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

Borges, Juliana Pereira
Mendes, Fernanda de Souza Nogueira Sardinha
Rangel, Marcus Vinícius Dos Santos
Lopes, Gabriella de Oliveira
Silva, Gilberto Marcelo Sperandio da
Mazzoli-Rocha, Flavia
Saraiva, Roberto Magalhães
Sousa, Andrea Silvestre de
Tibirica, Eduardo
Mediano, Mauro Felippe Felix
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Microvascular Research
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.
Cardiac rehabilitation, Chagas heart disease, Cutaneous vascular conductance, Endothelial function, Microvascular flowmetry