BACKGROUND: COVID-19 has become a dramatic health problem during this century. In addition to high mortality rate, COVID-19 survivors are at increased risk for cardiovascular diseases 1-year after infection. Explanations for these manifestations are still unclear but can involve a constellation of biological alterations. We hypothesized that COVID-19 survivors compared with controls exhibit sympathetic overdrive, vascular dysfunction, cardiac morpho-functional changes, impaired exercise capacity, and increased oxidative stress. METHODS: Nineteen severe COVID-19 survivors and 19 well-matched controls completed the study. Muscle sympathetic nerve activity (microneurography), brachial artery flow-mediated dilation and blood flow (Doppler-Ultrasound), carotid-femoral pulse wave velocity (Complior), cardiac morpho-functional parameters (echocardiography), peak oxygen uptake (cardiopulmonary exercise testing), and oxidative stress were measured ~3 months after hospital discharge. Complementary experiments were conducted on human umbilical vein endothelial cells cultured with plasma samples from subjects. RESULTS: Muscle sympathetic nerve activity and carotid-femoral pulse wave velocity were greater and brachial artery flow-mediated dilation, brachial artery blood flow, E/e′ ratio, and peak oxygen uptake were lower in COVID-19 survivors than in controls. COVID-19 survivors had lower circulating antioxidant markers compared with controls, but there were no differences in plasma-treated human umbilical vein endothelial cells nitric oxide production and reactive oxygen species bioactivity. Diminished peak oxygen uptake was associated with sympathetic overdrive, vascular dysfunction, and reduced diastolic function in COVID-19 survivors. CONCLUSIONS: Our study revealed that COVID-19 survivors have sympathetic overactivation, vascular dysfunction, cardiac morpho-functional changes, and reduced exercise capacity. These findings indicate the need for further investigation to determine whether these manifestations are persistent longer-term and their impact on the cardiovascular health of COVID-19 survivors.

Introduction: Although the rapid weight loss process is undertaken by combat sports athletes very often, the impact of this practice on cardiovascular health is not fully understood. Objective: To verify the effects of the rapid weight loss process undertaken by combat sports athletes on hemodynamic parameters, cardiovascular autonomic modulation and mood state. Methods: Eight male fighters (21.62±1.49 years, 71.25±3.54 kg, 1.74±0.03 cm) were assessed in the city of São Paulo. The subjects had 5.37±0.77 years of practice and were training 5.75±0.45 days per week, for 3.05±0.69 hours per day. The athletes were assessed on 2 occasions: 14 days before and 1 day before official weigh-in. Weight, height and bioimpedance were used for body composition analysis. Mood state was assessed using the Brums Mood Scale. Blood pressure was measured at rest with a digital meter. Cardiovascular autonomic modulation was obtained through an analysis of heart rate variability recorded for 25 minutes at rest. The Student's t-test for dependent samples was used for comparison between time points. Values of p<0.05 were considered significant. Results: No differences in body composition were observed between the time points evaluated. After the weight loss strategy, increases in mood state parameters related to anger, vigor and fatigue categories were observed. Blood pressure did not change between the time points evaluated. However, an increase in heart rate associated with greater sympathetic modulation was observed after the weight loss strategy. There were no differences in autonomic modulation parameters representing parasympathetic activity. Conclusions: The study provided evidence of a higher cardiovascular risk in athletes as a result of this rapid weight loss practice, which is very concerning since combat sports athletes repeat this process several times during their lives. Level of Evidence IV; Study type: Case series.

