Background: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. Objective: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. Methods: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). Results: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. Conclusions: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.
OBJECTIVE:The aim of this study was to evaluate if there is a relationship between the number of comorbidities, autonomic modulation, and quality of life in patients diagnosed with coronary artery disease. METHODS: A cross-sectional study was conducted at an outpatient rehabilitation center in Presidente Prudente-SP, Brazil. A total of 27 participants (65.33±9.23 years) diagnosed with coronary artery disease were assessed, from a cardiac rehabilitation program, independent of sex or age. The number of comorbidities was evaluated using the Self-Administered Comorbidity Questionnaire, and quality of life was evaluated using the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) (eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health). To evaluate the cardiac autonomic modulation, the heart rate was registered beat to beat using an heart rate monitor in the supine position during rest for 30 min. A total of 1000 RR intervals were considered to calculate linear (time domain: RMSSD, SDNN; frequency domain: LF, HF, LF/HF) and nonlinear indices (SD1, SD2, SD1/SD2) of heart rate variability. RESULTS: A negative correlation was observed between the aggregation of comorbidities and the pain domain of the p=0.03). No significant correlations were observed between other variables (p>0.05). CONCLUSION: The number of comorbidities is inversely related to the pain domain of the SF-36, suggesting that a higher pain level is related to a higher number of comorbidities in coronary artery disease patients.
Objectives: This study evaluated the capacity of cardiac risk stratification protocols on simple complications that occur during activities of a cardiovascular rehabilitation program. Design: Observational longitudinal cohort study. Setting: Outpatient clinic of cardiovascular rehabilitation. Subject: Patients diagnosed with cardiovascular disease and/or risk factors. Interventions: Not applicable. Main measures: The relationship between the cardiac risk classes of seven risk stratification protocols and the occurrence of simple complications (such angina, abnormal changes in blood pressure, arrhythmias, fatigue, muscle pain, pallor) was assessed using the chi-square test, and when statistical significance was observed, sensitivity, specificity and accuracy were determined. Results: About 76 patients were analyzed. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) protocol showed a statistically significant relationship between simple complications and cardiac risk classes ( P-value = 0.046), however the results of sensitivity (0.53), specificity (0.52), and accuracy (0.53) were not significant. The other protocols analyzed were not significant: American College of Sports Medicine ( P-value = 0.801), Brazilian Society of Cardiology ( P-value = 0.734), American Heart Association ( P-value = 0.957), Pashkow ( P-value = 0.790), Society French Cardiology ( P-value = 0.314), and Spanish Society of Cardiology ( P-value = 0.078). Conclusion: The AACVPR protocol showed a significant relationship between the risk classes and the occurrence of simple complications, however, the low values obtained for sensitivity, specificity and accuracy show that it is not useful for this purpose. Clinical trials registration: NCT03446742.
Caracterizada pelo acúmulo excessivo de gordura corporal a obesidade se torna um problema de saúde pública com o avanço da idade podendo ser avaliada por meio do índice de massa corpórea (IMC) e o Índice de conicidade (IC). O objetivo foi determinar a prevalência de obesidade e comparar risco coronariano em homens e mulheres participantes do programa de prevenção primária e secundária de doenças cardiovasculares de um centro de reabilitação. Os voluntários foram identificados e tiveram avaliadas medidas antropométricas e de circunferência da cintura para o cálculo do IMC e IC. O método estatístico utilizado foi Shapiro-Wilk para normalidade e posterior teste t de Student e Man-Withney (p<0,05). Foi observado predomínio de sobrepeso, e maior risco coronariano no sexo masculino, com diferenças significantes neste último. Concluiu-se que há prevalência de sobrepeso na população avaliada e maior risco coronariano em homens, sendo indicados programas preventivos que podem amenizar este fator prevenindo eventos cardiovasculares. Palavras-chave: obesidade, risco coronariano, doenças cardiovasculares, prevenção, fatores de risco.
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