title: Cardiac autonomic dysfunction in chronic stroke women is attenuated after submaximal exercise test, as evaluated by linear and nonlinear analysis.
abstract: BACKGROUND
  We evaluated cardiac autonomic modulation in women with chronic ischemic stroke (at least 4 years post-stroke) at rest and in response to submaximal exercise test.
  
  
  METHODS
  Fourteen post-stroke women (S group) and 10 healthy women (C group) participated in this study. Autonomic modulation (using linear and nonlinear analysis), blood pressure and metabolic variables at rest were evaluated immediately after the exercise test and during the recovery period (20 min). All participants underwent submaximal exercise test on cycle ergometer with gas analysis.
  
  
  RESULTS
  At rest, the S group displayed higher lactate concentration, systolic (SBP) and diastolic blood pressure (DBP) values when compared to C group. Furthermore, the S group had lower heart rate variability (HRV) in time domain (SDNN: S = 30 ± 5 vs. 40 ± 8 ms; rMSSD: S = 14 ± 2 vs. C = 34 ± 3 ms), decreased high frequency band of pulse interval (S = 8.4 ± 2 vs. 33.1 ± 9 %) and 2V pattern of symbolic analysis (S = 17.3 ± 1 vs. 30 ± 3 %) (both indicators of cardiac vagal modulation) when compared to C group. Immediately after exercise, S group presented higher values of lactate, SBP, DBP and double product when compared to C group, as well as decreased heart rate recovery (HRR) measured at the first, second and third minutes. At recovery time, all HRV parameters in time and frequency domains improved in the S group; however, HF band remained lower when compared to C group.
  
  
  CONCLUSIONS
  After the exercise test, women with chronic stroke presented reduced heart rate variability, reduced cardiac vagal modulation, as well as reduced HRR, while displayed an improvement of heart rate variability and cardiac vagal modulation when compared to their baseline. These results reinforce the importance of a physically active lifestyle for cardiovascular autonomic disorders observed in chronic stroke women.
authors.affiliation: Human Movement Laboratory, São Judas Tadeu University (USJT), São Paulo/SP, Brazil. prof.julianavalente@gmail.com.
authors.forename: Juliana Valente
authors.initials: JV
authors.lastname: Francica
authors.affiliation: Human Movement Laboratory, São Judas Tadeu University (USJT), São Paulo/SP, Brazil. alinebigongiari@hotmail.com.
authors.forename: Aline
authors.initials: A
authors.lastname: Bigongiari
authors.affiliation: School of Arts, Sciences and Humanities, University of São Paulo, São Paulo/SP, Brazil. mochi@usp.br.
authors.forename: Luís
authors.initials: L
authors.lastname: Mochizuki
authors.affiliation: Hypertension Unit, Heart Institute (InCor), Medical School of University of Sao Paulo, São Paulo/SP, Brazil. katiascapini@yahoo.com.br.
authors.forename: Kátia Bilhar
authors.initials: KB
authors.lastname: Scapini
authors.affiliation: Hypertension Unit, Heart Institute (InCor), Medical School of University of Sao Paulo, São Paulo/SP, Brazil. oscaralbuquerque@yahoo.com.br.
authors.forename: Oscar Albuquerque
authors.initials: OA
authors.lastname: Moraes
authors.affiliation: Federal University of Maranhao (UFMA), São Luiz/MA, Brazil. cristiano.mostarda@gmail.com.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Mostarda
authors.affiliation: Human Movement Laboratory, São Judas Tadeu University (USJT), São Paulo/SP, Brazil. ecaperuto@yahoo.com.
authors.forename: Erico Chagas
authors.initials: EC
authors.lastname: Caperuto
authors.affiliation: Hypertension Unit, Heart Institute (InCor), Medical School of University of Sao Paulo, São Paulo/SP, Brazil. hipirigoyen@incor.usp.br.
authors.forename: Maria Cláudia
authors.initials: MC
authors.lastname: Irigoyen
authors.affiliation: Translational Physiology Laboratory, Universidade Nove de Julho (UNINOVE), São Paulo/SP, Brazil. prof.kangelis@uninove.br.
authors.forename: Katia
authors.initials: K
authors.lastname: De Angelis
authors.affiliation: Human Movement Laboratory, São Judas Tadeu University (USJT), São Paulo/SP, Brazil. prof.brodrigues@gmail.com.|Faculty of Physical Education, University of Campinas (UNICAMP), Av. Érico Veríssimo, 701. Cidade Universitária "Zeferino Vaz". Barão Geraldo, Campinas, SP. CEP, 13.083-851, Brazil. prof.brodrigues@gmail.com.
authors.forename: Bruno
authors.initials: B
authors.lastname: Rodrigues
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002908:Chronic Disease; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000294:innervation*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008875:Middle Aged; D020521:Stroke / Q000503:physiopathology*; D014630:Vagus Nerve / Q000503:physiopathology*
chemical_list: D001786:Blood Glucose; D019344:Lactic Acid