Effects of a home-based exercise program in body composition, abdominal fat and lipid profile in patients with coronary artery disease

Introduction: Coronary artery disease and aging seems to be associated with a sedentary lifestyle, contributing to increased abdominal fat and consequently metabolic complications. The exercise can break this cycle by stimulating lipolysis and the use of fatty acids. In Europe there is still a lack of cardiac rehabilitation programmes in hospitals, therefore, this study aims to demonstrate the advantages of implementing home-based exercise programmes, as well as, their effects on cardiovascular prevention. This study analyzed the effects of a home-based exercise programme, in patients with coronary artery disease (myocardial infarction for 1 year), in body composition, abdominal fat, lipid profile. Methods: An ongoing randomized controlled trial with a sample of 20 participants were randomly allocated to intervention (n = 10) and control groups (n = 10). Intervention group performed a specific exercise programme during 8 weeks, consisting of ten home based exercises taking into account flexibility, muscle endurance and strength as well as cardiovascular endurance. Skinfolds thickness were measure to calculate the percentage of total fat: Skinfolds used were suprailiac, abdominal horizontal and vertical. Body mass index calculation and blood tests for lipidic profile were performed. Results: After eight weeks the intervention group decreased significantly the percentage of total fat (p < 0.05), the suprailiac skinfold (p < 0.05), the abdominal horizontal and vertical skinfold (p < 0.05) when compared with control group. In the intervention group it was observed after 8 weeks a significant decrease in body mass index, LDL-cholesterol and triglycerides. Conclusions: Home-based exercise programme influenced body composition, abdominal fat and lipid profile. These results highlight the importance of implementing home based exercises that are easy and cheap to implement in cardiac patients, in order to promote health and reduce cardiovascular risk factors.

Effects of microcurrents and physical exercise on the abdominal fat: a randomized controlled trial in patients with coronary artery disease

Objectives: Coronary artery disease are associated with decreased levels of physical activity, contributing to increases in abdominal fat and consequently the metabolic risk. The use of microcurrents is an innovative and effective method to increase lipolytic rate of abdominal adipocytes. This study aims to investigate the effects of microcurrents with a homebased exercise program on total, subcutaneous and visceral abdominal adipose tissue in subjects with coronary artery disease. Methods: This controlled trial included 44 subjects with myocardial infarction, randomly divided into Intervention Group 1 (IG1; n = 16), Intervention Group 2 (IG2; n = 12) and Control Group (CG; n = 16). IG1 performed a specific exercise program at home during 8 weeks, and IG2 additionally used microcurrents on the abdominal region before the exercise program. All groups were subjected to health education sessions. Computed Tomography was used to evaluate abdominal, subcutaneous and visceral fat, accelerometers to measure habitual physical activity and the semiquantitative Food Frequency Questionnaire for dietary intake. Results: After 8 weeks, IG2 showed a significantly decreased in subcutaneous fat (p ≤ 0.05) when compared to CG. Concerning visceral fat, both intervention groups showed a significant decrease in comparison to the CG (p ≤ 0.05). No significant changes were found between groups on dietary intake and habitual physical activity, except for sedentary activity that decreased significantly in IG2 in comparison with CG (p ≤ 0.05). Conclusions: This specific exercise program showed improvements in visceral fat in individuals with coronary artery disease. Microcurrent therapy associated with a home-based exercise program suggested a decreased in subcutaneous abdominal fat.

Effects of the Mediterranean diet and exercise in subjects with coronary artery disease

Introduction The association of the Mediterranean diet and exercise appears to have a protective role, reducing cardiovascular risk. This study investigated the effects of education sessions on the Mediterranean diet and an exercise program in modifying eating behaviors, body composition and abdominal fat. Methods An experimental study was performed on 20 subjects with known coronary heart disease randomly assigned to experimental (n=10) and control (n=10) groups. Both groups received education sessions on the Mediterranean diet, but the experimental group also followed an eight-week program of specific exercises. A semiquantitative food frequency questionnaire was administered to analyze food intake, bioimpedance was used to measure weight, fat mass and lean mass, and waist circumference was measured to calculate waist-to-height ratio. Results After eight weeks, protein (p<0.05) and cholesterol (p<0.05) intake in the experimental group had decreased significantly compared with the control group. Between the beginning and end of the study, there were significant decreases in the control group in carbohydrate (p<0.05) and saturated fat intake (p<0.05). In both groups the percentage of total fat (p<0.05) and fat mass (p<0.05) was significantly decreased. In the experimental group the waist-to-height ratio was significantly reduced (p<0.05). Conclusion The Mediterranean diet reduced carbohydrate and saturated fat intake, reflected in reduced fat mass. The association of the exercise program showed additional benefits in reduction of protein and cholesterol intake and abdominal fat.