Considering the increase of cardiovascular risk with the progression of the atherogenic process and the effectiveness of physical training as a strategy to control/manage the cardiac dysfunction in populations exposed to elevated risks, the aim of this study was to evaluate the cardiovascular and autonomic effects of an aerobic exercise training protocol in an experimental model of atherosclerosis. Considering the cardioprotective effects already known about physical training the hypothesis of this study is that the aerobic exercise training will promote systemic benefits on hemodynamics and autonomic in a model of atherosclerosis. For this, sixteen ApoE‐knockout mice, 15 months old, were divided in 2 groups (n=8, each): sedentary group (APOE 15) and moderate intensity exercise training group (APOE 15T). The exercise training lasted for 6 weeks (5 days/week, 1 hour/day, intensity 60–75% of the maximum treadmill test). At the end of the protocol, the animals were submitted to echocardiography analysis and cannulation for a direct recording of the arterial blood pressure (AP), and then, baroreflex sensitivity and cardiovascular autonomic modulation were evaluated. The aerobic exercise training improved running capacity (APOE 15: 594.90±46.95; APOE 15T: 878.6±68.54 s) and cardiac diastolic function (E/A: APOE 15: 1.10±0.05; APOE 15T: 1.70±0.24), as well as decreased diastolic blood pressure (DAP: APOE 15: 107.0±5.202; APOE 15T: 95.12±0.79 mmHg) and induced resting bradycardia (HR: APOE 15: 704±21; APOE 15T: 613±20 bpm) associated with heart rate variability increase (Var‐PI: APOE 15:1.25±0.09; APOE 15T: 8.81±1.98 ms2; SD‐Pl: APOE 15: 1.09±0.06; APOE 15T: 2.77±0.37 ms). In addition, greater cardiac parasympathetic modulation (RMSSD: APOE 15: 0.99±0.06; APOE 15T: 1.41±0.10 ms) and baroreflex sensitivity improvement (Alpha Index: APOE 15: 0.31±0.044; APOE 15T: 0.66±0.10 ms/mmHg) were also observed. In conclusion, aerobic exercise training may be considered an important non‐pharmacological strategy for the management of cardiovascular risk induced by atherosclerosis, improving running capacity, diastolic function as well as the hemodynamic status and autonomic modulation.

IntroductionConsidering the increase in cardiometabolic risk after menopause, and that diet and exercise training (ET) are the pillars of prevention/treatment strategies, the objective of this study was to evaluate the metabolic, hemodynamic and autonomic effects of exercise training in an experimental model of menopausal undergoing a high‐fat diet followed by dietary adjustment. Twenty female C57BL/6J mice (8 weeks aged), all oophorectomized (bilateral ovarian removal) divided into 4 experimental groups (n = 5) were used: sedentary submitted to a high‐fat diet (OSD), sedentary submitted to 4 weeks of high‐fat diet and 4 weeks of control diet (OSRa), trained submitted to a high‐fat diet (OTD), trained submitted to 4 weeks of high‐fat diet and 4 weeks of control diet (OTRa). Oophorectomy was performed at the end of the 4th week of the protocol. Fasting glycemia and oral glucose tolerance were evaluated. ET had duration of 4 weeks (6th to 9th week of protocol, 5 days/week, 1 hour/day, intensity 50–70% of the maximum treadmill test). At the end of the protocol, the animals were cannulated for direct recording of arterial pressure (AP), after which baroreflex sensitivity and cardiovascular autonomic modulation were analyzed.RESULTSDietary adjustment promoted a reduction in glycemia and a better glucose tolerance, associated with reduction in cardiac sympathetic modulation (LF‐PI: OSD: 0.54±0.02; OSRa: 0.37±0.06; OTD: 3.0±0.02, OTRa: 0.19±0.02 ms2) and vascular (LF‐SAP: OSD: 11.3±1.7, OSRa: 3.6±0.9, OTD: 1.6±0.2; OTR:3.0±0.5mmHg2). ET, with or without dietary adjustment, increased physical capacity, reduced heart rate, improved