Função autonômica cardíaca e análise linear e simbólica da variabilidade da frequência cardíaca de diabéticos do tipo 2: efeitos crônicos do exercício resistido
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Data
2017-12-01
Autores
Silva, Cristiano Sales da [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O Diabetes Mellitus (DM) pode promover alterações no sistema nervoso autonômico (SNA) cardíaco e estas podem ser verificadas pela Variabilidade da Frequência Cardíaca (VFC). O exercício físico (EF) regular é uma terapia não medicamentosa do DM-2 e nos últimos anos vem ganhando destaque o treinamento resistido (TR). Objetivo: verificar a influência de 12 semanas de TR sobre a modulação autonômica da FC em pacientes com DM-2. Materiais e Métodos: foram estudados 8 pacientes com DM-2 (62,37±9,65 anos). Após avaliação inicial (anamnese, exames físicos e clínico) foram coletos os intervalos R-R (iR-R) da frequência cardíaca (FC) na condição de repouso supino por 20minutos (min.). A VFC foi analisada por método linear utilizando-se os índices no domínio do tempo (RMSSD e SDNN), da frequência (HF, LF e a razão LF/HF), geométricos (SD1, SD2 e razão SD1/SD2) e pelo método não linear utilizando-se análise simbólica (AS) pelos componentes 0V, 1V, 2UV, 2LV e ainda, o índice de complexidade (IC) e o IC normalizado (ICN). O TR foi composto por 12 semanas, 60% 1RM, 5 exercícios para grandes grupos musculares (2 exercícios para membros superiores e tórax e outros 3 para membros inferiores). Após o término do TR os pacientes foram reavaliados nas mesmas condições que no pré TR. Foi realizado teste de normalidade de Shapiro-Wilk e os testes t-Student para amostras pareadas e de Wilcoxon quando não houve normalidade. Significância para p<0,05. Resultados: as variações dos dados entre o pós TR e os iniciais não apresentaram diferença estatística (p>0,05) nas variáveis de VFC calculadas tanto pelo método linear quanto pelo não linear. (RR: ∆=58,11±98,09; FC: ∆=-4,79±7,23; SDNN: ∆=2,38±7,34; RMSSD: ∆=2,97±7,55; SD1: ∆=2,11±5,35; SD2: ∆=-2,83±9,24; SD1/SD2: ∆=-0,02±0,08; LF(ms2): ∆=48,00±0,01; HF(ms2): ∆=15,00±121,88; HF(un): ∆=-6,11±12,93; LF/HF: ∆=0,03±0,50; 0V%: ∆=0,00±9,25; 1V%: ∆=-0,29±4,24; 2LV%: ∆=-2,41±8,35; 2UV%: ∆=2,70 ± 8,83; IC: ∆= 0,02 ± 0,19; ICN: ∆= 0,02 ± 0,09. Conclusões: 12 semanas de TR moderado não promove efeitos positivos sobre a VFC em pacientes com DM-2.
