Skeletal muscle mitochondrial ATP production rate and walking performance in peripheral arterial disease

This study tested the hypotheses that skeletal muscle mitochondrial ATP production rate (MAPR) is impaired in patients with peripheral arterial disease (PAD) and that it relates positively to their walking performances. Seven untrained patients, eight exercise-trained patients and 11 healthy controls completed a maximal walking test and had muscle sampled from the gastrocnemius medialis muscle. Muscle was analysed for its MAPR in the presence of pyruvate, palmitoyl-L-carnitine or both, as well as citrate synthase (CS) activity. MAPRs were not different between untrained PAD and controls. In contrast, MAPRs (pyruvate) were significantly higher in trained PAD vs. controls. MAPR (pyruvate combinations) was also significantly higher in trained than untrained PAD muscle. MAPR and CS activity were highly correlated with walking performance in patients, but not in controls. These data do not support the hypothesis that isolated mitochondria are functionally impaired in PAD and demonstrate that the muscle mitochondrial capacity to oxidize carbohydrate is positively related to walking performance in these patients.

Cold Storage Preservation and Warm Ischaemic Injury to Isolated Arterial Segments: Endothelial Cell Injury

Injury to endothelial calls is thought to be important to the development of the vascular lesion of chronic rejection. It was the aim of this study to develop a semiquantitative method to assess endothelial injury in arterial grafts and to document the injury produced by cold storage preservation and additional warm ischaemia. Twelve- and 24-h cold preservation of rat aortic segments, together with an additional 1 h of warm ischaemia, were assessed. Electron micrographs of representative endothelial cells were scored for cytoplasmic, nuclear and mitochondrial injury. The overall injury score was obtained by addition of the individual scores. Storage for up to 24 h in University of Wisconsin (UW) and Terasaki did not produce any injury. Twenty-four hours of storage in Euro-Collins resulted in endothelial cell death. Injury occurred after 12 h of storage in Ross, Collins and normal saline, and the injury increased following 24 h of storage. One hour of warm ischaemia did not increase the injury. Injury to endothelial cells varies with the preservation solution used and the time of cold storage, so that both the type of solution and the storage time should be taken into account in clinical studies looking at the influence of cold ischaemia time and graft outcome.

A comparative study of carbon gasification with O-2 and CO2 by density functional theory calculations

A comparative study of carbon gasification with O-2 and CO2 was conducted by using density functional theory calculations. It was found that the activation energy and the number of active sites in carbon gasification reactions are significantly affected by both the capacity and manner of gas chemisorption. O-2 has a strong adsorption capacity and the dissociative chemisorption of O-2 is thermodynamically favorable on either bare carbon surface or even isolated edge sites. As a result, a large number of semiquinone and o-quinone oxygen can be formed indicating a significant increase in the number of active sites. Moreover, the weaker o-quinone C-C bonds can also drive the reaction forward at (ca. 30%) lower activation energy. Epoxy oxygen forms under relatively high O-2 pressure, and it can only increase the number of active sites, not further reduce the activation energy. CO2 has a lower adsorption capacity. Dissociative chemisorption of CO2 can only occur on two consecutive edge sites and o-quinone oxygen formed from CO2 chemisorption is negligible, let alone epoxy oxygen. Therefore, CO2-carbon reaction needs (ca 30%) higher activation energy. Furthermore, the effective active sites are also reduced by the manner Of CO2 chemisorption. A combination of the higher activation energy and the fewer active sites leads to the much lower reaction rate Of CO2-carbon.

Remifentanil versus dexmedetomidina como coadjuvantes de técnica anestésica padronizada em pacientes com obesidade mórbida

