Obesity as an additional factor for autonomic imbalance and poor sleep behavior in chronic obstructive pulmonary disease: a case-control study

OBJECTIVES: We compared the autonomic modulation and sleep behavior of eutrophic and overweight patients with chronic obstructive pulmonary disease (COPD). METHODS: COPD participants were divided into the overweight and eutrophic groups. Pulmonary function, blood pressure, body composition, autonomic modulation, and the Pittsburgh Sleep Quality Index score were assessed. Participants performed the six-minute walk test for functional assessment. RESULTS: Spirometric variables obtained in eutrophic and overweight individuals with COPD showed no statistically different results. We observed that the SDNN index indicated lower overall variability (p=0.003), and root mean square of successive differences between normal heart beats (RMSSD) (p=0.04) indicated lower parasympathetic modulation in the overweight group than observed in the eutrophic group. The indexes of the frequency domain presented lower values of total variability (p<0.01), low frequency bands (p<0.01), and high frequency (p=0.02), suggesting a higher sympathetic modulation and reduced parasympathetic modulation of the overweight group compared to eutrophic group. The overweight group also showed reduced sleep quality than the eutrophic group. CONCLUSION: Overweight COPD patients showed lower autonomic modulation and impaired sleep quality, latency, and efficiency as compared eutrophic subjects. These results reinforce the importance of weight control and the acquisition of healthy habits in this population.

Impact of exercise training and detraining after myocardial infarction: a literature review

Despite the advances in the treatment and prevention, myocardial infarction (MI) remains the leading causeof morbidity and mortality worldwide. Different degrees of ventricular dysfunction, changes in hemodynamicand molecular mechanisms, as well as neurohumoral derangements, are substantially associated with increasedmortality rate in MI patients. Cardiovascular, metabolic and autonomic benefits of acute and chronic exercise training (ET) have led many researchers to suggest ET as an important tool in the management of coronary artery disease and after MI. Regarding cardiovascular rehabilitation, several factors, such as illness, injury, travel, vacation or even rehabilitation program discharge may often interfere with the ET process, leading toa disruption in physical activity patterns by either decreasing training level or frequency or interrupting thetraining program altogether. Thus, it is necessary to identify the impact of ET after MI, as well as the possibleconsequences of such disruption in infarcted individuals.