volunteers performed physical exercise on a treadmill with intensity equivalent to 60% of V max. Heart rate recovery in the first (HRR1) and third (HRR3) minute after exercise were measured and heart rate variability (HRV) was examined in the time and frequency domain. Additionally, we performed the quantitative analysis of the Poincaré plot. HRV was recorded in the following phases: the 10-minute period before exercise, during exercise and the 60 minute period after exercise. RESULTS: We found no significant difference between G1 and G2 concerning HRV changes during exercise. The G2 group exhibited a delayed recovery of SDNN, RMSSD, RRTri, LF, HF, LF/HF, SD1 and SD2 indices during recovery from exercise. HRR1 and HRR3 was greater in the G2 group. CONCLUSION: Normotensive physically active men with DAP between 80 and 90 mmHg presented faster heart rate recovery and an accelerated recovery of heart rate autonomic control after aerobic exercise.
International Journal of Environmental Research and Public Health, 2021
Background and purpose: The development of public policies must be guided by full knowledge of th... more Background and purpose: The development of public policies must be guided by full knowledge of the health–disease process of the population. Aerobic exercises are recommended for rehabilitation in stroke patients, and have been shown to improve heart rate variability (HRV). Our aim was to compare the cardiac autonomic modulation of elderly stroke patients with that of healthy elderly people during and after an acute bout of aerobic exercise. Methods: A total of 60 elderly people participated in the study (30 in the control group, mean age of 67 ± 4 years; 30 in the stroke group, mean age of 69 ± 3 years). HRV was analyzed in rest—10 min of rest in supine position; exercise—the 30 min of peak exercise; and recovery—30 min in supine position post-exercise. Results: Taking rest and exercises together, for SDNN, RMSSD, pNN50, RRTri, and TINN, there was no difference between the stroke and control groups (p = 0.062; p = 0.601; p = 0.166; p = 0.224, and p = 0.059, respectively). The HF (m...
Blindness affect the daily life activities and the causes and prevalence are different worldwide.... more Blindness affect the daily life activities and the causes and prevalence are different worldwide. This study aimed to investigate the pattern of the autonomic nervous system modulation on the heart in blind and normal vision subjects submitted acutely to low vision. Normal vision (NV) subjects (N = 32) and blind patients (N = 24) were submitted to HRV analysis during resting, intervention and recovery periods. Intervention consisted of handling objects, short walking, and cognitive activities performed with pedagogic games while using sleeping masks. No difference was observed in indexes in the time and frequency domain, and in the geometric indexes comparing blind and NV subjected to acute low vision during resting and recovery. Nevertheless, during intervention, RMSSD, pNN50, and SD1were found lower in blind than in NV subjects. Therefore, blind patients showed similar HRV at resting or upon possible stressful challenges compared to NV subjects acutely subjected to low vision, ind...
Entropy, 2021
Objective: the complexity of heart-rate variability (HRV) in amyotrophic lateral sclerosis (ALS) ... more Objective: the complexity of heart-rate variability (HRV) in amyotrophic lateral sclerosis (ALS) patients with different pulmonary capacities was evaluated. Methods: We set these according to their pulmonary capacity, and specifically forced vital capacity (FVC). We split the groups according to FVC (FVC > 50% (n = 29) and FVC < 50% (n = 28)). In ALS, the presence of an FVC below 50% is indicative of noninvasive ventilation with two pressure levels and with the absence of other respiratory symptoms. As the number of subjects per group was different, we applied the unbalanced one-way analysis of variance (uANOVA1) test after three tests of normality, and effect size by Cohen’s d to assess parameter significance. Results: with regard to chaotic global analysis, CFP4 (p < 0.001; d = 0.91), CFP5 (p = 0.0022; d = 0.85), and CFP6 (p = 0.0009; d = 0.92) were enlarged. All entropies significantly increased. Shannon (p = 0.0005; d = 0.98), Renyi (p = 0.0002; d = 1.02), Tsallis (p = ...
Scientific Reports, 2020
Previous studies have demonstrated that regular avocado consumption presents advantageous effects... more Previous studies have demonstrated that regular avocado consumption presents advantageous effects on cardiovascular system. However, little attention has been paid to the use of avocado as a dietary supplement, in particular, for individuals involved in physical exercise training. Therefore, this study aims to evaluate the effect of acute avocado pulp intake on cardiovascular and autonomic recovery subsequent to moderate exercise. Using a crossover, randomized, double-blind and placebo-controlled trial design, 16 healthy female adults underwent two protocols: Avocado pulp (600 mg in capsule) and placebo (600 mg starch in capsule). After the ingestion of Avocado pulp or placebo, the subjects were seated for 60 min at rest, followed by running on a treadmill at a submaximal level and then remained seated for 60 min during recovery from the exercise. Heart rate (HR), heart rate variability (HRV) [rMSSD, SD1, HF (ms2)] and skin conductance were evaluated before and during exercise, as w...