Justificativa e objetivos: comparou-se a ação de duas drogas coadjuvantes da anestesia, remifentanil e dexmedetomidina, na recuperação anestésica e na evolução do pH e da PaCO2, em pacientes com obesidade mórbida que foram submetidos à cirurgia de Capella. Método: o estudo foi aleatório, prospectivo e duplamente encoberto. Noventa e dois pacientes foram designados a um de dois grupos e submetidos à técnica anestésica (geral/peridural) padronizada. O grupo Remifentanil (Grupo R) e o da Dexmedetomidina (Grupo D) receberam infusão contínua por via venosa destas drogas (0,1 µg.kg-1.min-1 e 0,5 µg.kg-1.h-1 peso ideal mais 30% para ambas) logo após a intubação traqueal. Os pacientes foram monitorizados com pressão arterial média invasiva, oximetria de pulso, EEG bispectral (BIS), capnografia, estimulador de nervo periférico e ECG. Foram avaliados: 1) diferentes tempos de recuperação anestésica (abertura dos olhos, reinicio da respiração espontânea, tempo de extubação traqueal, tempo para de alta da sala de recuperação pós-anestésica e hospitalar), 2) a evolução da gasometria arterial, e 3) analgesia pós-operatória. Resultados: oitenta e oito pacientes foram avaliados. Os pacientes do grupo R apresentaram abertura ocular precoce (9,49 ± 5,61 min versus 18,25 ± 10,24 min, p < 0,0001), menor tempo para reiniciar a ventilação espontânea (9,78 ± 5,80 min versus 16,58 ± 6,07 min, p < 0,0001), e menor tempo para a extubação traqueal (17,93 ± 10,39 min versus 27,53 ± 13,39 min, p < 0,0001). Não houve diferença quanto ao tempo para alta anestésica (105,18 ± 50,82 min versus 118,69 ± 56,18 min) e para alta hospitalar (51,13 ± 6,37 horas versus 52,50 ± 7,09 horas). Os dois grupos apresentaram diminuição dos valores de pH e da PaO2 imediatamente após a extubação traqueal comparados com valores pré-operatórios, e que se manteve até a alta da SRPA. O grupo D apresentou valores maiores de PaCO2 após a extubação traqueal, comparados com valores pré-operatórios no mesmo grupo (p < 0,05), divergente do Grupo R; 41% dos pacientes do Grupo R e 60% do Grupo D (p < 0,02) requisitaram medicação analgésica de resgate no primeiro dia de pós-operatório. Conclusões: na população avaliada, a associação de remifentanil em técnica anestésica padronizada resultou em recuperação anestésica mais rápida, manutenção dos valores de PaCO2 durante o período pós-operatório imediato e menor consumo de analgésicos de resgate no período pós-operatório, quando comparada à dexmedetomidina.

The left ventricular contractility of the rat heart is modulated by changes in flow and a1-adrenoceptor stimulation

Myocardial contractility depends on several mechanisms such as coronary perfusion pressure (CPP) and flow as well as on a1-adrenoceptor stimulation. Both effects occur during the sympathetic stimulation mediated by norepinephrine. Norepinephrine increases force development in the heart and produces vasoconstriction increasing arterial pressure and, in turn, CPP. The contribution of each of these factors to the increase in myocardial performance needs to be clarified. Thus, in the present study we used two protocols: in the first we measured mean arterial pressure, left ventricular pressure and rate of rise of left ventricular pressure development in anesthetized rats (N = 10) submitted to phenylephrine (PE) stimulation before and after propranolol plus atropine treatment. These observations showed that in vivo a1-adrenergic stimulation increases left ventricular-developed pressure (P<0.05) together with arterial blood pressure (P<0.05). In the second protocol, we measured left ventricular isovolumic systolic pressure (ISP) and CPP in Langendorff constant flow-perfused hearts. The hearts (N = 7) were perfused with increasing flow rates under control conditions and PE or PE + nitroprusside (NP). Both CPP and ISP increased (P<0.01) as a function of flow. CPP changes were not affected by drug treatment but ISP increased (P<0.01). The largest ISP increase was obtained with PE + NP treatment (P<0.01). The results suggest that both mechanisms, i.e., direct stimulation of myocardial a1-adrenoceptors and increased flow, increased cardiac performance acting simultaneously and synergistically.