baroreflex sensitivity, increased cardiac parasympathetic modulation (HF‐PI: OSD: 0.47±0.04, OSRa: 0,63±0.07, OTD: 0.86±0.02, OTRa: 0.75±0.07 ms2) and reduction of cardiac and vascular sympathetic modulation. However, only the association of ET with dietary adjustment was able to promote reduction in body weight, glycemia, improvement in glucose tolerance, reduction in blood pressure (mean AP: OSD: 123±2.1, OSRa: 114±0.8; OTD: 120±1.4; OTR: 110±4.0 mmHg), and further increase in parasympathetic modulation. Thus, the association of ET with dietary adjustment may be considered an important behavior for the management of cardiovascular risk in the association of obesity with ovarian deprivation.Support or Funding InformationCoordenação de Aperfeiçoamento de Pessoal de Nível Superior ‐ Brazil (CAPES) ‐ Funding Code: 001.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

After menopause there is a greater tendency to visceral fat accumulation and increased arterial pressure, contributing to obesity and increased cardiovascular risk. On the other hand, exercise training promotes important benefits on cardiometabolic risk factors. In this sense, the American College of Sports Medicine suggests that the weekly frequency to practice regular physical activity should be, at least, 3 days a week. However, this recommendation applies to the general population, so the association of risk factors that is so frequently observed after menopause is not considered. Thus, the aim of this study was to compare the effects of different volumes of moderate aerobic exercise training on metabolic, hemodynamic and autonomic parameters in an experimental model of menopause fed with high‐fat diet. For this, 32 C57BL/6J ovariectomized mice fed a high‐fat diet were used, divided into 4 groups (n=8 each): sedentary (OSD); trained 3 days a week (OTD3); trained 5 days a week (OTD5); trained 7 days a week (OTD7). The administration of the high‐fat diet lasted 9 weeks, and the ovariectomy was performed at the end of the 4th week. Fasting glycemia and oral glucose tolerance were assessed before the ovariectomy and at the end of the study. Exercise training lasted 4 weeks (6th to 9th week of the protocol) at moderate intensity. At the end of the study, the animals were cannulated for direct arterial pressure recording, baroreflex sensitivity and cardiovascular autonomic modulation analysis. The results demonstrate that the greater volume of exercise training (OTD7) provided a marked reduction in body weight, adipose tissue (OSD: 0.060±0.007; OTD3: 0.051±0.005; OTD5: 0.052±0.009; OTD7: 0.029±0.003 grams) and blood glucose fasting time (OSD: 158±6; OTD3: 145±5; OTD5: 143±5; OTD7: 133±5 mg/dL). In cardiovascular parameters, both exercise training performed 5 days (OTD5) and 7 days (OTD7) a week were able to reduce systolic and mean arterial pressure (OSD: 113±2; OTD3: 111±2; OTD5: 102±3; OTD7: 103±2 mmHg), heart rate (OSD: 655±14; OTD3: 538±30; OTD5: 532±36; OTD7: 520±12 bpm), improve baroreflex sensitivity (Bradycardic response ‐ OSD: 1.5±0.2; OTD3: 2.1±0.1; OTD5: 2.5±0.3; OTD7: 2.4±0.1 bpm/mmHg), increase parasympathetic modulation (AF‐IP ‐ OSD: 16.5±1.8; OTD3: 20.8±2.2; OTD5: 39.1±7.5; OTD7: 38.8±8.4 nu), reduce sympathovagal balance (LF/HF ‐ OSD: 2,7±0.6; OTD3: 1.7±0.2; OTD5: 0.9±0.3; OTD7: 0.9±0.2) and improve the variance of systolic arterial pressure (VAR‐SAP ‐ OSD: 20±4; OTD3: 19±2; OTD5: 10±2; OTD7: 11±2 mg/dL). In conclusion, the female public, especially after menopause, lacks specific guidelines for the practice of physical activity, since the minimum recommended for the general population (3 days a week) is not effective in managing the observed cardiometabolic risk factors in the association of ovarian deprivation and obesity. Support or Funding Information This study was supported by CNPq (435123/2018‐1 ICS).