PLOS ONE, 2020
Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menop... more Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menopausal symptoms, mainly vasomotor symptoms and their imbalance to cardiovascular risk. It is not clear in the literature which index represents this imbalance and what is their involvement with the menopausal state. The aim of this study was to evaluate HRV in menopausal transition and post-menopausal symptoms with different intensities. This cross-sectional study was conducted in Rio Branco, State of Acre, Brazil from October 2016 to July 2017. We used Kupperman-Blatt Menopausal Index (KMI) to measure menopausal symptoms intensity. HRV analysis was performed based on the guidelines of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HRV is lower in the group with moderate/intense menopausal symptoms compared to mild symptoms.
Clinics, 2019
We aimed to evaluate the effects of cataract surgery on cardiac autonomic modulation. METHODS: A ... more We aimed to evaluate the effects of cataract surgery on cardiac autonomic modulation. METHODS: A cross-sectional and analytical study was conducted at the Hospital Maria Braido in the city of Sã o Caetano do Sul, Sã o Paulo, between 2015 and 2016. We investigated 19 patients of both sexes who were all over 50 years old; all patients had a diagnosis of senile or bilateral cataracts and were recommended to undergo implantation of the intraocular lens. Heart rate variability (HRV) was evaluated before, during and after cataract surgery. RESULTS: There were no significant changes in the time and geometric domains of HRV before, during or after surgery. The high-frequency (HF) band in normalized units (nu) on the spectral analysis significantly increased (p=0.02, Cohen's d=0.9, large effect size). However, the low-frequency (LF) band in nu significantly decreased during surgery (p=0.02, Cohen's d=0.9, large effect size). CONCLUSION: Throughout the intraocular lens implantation cataract surgery, there was an increase in parasympathetic modulation and a decrease in the sympathetic component of the heart rate (HR). We propose that this result is attributable to the supine position of the patients during surgery and the trigeminal reflex.
Journal of Multidisciplinary Healthcare, 2019
Introduction: Physical exercises help in the rehabilitation and recovery of various diseases. Car... more Introduction: Physical exercises help in the rehabilitation and recovery of various diseases. Cardiovascular and hypertension problems are the main causes of people being affected by kidney problems, which as a consequence, affects the heart rate variability (HRV) of the individual. Physical activity developed in a well-planned and thorough way can be a component in the treatment of this problem. Objective: We aimed to evaluate the effects of aerobic exercise intervention during hemodialysis on autonomic heart rate regulation in individuals with chronic kidney disease (CKD). Methods: This was a longitudinal trial conducted in 19 CKD patients. The patients underwent three weekly sessions of aerobic exercise during hemodialysis for 30 mins for 12 weeks (three months). Results: HRV was analyzed before and after the protocol training. Linear indices of HRV were not different between before and after the protocol training. Nonlinear HRV analysis indicated reduced values of determinism (p=0008, Cohen's d=0.82) and entropy (p=003, Cohen's d=0.84) after the training protocol. Conclusion: In conclusion, aerobic exercise training during hemodialysis did not improve autonomic control of heart rate in CKD patients.
Medicine, 2019
Introduction: Chronic renal disease (CRD) affects a large portion of the population and is direct... more Introduction: Chronic renal disease (CRD) affects a large portion of the population and is directly related to cardiovascular problems and hypertension, among others. Studies show that heart rate variability is directly affected by these problems. Physical-oriented exercises have been shown to be of fundamental importance in improving the adverse effects to dialysis treatment. Objective: To analyze the effects of aerobic training during hemodialysis on autonomic heart rate modulation in patients with CRD. Method: Experimental study of an open, single group clinical trial. In this clinical trial, patients with CRD will initially undergo international physical activity questionnaire and kidney disease quality of life short form protocols, as well as monitoring of heart rate systolic, and diastolic blood pressure. After evaluation of the initial parameters, patients will undergo an aerobic exercise program for 12 weeks, in 3 weekly sessions, lasting 30 minutes a session. These evaluati...
