Exercise training improves microvascular function in patients with Chagas heart disease: Data from the PEACH study

Juliana Pereira Borges; Fernanda de Souza Nogueira Sardinha Mendes; Marcus Vinícius Dos Santos Rangel; Gabriella de Oliveira Lopes; Gilberto Marcelo Sperandio da Silva; Paula Simplício da Silva; Flavia Mazzoli-Rocha; Roberto Magalhães Saraiva; Andrea Silvestre de Sousa; Eduardo Tibirica; Mauro Felippe Felix Mediano

doi:10.1016/j.mvr.2020.104106

Exercise training improves microvascular function in patients with Chagas heart disease: Data from the PEACH study

Microvasc Res. 2021 Mar:134:104106. doi: 10.1016/j.mvr.2020.104106. Epub 2020 Nov 17.

Affiliations

¹ Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil. Electronic address: julipborges@gmail.com.
² Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
³ Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.
⁴ Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil; Department of Research and Education, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, RJ, Brazil.
⁵ Department of Research and Education, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, RJ, Brazil.
⁶ Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil; Department of Research and Education, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, RJ, Brazil.

PMID: 33212111
DOI: 10.1016/j.mvr.2020.104106

Abstract

Background: Chagas heart disease (CHD) impairs the systemic microvascular function. We investigated the effects of exercise training on cutaneous microvascular function among patients with CHD.

Methods: Patients from the PEACH study were randomly assigned to a supervised exercise training 3 times/week for 6 months (Trained; n = 10) or a control group (Untrained; n = 8). Both groups underwent evaluation of microvascular function before, and at 3- and 6-months of follow-up. Cutaneous vascular conductance (CVC) was assessed in the skin of the forearm using laser speckle contrast imaging coupled with iontophoresis of acetylcholine (ACh), sodium nitroprusside (SNP) and during post-occlusive reactive hyperemia (PORH).

Results: At 3-months of follow-up, no difference was detected between groups in CVC responses to ACh (p = 0.50), SNP (p = 0.26) and HRPO (p = 0.65). However, at 6-months of follow-up, trained vs. untrained patients improved CVC induced by SNP-iontophoresis (0.19 ± 0.10 vs. 0.14 ± 0.15 APU.mmHg^-1; p = 0.05) and PORH (0.63 ± 0.15 vs. 0.48 ± 0.18 APU.mmHg^-1; p = 0.05). CVC response to ACh-iontophoresis was similar between groups (0.19 ± 0.11 vs. 0.22 ± 0.17 APU.mmHg^-1; p = 0.38).

Conclusion: Exercise training performed during 6 months improved the cutaneous microvascular function of CHD patients. Further studies evaluating the mechanism involved in this response are warranted.

Keywords: Cardiac rehabilitation; Chagas heart disease; Cutaneous vascular conductance; Endothelial function; Microvascular flowmetry.

Publication types

Equivalence Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Brazil
Cardiac Rehabilitation*
Chagas Cardiomyopathy / diagnostic imaging
Chagas Cardiomyopathy / parasitology
Chagas Cardiomyopathy / physiopathology
Chagas Cardiomyopathy / rehabilitation*
Exercise Therapy*
Female
Humans
Male
Microcirculation*
Middle Aged
Recovery of Function
Regional Blood Flow
Skin / blood supply*
Time Factors
Treatment Outcome