Effects of ouabain on vascular reactivity

Ouabain is an endogenous substance occurring in the plasma in the nanomolar range, that has been proposed to increase vascular resistance and induce hypertension. This substance acts on the a-subunit of Na+,K+-ATPase inhibiting the Na+-pump activity. In the vascular smooth muscle this effect leads to intracellular Na+ accumulation that reduces the activity of the Na+/Ca2+ exchanger and to an increased vascular tone. It was also suggested that circulating ouabain, even in the nanomolar range, sensitizes the vascular smooth muscle to vasopressor substances. We tested the latter hypothesis by studying the effects of ouabain in the micromolar and nanomolar range on phenylephrine (PE)-evoked pressor responses. The experiments were performed in normotensive and hypertensive rats in vivo, under anesthesia, and in perfused rat tail vascular beds. The results showed that ouabain pretreatment increased the vasopressor responses to PE in vitro and in vivo. This sensitization after ouabain treatment was also observed in hypertensive animals which presented an enhanced vasopressor response to PE in comparison to normotensive animals. It is suggested that ouabain at nanomolar concentrations can sensitize vascular smooth muscle to vasopressor stimuli possibly contributing to increased tone in hypertension.

Oral rapamycin attenuates atherosclerosis without affecting the arterial responsiveness of resistance vessels in apolipoprotein E-deficient mice

The objective of the present study was to assess the effects of the immunosuppressant rapamycin (Rapamune®, Sirolimus) on both resistance vessel responsiveness and atherosclerosis in apolipoprotein E-deficient 8-week-old male mice fed a normal rodent diet. Norepinephrine (NE)-induced vasoconstriction, acetylcholine (ACh)- and sodium nitroprusside (SNP)-induced vasorelaxation of isolated mesenteric bed, and atherosclerotic lesions were evaluated. After 12 weeks of orally administered rapamycin (5 mg·kg-1·day-1, N = 9) and compared with untreated (control, N = 9) animals, rapamycin treatment did not modify either NE-induced vasoconstriction (maximal response: 114 ± 4 vs 124 ± 10 mmHg, respectively) or ACh- (maximal response: 51 ± 8 vs 53 ± 5%, respectively) and SNP-induced vasorelaxation (maximal response: 73 ± 6 vs 74 ± 6%, respectively) of the isolated vascular mesenteric bed. Despite increased total cholesterol in treated mice (982 ± 59 vs 722 ± 49 mg/dL, P < 0.01), lipid deposition on the aorta wall vessel was significantly less in rapamycin-treated animals (37 ± 12 vs 68 ± 8 µm2 x 103). These results indicate that orally administered rapamycin is effective in attenuating the progression of atherosclerotic plaque without affecting the responsiveness of resistance vessels, supporting the idea that this immunosuppressant agent might be of potential benefit against atherosclerosis in patients undergoing therapy.

Influence of renal denervation on blood pressure, sodium and water excretion in acute total obstructive apnea in rats

Obstructive apnea (OA) can exert significant effects on renal sympathetic nerve activity (RSNA) and hemodynamic parameters. The present study focuses on the modulatory actions of RSNA on OA-induced sodium and water retention. The experiments were performed in renal-denervated rats (D; N = 9), which were compared to sham (S; N = 9) rats. Mean arterial pressure (MAP) and heart rate (HR) were assessed via an intrafemoral catheter. A catheter was inserted into the bladder for urinary measurements. OA episodes were induced via occlusion of the catheter inserted into the trachea. After an equilibration period, OA was induced for 20 s every 2 min and the changes in urine, MAP, HR and RSNA were recorded. Renal denervation did not alter resting MAP (S: 113 ± 4 vs D: 115 ± 4 mmHg) or HR (S: 340 ± 12 vs D: 368 ± 11 bpm). An OA episode resulted in decreased HR and MAP in both groups, but D rats showed exacerbated hypotension and attenuated bradycardia (S: -12 ± 1 mmHg and -16 ± 2 bpm vs D: -16 ± 1 mmHg and 9 ± 2 bpm; P < 0.01). The basal urinary parameters did not change during or after OA in S rats. However, D rats showed significant increases both during and after OA. Renal sympathetic nerve activity in S rats increased (34 ± 9%) during apnea episodes. These results indicate that renal denervation induces elevations of sodium content and urine volume and alters bradycardia and hypotension patterns during total OA in unconscious rats.