Journal of Medical - Clinical Research & Reviews, 2018
Introduction: The main cause of death in the world is cardiovascular diseases and among the diffe... more Introduction: The main cause of death in the world is cardiovascular diseases and among the different risk factors, we can mention air pollution. Objectives: Describe the findings on the effects of air pollution on the autonomic cardiac modulation. Methods: The research was conducted using Scopus, PubMed, Web of Science and SciELO, over the term from 1996 to 2016. Manuscripts written in Portuguese or English, with keywords environmental pollution; air pollution; cardiovascular system; autonomic nervous system, texts dealing with environmental pollution and its relation to human exposition and original papers with the full text available on line were included. Results: The electronic search in databases resulted in 194 articles which were filtered according to gratuity full text delimited topic as well as the couple eliminated, resulting in 25 articles. Of these articles, 12 articles were included that specifically addressed the autonomic cardiac modulation. These remaining items were analyzed in Microsoft Office Excel 2010 program. Conclusion: The effects of air pollution on autonomic cardiac modulation are, in short, a reduction in autonomic cardiac modulation facing air pollution and its increases.
Medicine, 2018
Cardiovascular autonomic dysfunction reflex of the pathophysiology of diabetes mellitus (DM) favo... more Cardiovascular autonomic dysfunction reflex of the pathophysiology of diabetes mellitus (DM) favors an increase in morbidity and mortality related to cardiovascular events, and for this reason has been one of the most studied clinical entities. An experimental study of a randomized clinical trial type was therefore proposed to analyze the hemodynamic and glycemic response after the practice of a rehabilitation program in patients with type 2 diabetes mellitus (T2DM). In this clinical trial the patients will initially be submitted to an evaluation protocol that consists of assessing blood pressure, heart rate, Borg scale, respiratory rate, oxygen saturation, distance traveled through the 6-minute walk test, quality of life questionnaire, Pittsburgh sleep quality questionnaire, and still glycated hemoglobin and heart rate variability through the cardiofrequency meter. After careful evaluation of the patients, they will be submitted to a metabolic rehabilitation program composed of aer...
Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, Jan 25, 2017
To evaluate the influence of functional training on the geometric indices of heart rate variabili... more To evaluate the influence of functional training on the geometric indices of heart rate variability (HRV) and fractal correlation properties of the dynamics of heart rate in menopausal women. Of 39 women who were in the period of menopause for more than a year and who did not practice any regular physical activity were divided into: Functional training group (FTG = 50 ± 4.5 years; 67.64 ± 11.64 kg; 1.5 ± 0.05 m) that executed the functional training (FT) and all proposals by reviews and the Control group (58.45 ± 4.8 years; 66.91 ± 13.24 kg; 1.55 ± 0.05 m) who performed all assessments but not FT. The training consisted of 18 weeks (three times a week) and the volunteers performed three sets of 11 functional exercises followed by a walk in each of the sessions. The autonomic nervous system modulation was evaluated by analysis of HRV and the indices obtained were: RR intervals, RRTRI, TINN, SD1, SD2, SD1/SD2, qualitative analysis of Poincaré plot and DFA (alfa-1, alfa-2 and alfa-1/al...
Journal of Cardiology and Therapy, 2016
Nine studies were included, among which eight were performed in adults and concluded that HRV dur... more Nine studies were included, among which eight were performed in adults and concluded that HRV during weaning becomes important because it can provide information on pathophysiological imbalances reflected in the success or failure of weaning. Only one article conducted the study in children and stated that the value of HRV as a predictor of extubation still requires further evaluation. CONCLUSION: Behavior of the cardiac autonomic modulation during the weaning process is characterized by reduced HRV and vagal withdrawal in patients with failure weaning needing to be reconnected to the mechanical ventilation support.
International Archives of Medicine, 2016
Introduction: Ebstein's anomaly is a rare malformation that corresponds to less than 1% of all co... more Introduction: Ebstein's anomaly is a rare malformation that corresponds to less than 1% of all congenital heart anomalies. It consists in the caudal displacement of the tricuspid valve with retrograde flow to the right atrium due to valvular insufficiency and it is characterized by a variable spectrum of severity, being higher in the neonatal period. Objective: to report an Ebstein's anomaly case which early diagnosis avoided iatrogenic ducts. Case report: a newborn at term, appropriate weight for gestational age, female, was born of natural childbirth, with Apgar score 8/9 from pregnancy without complications. At birth, not in need of resuscitation in the delivery room, but presented heart murmur and fall of saturation, being supported and then forwarded to the NICU. Not present hemodynamic instability. The chest x-ray showed increased cardiac area with increased right atrium. The Transthoracic Echocardiogram showed mild right ventricular dilatation and important of the right atrium, tricuspid valve dysplasia with low implantation of posterior leaflet of tricuspid insufficiency presence important to Doppler, being diagnosed with Ebstein's anomaly. Evolved with progressive improvement of the frame and saturation above 95% on room air to pulse oximetry. Patient follows in outpatient follow-up in use of inotropic and diuretic, remaining asymptomatic. Conclusion: the recognition of the gravity of the picture is relevant to the proper management in order to prevent iatrogenic ducts, which can lead to complications or permanent sequelae.
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Papers by Luiz Carlos de Abreu