Body Composition – ABC CARDIOL

IJCS

Original Article

Heart Rate Reactivity to Acute Mental Stress is Associated With Parasympathetic Withdrawal and Adiposity in Firefighters

Haissa A. Mendes et al. Natália E. Canto Luiz Rodrigo A. Lima Guilherme F. Speretta

Abstract

Background

Firefighters are regularly exposed to stress and have a high incidence of cardiovascular events. Investigating cardiovascular and autonomic reactivity to acute mental stress (AMS) and its association with adiposity may contribute to explaining the increased cardiovascular risk in these professionals.

Objectives

To evaluate cardiovascular and autonomic reactivity to AMS in firefighters while considering adiposity parameters.

Methods

This study recorded the blood pressure and heart rate (HR) of twenty-five firefighters (38±8 years) at rest, while performing the Stroop color-word test to induce AMS, and recovery. Cardiac autonomic modulation (HR variability), baroreflex sensitivity (BRS — sequential method), and adiposity (electrical bioimpedance) were assessed. One-way or two-way analysis of variance followed by Tukey’s post hoc test and multiple linear regression were performed. The significance level was P<0.05.

Results

The AMS increased mean arterial pressure (MAP — Δ16±13 mmHg) and HR (Δ14±7 bpm) ( P <0.05). These responses were associated with parasympathetic modulation withdrawal (RMSSD: baseline: 29.8±18 vs. AMS: 21.5±14 ms; High-frequency: baseline: 5.2±1.4 vs. AMS: 4.5±1.3 Ln ms ² ; P <0.05) and decreased in the Up gain of the baroreflex (baseline: 8.9±5.1 vs. AMS: 6.3±3.0 mmHg/ms; P <0.05). Groups divided by HR reactivity peak showed parasympathetic modulation withdrawal only in firefighters with lower adiposity (RMSSD: baseline: 27.8±17.6 vs. AMS: 14.4±9.2 ms; High-Frequency: baseline: 5.3±1.2 vs. AMS: 3.8±1.4 Ln ms ² ; P <0.05). Fat percentage (β = -0.499), BRS (β = 0.486), and sympathetic/parasympathetic balance (β = -0.351) were predictors of HR reactivity ( P <0.05).

Conclusion

Our results demonstrated that HR reactivity to AMS modulated by cardiac vagal withdrawal seems to be influenced by body composition in this group of firefighters.

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IJCS

Original Article

Impact of Coronary Artery Bypass Grafting on Muscle Mass Reduction on the 7th Postoperative Day

Bárbara de Oliveira Costa et al. Gabrielle Maciel Ana Beatriz Huguenin Geisiane da Silva … Sheila Moreira da Silva Guimarães Wanise Maria de Souza Cruz Alexandre Siciliano Colanfranceschi Gilson Teles Boaventura

Abstract

Background:

Ischemic heart failure is a chronic and degenerative disease with high morbidity and mortality in the world. Coronary artery bypass grafting is indicated as elective treatment and may cause a catabolic state that depletes energy reserves. Data on body composition evaluation in the postoperative period of major cardiac surgery are limited.

Objective:

To evaluate the influence of elective coronary artery bypass grafting on body composition on the seventh postoperative day of patients with ischemic heart failure.

Methods:

A cross-sectional study was carried out in which eighteen volunteers with New York Heart Association Class II and III heart failure underwent coronary artery bypass grafting. The energy and protein reserves of the participants were evaluated by anthropometry in the preoperative and on the seventh postoperative day. Paired t-Test or Mann-Whitney test was used if applicable. A significance level was considered at p value < 0.05.

Results:

A significant loss of muscle mass was observed through the reduction of arm muscle circumference after surgery (4.2%, p 0.007). Major surgery causes hypermetabolic state and systemic inflammatory stimulus, due to the release of hormones and cytokines that may justify the observed loss of muscle mass.

Conclusion:

Coronary artery bypass grafting had an impact on muscle mass reduction seven days after surgery in patients with ischemic heart failure.

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IJCS

Original Article

Acuracy and Concordance of Anthropometric Indicators and Body Composition in Heart Failure

Daniela de Oliveira Rocha et al. Raquel Costa Silva Dantas Fernanda Lambert de Andrade Regina Ranielly dos Santos Avelino … Clélia de Oliveira Lyra Rosiane Viana Zuza Diniz Niethia Regina Dantas de Lira Karine Cavalcanti Mauricio Sena-Evangelista

Abstract

Background:

Anabolic/catabolic disorder in heart failure (HF) favors cardiac cachexia, implying a reduction in HF survival.

Objectives:

To assess the accuracy and concordance of the diagnosis of protein malnutrition and excess fat among the anthropometric and body composition methods in individuals with HF.

Method:

A study of accuracy that included 60 individuals with HF. Body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TST), adductor pollicis muscle thickness (APMT), arm muscle circumference (AMC) and corrected arm muscle area (cAMA). Fat free mass index (FFMI) and body fat percentage (BF%), obtained by electrical bioimpedance (EBI), were used to compare the diagnosis of protein malnutrition and excess fat. Accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive value. The concordance of the EBI diagnosis and other methods was performed by the chi-square test and kappa (k) statistic, where p<0.05 was considered significant.

Results:

Higher frequencies of protein malnutrition were identified by cAMA and AMC, and excess fat by BF%. BMI presented low sensitivity (43%) and accuracy (38.5%), with moderate concordance (0.50). AMC sensitivity was 86%, accuracy 66.4%, and acceptable concordance (0.36) compared to FFMI. Similar percentages of moderate sensitivity and low accuracy were observed for TST and BMI.

Conclusion:

AMC may be useful to identify protein malnutrition and TST has not been adequate to diagnose adiposity. BMI was not sensitive to assess muscle and adipose reserve. EBI was more accurate.

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IJCS

Original Article

Effects of Conventional and Virtual Reality Cardiovascular Rehabilitation in Body Composition and Functional Capacity of Patients with Heart Diseases: Randomized Clinical Trial

João Pedro Lucas Neves Silva et al. Luiz Felipe Marques Novaes Lorrany Caroline Rocha dos Santos Bianca Pinhal Galindo … Margaret Assad Cavalcante Bruna Corral Garcia de Araújo Francis Lopes Pacagnelli Ana Paula Coelho Figueira Freire

Abstract

Background:

Virtual reality is an alternative therapeutic resource to be inserted into cardiovascular rehabilitation, stimulating the practice of physical activity through man-machine interaction.

Objective:

To compare the effects of conventional and virtual reality cardiac rehabilitation on body composition and functional capacity in patients with heart disease.

Methods:

Randomized clinical trial with 27 cardiac patients divided into conventional rehabilitation group (CRG) and virtual reality rehabilitation group (VRG). They underwent a rehabilitation program with 60-minute training sessions twice a week for eight weeks. The VRG training consisted of exercises from the Xbox 360^® with Kinect(tm), using YourShape(tm) and Dance Central 3(tm) games. The CRG used conventional treadmills for aerobic exercise and free weights for resistance exercise. Bioimpedance and 6-minute walk test (6MWT) were evaluated at baseline and after training. For main outcome analysis, Student t and Mann Whitney tests were used with a 5% significance level.

Results:

The VRG showed a significant increase in body fat percentage and fat weight when compared to the CRG, and a smaller amount of total water. There was a significant improvement in functional capacity evidenced by the increase in the distance covered in the 6MWT (54.00 m and 32.25 m in the CRG and VRG, respectively), but the gains did not differ between the groups.

Conclusion:

The two rehabilitation modalities had no effect on the body composition of the groups. In addition, the improvement in functional capacity was similar in both groups.

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