Transitory increased blood pressure after upper airway surgery for snoring and sleep apnea correlates with the apnea-hypopnea respiratory disturbance index

A transitory increase in blood pressure (BP) is observed following upper airway surgery for obstructive sleep apnea syndrome but the mechanisms implicated are not yet well understood. The objective of the present study was to evaluate changes in BP and heart rate (HR) and putative factors after uvulopalatopharyngoplasty and septoplasty in normotensive snorers. Patients (N = 10) were instrumented for 24-h ambulatory BP monitoring, nocturnal respiratory monitoring and urinary catecholamine level evaluation one day before surgery and on the day of surgery. The influence of postsurgery pain was prevented by analgesic therapy as confirmed using a visual analog scale of pain. Compared with preoperative values, there was a significant (P < 0.05) increase in nighttime but not daytime systolic BP (119 ± 5 vs 107 ± 3 mmHg), diastolic BP (72 ± 4 vs 67 ± 2 mmHg), HR (67 ± 4 vs 57 ± 2 bpm), respiratory disturbance index (RDI) characterized by apnea-hypopnea (30 ± 10 vs 13 ± 4 events/h of sleep) and norepinephrine levels (22.0 ± 4.7 vs 11.0 ± 1.3 µg l-1 12 h-1) after surgery. A positive correlation was found between individual variations of BP and individual variations of RDI (r = 0.81, P < 0.01) but not between BP or RDI and catecholamines. The visual analog scale of pain showed similar stress levels on the day before and after surgery (6.0 ± 0.8 vs 5.0 ± 0.9 cm, respectively). These data strongly suggest that the cardiovascular changes observed in patients who underwent uvulopalatopharyngoplasty and septoplasty were due to the increased postoperative RDI.

Ambulatory blood pressure and Doppler echocardiographic indexes of borderline hypertensive men presenting an exaggerated blood pressure response during dynamic exercise

Borderline hypertension (BH) has been associated with an exaggerated blood pressure (BP) response during laboratory stressors. However, the incidence of target organ damage in this condition and its relation to BP hyperreactivity is an unsettled issue. Thus, we assessed the Doppler echocardiographic profile of a group of BH men (N = 36) according to office BP measurements with exaggerated BP in the cycloergometric test. A group of normotensive men (NT, N = 36) with a normal BP response during the cycloergometric test was used as control. To assess vascular function and reactivity, all subjects were submitted to the cold pressor test. Before Doppler echocardiography, the BP profile of all subjects was evaluated by 24-h ambulatory BP monitoring. All subjects from the NT group presented normal monitored levels of BP. In contrast, 19 subjects from the original BH group presented normal monitored BP levels and 17 presented elevated monitored BP levels. In the NT group all Doppler echocardiographic indexes were normal. All subjects from the original BH group presented normal left ventricular mass and geometrical pattern. However, in the subjects with elevated monitored BP levels, fractional shortening was greater, isovolumetric relaxation time longer, and early to late flow velocity ratio was reduced in relation to subjects from the original BH group with normal monitored BP levels (P<0.05). These subjects also presented an exaggerated BP response during the cold pressor test. These results support the notion of an integrated pattern of cardiac and vascular adaptation during the development of hypertension.

Diverse effects of renal denervation on ventricular hypertrophy and blood pressure in DOCA-salt hypertensive rats

Cardiac hypertrophy that accompanies hypertension seems to be a phenomenon of multifactorial origin whose development does not seem to depend on an increased pressure load alone, but also on local growth factors and cardioadrenergic activity. The aim of the present study was to determine if sympathetic renal denervation and its effects on arterial pressure level can prevent cardiac hypertrophy and if it can also delay the onset and attenuate the severity of deoxycorticosterone acetate (DOCA)-salt hypertension. DOCA-salt treatment was initiated in rats seven days after uninephrectomy and contralateral renal denervation or sham renal denervation. DOCA (15 mg/kg, sc) or vehicle (soybean oil, 0.25 ml per animal) was administered twice a week for two weeks. Rats treated with DOCA or vehicle (control) were provided drinking water containing 1% NaCl and 0.03% KCl. At the end of the treatment period, mean arterial pressure (MAP) and heart rate measurements were made in conscious animals. Under ether anesthesia, the heart was removed and the right and left ventricles (including the septum) were separated and weighed. DOCA-salt treatment produced a significant increase in left ventricular weight/body weight (LVW/BW) ratio (2.44 ± 0.09 mg/g) and right ventricular weight/body weight (RVW/BW) ratio (0.53 ± 0.01 mg/g) compared to control (1.92 ± 0.04 and 0.48 ± 0.01 mg/g, respectively) rats. MAP was significantly higher (39%) in DOCA-salt rats. Renal denervation prevented (P>0.05) the development of hypertension in DOCA-salt rats but did not prevent the increase in LVW/BW (2.27 ± 0.03 mg/g) and RVW/BW (0.52 ± 0.01 mg/g). We have shown that the increase in arterial pressure level is not responsible for cardiac hypertrophy, which may be more related to other events associated with DOCA-salt hypertension, such as an increase in cardiac sympathetic activity.