Effects of microcurrents and physical exercise on the abdominal fat in patients with coronary artery disease

Introduction Coronary artery disease is associated with decreased levels of physical activity, contributing to increases in abdominal fat and consequently increasing metabolic risk. The innovative use of microcurrents may be an effective method to increase the lipolytic rate of abdominal adipocytes. This study aimed to investigate the effects of utilizing microcurrents in a home-based exercise program in subjects with coronary artery disease to assess changes in total, subcutaneous and visceral abdominal adipose tissue. Methods This controlled trial included 44 subjects with myocardial infarction, randomly divided into Intervention Group 1 (IG1; n = 16), Intervention Group 2 (IG2; n = 12) and Control Group (CG; n = 16). IG1 performed a specific exercise program at home during 8 weeks, and IG2 additionally used microcurrents on the abdominal region before the exercise program. All groups were given health education sessions. Computed tomography was used to evaluate abdominal, subcutaneous and visceral fat, accelerometers to measure habitual physical activity and the semi-quantitative food frequency questionnaire for dietary intake. Results After 8 weeks, IG2 showed a significantly decrease in subcutaneous fat (p ≤ 0.05) when compared to CG. Concerning visceral fat, both intervention groups showed a significant decrease in comparison to the CG (p ≤ 0.05). No significant changes were found between groups on dietary intake and habitual physical activity, except for sedentary activity that decreased significantly for IG2 in comparison with CG (p ≤ 0.05). Conclusion This specific home-based exercise program using microcurrent therapy for individuals with coronary artery disease showed improvements in visceral and subcutaneous abdominal fat.

Analysing the usefulness of motion correction software in myocardial perfusion imaging

Introduction Myocardial Perfusion Imaging (MPI) is a very important tool in the assessment of Coronary Artery Disease ( CAD ) patient s and worldwide data demonstrate an increasingly wider use and clinical acceptance. Nevertheless, it is a complex process and it is quite vulnerable concerning the amount and type of possible artefacts, some of them affecting seriously the overall quality and the clinical utility of the obtained data. One of the most in convenient artefacts , but relatively frequent ( 20% of the cases ) , is relate d with patient motion during image acquisition . Mostly, in those situations, specific data is evaluated and a decisi on is made between A) accept the results as they are , consider ing that t he “noise” so introduced does not affect too seriously the final clinical information, or B) to repeat the acquisition process . Another possib ility could be to use the “ Motion Correcti on Software” provided within the software package included in any actual gamma camera. The aim of this study is to compare the quality of the final images , obtained after the application of motion correction software and after the repetition of image acqui sition. Material and Methods Thirty cases of MPI affected by Motion Artefacts and repeated , were used. A group of three, independent (blinded for the differences of origin) expert Nuclear Medicine Clinicians had been invited to evaluate the 30 sets of thre e images - one set for each patient - being ( A) original image , motion uncorrected , (B) original image, motion corrected, and (C) second acquisition image, without motion . The results so obtained were statistically analysed . Results and Conclusion Results obtained demonstrate that the use of the Motion Correction Software is useful essentiall y if the amplitude of movement is not too important (with this specific quantification found hard to define precisely , due to discrepancies between clinicians and other factors , namely between one to another brand); when that is not the case and the amplitude of movement is too important , the n the percentage of agreement between clinicians is much higher and the repetition of the examination is unanimously considered ind ispensable.

Efeitos de um programa de exercícios específico no domicílio, em indivíduos com doença arterial coronária, na composição corporal, gordura abdominal, perfil lipídico, glicose e nível de atividade física