Diabetes Mellitus (DM) can promote changes in the cardiac autonomic nervous system (ANS) and these can be verified by Heart Rate Variability (HRV). Regular physical exercise (PE) is a non-medicated DM-2 therapy and in recent years the resistance training (RT) has been gaining prominence. Objective: verify the influence of 12 weeks of RT on the autonomic modulation of HR in patients with DM-2. Materials and Methods: 8 patients with DM-2 (62.37 ± 9.65 years) were studied. After an initial evaluation (anamnesis, physical and clinical examinations) the R-R intervals (HRR) of the heart rate (HR) were collected in the supine rest condition for 20 minutes (min). The HRV was analyzed by linear method using the time domain indexes (RMSSD and SDNN), frequency (HF, LF and LF / HF ratio), geometric (SD1, SD2 and SD1 / SD2 ratio) and method non-linear using the symbolic analysis (SA) for the components 0V, 1V, 2UV, 2LV and the complexity index (CI) and the standardized IC (IC). The RT was composed of 12 weeks, 60% 1RM, 5 exercises for large muscle groups (2 exercises for upper limbs and thorax and 3 exercises for lower limbs). After the end of the RT the patients were reevaluated under the same conditions as in the before RT. The Shapiro-Wilk normality test and Student's t-tests for paired and Wilcoxon samples were performed when there was no normality. Significance for p <0.05. RESULTS: Variations in the data between the RT and the initials did not present statistical difference (p> 0.05) in the HRV variables calculated by both the linear and the nonlinear method. (RR: Δ = 58.11 ± 98.09, HR = -4.79 ± 7.23, SDNN: Δ = 2.38 ± 7.34, RMSSD: Δ = 2.97 ± 7.55; SD1: Δ = 2.11 ± 5.35, SD2: Δ = -2.83 ± 9.24, SD1 / SD2: Δ = -0.02 ± 0.08, LF (ms2): Δ = 48.00 ± 0.01, HF (ms2): Δ = 15.00 ± 121.88, HF (un): Δ = -6.11 ñ 12.93, LF / HF: Δ = 0.03 ± 0.50; 0V%: Δ = 0.009.25; 1V%: Δ = -0.29 ± 4.24; 2LV%: Δ = -2.41 ± 8.35; 2UV%: Δ = 2.70 ± 8.83 CI: Δ = 0.02 ± 0.19 ICN: Δ = 0.02 ± 0.09 Conclusions: 12 weeks of moderate RT does not promote positive effects on HRV in patients with DM-2.
Diabetes Mellitus (DM) can promote changes in the cardiac autonomic nervous system (ANS) and these can be verified by Heart Rate Variability (HRV). Regular physical exercise (PE) is a non-medicated DM-2 therapy and in recent years the resistance training (RT) has been gaining prominence. Objective: verify the influence of 12 weeks of RT on the autonomic modulation of HR in patients with DM-2. Materials and Methods: 8 patients with DM-2 (62.37 ± 9.65 years) were studied. After an initial evaluation (anamnesis, physical and clinical examinations) the R-R intervals (HRR) of the heart rate (HR) were collected in the supine rest condition for 20 minutes (min). The HRV was analyzed by linear method using the time domain indexes (RMSSD and SDNN), frequency (HF, LF and LF / HF ratio), geometric (SD1, SD2 and SD1 / SD2 ratio) and method non-linear using the symbolic analysis (SA) for the components 0V, 1V, 2UV, 2LV and the complexity index (CI) and the standardized IC (IC). The RT was composed of 12 weeks, 60% 1RM, 5 exercises for large muscle groups (2 exercises for upper limbs and thorax and 3 exercises for lower limbs). After the end of the RT the patients were reevaluated under the same conditions as in the before RT. The Shapiro-Wilk normality test and Student's t-tests for paired and Wilcoxon samples were performed when there was no normality. Significance for p <0.05. RESULTS: Variations in the data between the RT and the initials did not present statistical difference (p> 0.05) in the HRV variables calculated by both the linear and the nonlinear method. (RR: Δ = 58.11 ± 98.09, HR = -4.79 ± 7.23, SDNN: Δ = 2.38 ± 7.34, RMSSD: Δ = 2.97 ± 7.55; SD1: Δ = 2.11 ± 5.35, SD2: Δ = -2.83 ± 9.24, SD1 / SD2: Δ = -0.02 ± 0.08, LF (ms2): Δ = 48.00 ± 0.01, HF (ms2): Δ = 15.00 ± 121.88, HF (un): Δ = -6.11 ñ 12.93, LF / HF: Δ = 0.03 ± 0.50; 0V%: Δ = 0.009.25; 1V%: Δ = -0.29 ± 4.24; 2LV%: Δ = -2.41 ± 8.35; 2UV%: Δ = 2.70 ± 8.83 CI: Δ = 0.02 ± 0.19 ICN: Δ = 0.02 ± 0.09 Conclusions: 12 weeks of moderate RT does not promote positive effects on HRV in patients with DM-2.
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Palavras-chave
Variabilidade da frequencia cardíaca, Diabetes mellitus, Exercício resistido, Medicina esportiva, Função autonômica cardíaca, Heart rate variability, Resistance exercise, Function autonomic, Training resistance