Efeito de dezesseis semanas de treinamento de resistência aeróbia na função vascular de jovens sedentários

Introdução: Muito embora os estudos apontem para um efeito positivo do exercício físico, em especial o treinamento com exercício aeróbio, sobre a pressão arterial e a distensibilidade arterial, pouco se sabe sobre os efeitos do treinamento com exercício de resistência aeróbia sobre a complacência vascular de indivíduos jovens saudáveis. Objetivos: Avaliar o efeito de 16 semanas de treinamento de resistência aeróbia sobre a função vascular e a pressão arterial de indivíduos jovens sedentários. Métodos: Foram avaliados 56 voluntários (de ambos os sexos, na faixa etária de 18 à 29 anos) antes e após 16 semanas de treinamento com corrida 3 vezes por semana. As medidas de pressão arterial foram realizadas de acordo com a VI Diretrizes Brasileiras de Hipertensão e a velocidade de onda de pulso (VOP) foi realizada com a utilização de um gravador automático computadorizado e os resultados foram analisados pelo programa Complior®. Resultados: Dos 56 indivíduos que participaram do presente estudo, 44 eram do sexo masculino (78,5%) e 12 do sexo feminino (21,5 %). Eles apresentaram idade de 22 ± 3 anos, estatura de 1,75 ± 0,07 metros, circunferência de cintura de 79,6 ± 7,8 cm e PAM de 79 ± 6,4 mmHg. O treinamento promoveu redução da FC repouso (69 ± 7,0 vs. 61 ± 7,1; p<0,05) e aumento do VO2pico (43,3 ± 7,3 vs. 50,1 ± 7,2; p<0,05). Entretanto, pressão arterial sistólica (107 ± 9,4 vs. 110 ± 10), pressão arterial diastólica (63 ± 5,7 vs. 62 ± 5,5), pressão de pulso (44 ± 7,0 vs. 48 ± 7,0) e VOP (6,5 ± 1,1 vs. 6,5 ± 1,1) não apresentaram alteração após o treinamento físico (p>0,05). Conclusões: Podemos concluir que 16 semanas de treinamento de resistência aeróbia foram capazes de aumentar a aptidão cardiorrespiratória, porém não provocaram alterações sobre a velocidade de onda de pulso e pressão arterial em voluntários saudáveis e sedentários. Sugere-se que a ausência de adaptações vasculares após o treinamento seja devido às características da amostra – indivíduos jovens e saudáveis.

Matéria orgânica do solo e emissão de C-CO2 em diferentes manejos e cultivos agrícolas