contribuindo para o aumento da gordura abdominal, e consequentes complicações metabólicas. O exercício físico permite quebrar este ciclo através da estimulação da lipólise e da utilização de ácidos gordos. Objetivo: Verificar os efeitos de um programa de exercícios no domicílio, em indivíduos com doença arterial coronária, na composição corporal, gordura abdominal, perfil lipídico, glicose, e nível de atividade física. Métodos: Estudo experimental composto por 20 indivíduos, aleatorizados grupo experimental (GE) e grupo de controlo (GC), ambos com 10, tendo o GE sido sujeito ao programa durante 8 semanas. Realizou-se uma avaliação inicial e final, através da bioimpedância, Tomografia Computorizada (TC) abdominal, perimetria, adipometria, análises sanguíneas e acelerómetro. Resultados: Numa análise intergrupal, verificouse uma diminuição da percentagem (%) de gordura total (GT) calculado pela adipometria (p<0.01), na prega supra-ilíaca (p=0.005), na prega abdominal horizontal (p=0.001) e vertical (p=0.003) no GE, e da % de tempo em atividades moderadas no GC (p=0.035). Após 8 semanas o GE diminuiu a %GT (p=0.008); a massa gorda (MG) (p=0.002); perímetro abaixo da última costela (p=0.037) e acima das cristas-ilíacas (p=0.021); %GT calculado (p=0.002); pregas supra-ilíaca (p=0.008), abdominal horizontal (p=0.002) e vertical (p=0.033); TC abdominal subcutâneo (p=0.031) e %de tempo em atividades vigorosas (p=0.031). O GC diminuiu a %GT (p=0.002) e MG (p=0.008); aumentou o perímetro ao nível dos grandes trocânteres (p=0.008), diminuiu o rácio cintura/anca (p=0.002), e a %de tempo em atividades moderadas (p=0.031) e vigorosas (p=0.008). Parece existir uma tendência no GE para diminuição do rácio cintura/anca, c-LDL, triglicerídeos e aumento do nível de atividade moderado. Conclusão: O programa de exercícios no domicílio demonstrou uma diminuição da gordura abdominal, alteração da composição corporal, e parece promover uma melhoria no perfil lipídico e no aumento do nível de atividade física moderado.

Optimização e Validação da Produção de [13n]-Nh3 para Estudos Clínicos de Tomografia por Emissão de Positrões na Avaliação da Perfusão Miocárdica

A par das patologias oncológicas, as doenças do foro cardíaco, em particular a doença arterial coronária, são uma das principais causas de morte nos países industrializados, devido sobretudo, à grande incidência de enfartes do miocárdio. Uma das formas de diagnóstico e avaliação desta condição passa pela obtenção de imagens de perfusão miocárdica com radionuclídeos, realizada por Tomografia por Emissão de Positrões (PET). As soluções injectáveis de [15O]-H2O, [82Rb] e [13N]-NH3 são as mais utilizadas neste tipo de exame clínico. No Instituto de Ciências Nucleares Aplicadas à Saúde (ICNAS), a existência de um ciclotrão tem permitido a produção de uma variedade de radiofármacos, com aplicações em neurologia, oncologia e cardiologia. Recentemente, surgiu a oportunidade de iniciar exames clínicos com [13N]-NH3 para avaliação da perfusão miocárdica. É neste âmbito que surge a oportunidade do presente trabalho, pois antes da sua utilização clínica é necessário realizar a optimização da produção e a validação de todo o processo segundo as normas de Boas Práticas Radiofarmacêuticas. Após uma fase de optimização do processo, procedeu-se à avaliação dos parâmetros físico-químicos e biológicos da preparação de [13N]-NH3, de acordo com as indicações da Farmacopeia Europeia (Ph. Eur.) 8.2. De acordo com as normas farmacêuticas, foram realizados 3 lotes de produção consecutivos para validação da produção de [13N]-NH3. Os resultados mostraram um produto final límpido e ausente de cor, com valores de pH dentro do limite especificado, isto é, entre 4,5 e 8,5. A pureza química das amostras foi verificada, uma vez que relativamente ao teste colorimétrico, a tonalidade da cor da solução de [13N]-NH3 não era mais intensa que a solução de referência. As preparações foram identificadas como sendo [13N]-NH3, através dos resultados obtidos por cromatografia iónica, espectrometria de radiação gama e tempo de semi-vida. Por examinação do cromatograma obtido com a solução a ser testada, observou-se que o pico principal possuia um tempo de retenção aproximadamente igual ao pico do cromatograma obtido para a solução de referência. Além disso, o espectro de radiação gama mostrou um pico de energia 0,511 MeV e um outro adicional de 1,022 MeV para os fotões gama, característico de radionuclídeos emissores de positrões. O tempo de semi-vida manteve-se dentro do intervalo indicado, entre 9 e 11 minutos. Verificou-se, igualmente, a pureza radioquímica das amostras, correspondendo um mínimo de 99% da radioactividade total ao [13N], bem como a pureza radionuclídica, observando-se uma percentagem de impurezas inferiores a 1%, 2h após o fim da síntese. Os testes realizados para verificação da esterilidade e determinação da presença de endotoxinas bacterianas nas preparações de [13N]-NH3 apresentaram-se negativos.Os resultados obtidos contribuem, assim, para a validação do método para a produção de [13N]-NH3, uma vez que cumprem os requisitos especificados nas normas europeias, indicando a obtenção de um produto seguro e com a qualidade necessária para ser administrado em pacientes para avaliação da perfusão cardíaca por PET.