O manejo do solo deve ser realizado de tal forma que garanta a produção sustentável ao longo dos anos. Dentre as técnicas empregas, o manejo agroecológico e o plantio direto favorecem a manutenção da cobertura do solo e o aporte de matéria orgânica. Partindo da hipótese de que o maior aporte de resíduos culturais aumenta o conteúdo e estoque de matéria orgânica no solo, bem como reduz a emissão de C-CO2, o objetivo geral da pesquisa foi avaliar o impacto do manejo na matéria orgânica do solo e na emissão de C-CO2, nos períodos secos e chuvosos em diferentes cultivos agrícolas. O capítulo 1 foi desenvolvido na comunidade de Feliz Lembrança, Alegre–ES, onde foram avaliados sistemas de manejo em pastagem (PAST), café a pleno sol (PS) e café em sistema agroflorestal (SAF) e uma mata nativa (MN). O capítulo 2 foi desenvolvido no Incaper de Domingos Martins, onde se avaliou tratamentos de plantio direto de hortaliças sob palhada de gramínea (PD-G), leguminosa (PD-L), consórcio gramínea/leguminosa (PD-GL) e convencional utilizando enxada rotativa no pré-plantio (PC)em um delineamento de blocos casualizados. Amostras de solos em diferentes camadas foram coletadas para caracterização química e da matéria orgânica. Foram realizadas medições de emissão de C-CO2, temperatura do solo, umidade do solo e C biomassa microbiana do solo in situ. Foi utilizada análise de variância multivariada, vinculada a teste de aleatorização e aplicação de contrastes ortogonais no capítulo 1 e análise de variância aplicando teste F e teste de médias no capítulo 2. O SAF apresentou maior conteúdo de C orgânico total (19,8 g/kg) na camada de 0 a 5 cm e a PAST em subsuperfície. O menor estoque de C e N e os maiores valores de quociente metabólico foram encontrados no PS. O SAF reduziu a emissão de C-CO2 em 1,93 Mg ha-1 ano-1 em relação ao PS. O C orgânico total variou de 34,94 a 50,48 g/kg no PD-GL enquanto no sistema PC essa variação foi de 27,11 a 43,74 g/kg no perfil amostrado. A emissão média anual foi de 15,89 Mg C-CO2 ha-1 ano-1para a PD-G enquanto o PD-GL foi de 13,77; PD-L de 13,09 e PC de 11,20 Mg C-CO2 ha-1 ano-1. No PC, o balanço de C foi negativo (-2,15Mg ha-1), além de apresentar as menores médias anuais de umidade do solo e C biomassa microbiana e maior Qmet anual. Sistemas com contínuo e diversificado aporte de matéria orgânica promovem redução na emissão de C-CO2, bem como atuam no sequestro de C atmosférico.

Avaliação do risco cardiovascular e fatores associados na população de Anchieta-ES

As doenças cardiovasculares são as principais causas de morte no mundo e muitos constituem os fatores de risco para essas doenças. Objetiva-se investigar o risco cardiovascular para evento coronariano agudo de acordo com o escore de Framingham em população adulta do município de Anchieta-ES. Estudo transversal com dados da linha de base do estudo Carmen Anchieta, iniciado em 2010. A amostra foi sistemática e estratificada por micro área de abrangência das Unidades de Saúde da Família, sexo e idade e 539 pessoas foram selecionadas para este estudo por terem os dados completos. Os dados foram coletados mediante entrevista no domicílio, exames laboratoriais de sangue, verificação da pressão arterial e antropometria nas Unidades de Saúde. As variáveis de exposição constituem escolaridade, raça-cor, renda familiar, residência em espaço urbano ou rural, estado civil, consumo de álcool, atividade física, índice de massa corpórea e autoavaliação de saúde. Para a classificação do risco cardiovascular utilizou-se o escore de Framingham. Foi realizada análise bivariada e regressão logística multinomial para testar a hipótese de associação entre as variáveis e o risco cardiovascular mediante o cálculo da razão de chances (RC) e intervalo de confiança de 95%. O nível de significância foi p < 0,05. Os resultados mostraram predominância de pessoas nas faixas etárias entre 25 a 54 anos, casadas, pardas, ensino fundamental incompleto, baixa renda, insuficientemente ativas, com sobrepeso e obesidade em mais da metade da amostra, 38,6% ingeriam bebida alcoólica e 55,7% relaram saúde muito boa ou boa. O risco cardiovascular foi baixo em 74%, intermediário em 11,3% e elevado em 14,7%. Estiveram associados ao risco cardiovascular intermediário ser analfabeto 8,89 (3,193-24,756), ter ensino fundamental incompleto 3,17 (1,450-6,964) e ser viúvo/ separado 2,55 (1,165-5,583) e associados ao risco cardiovascular elevado ser analfabeto 11,34 (4,281-30,049), ensino fundamental incompleto 2,95 (1,362-6,407) e autoavaliação da saúde muito ruim/ruim 2,98 (1,072-8,307) e regular 2,25 (1,294-3,925). Ser solteiro constituiu fator de proteção 0,40 (0,183-0,902).