Browsing by Author "Gabrielli Nervi, Luigi Arnaldo"

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    Circulating Vascular Cell Adhesion Molecule-1 (sVCAM-1) Is Associated With Left Atrial Remodeling in Long-Distance Runners
    (FRONTIERS MEDIA SA, 2021) Contreras Briceño, Felipe; Herrera, Sebastián; Vega Adauy, Julián; Salinas, Manuel; Ocaranza Jeraldino, María Paz; Jalil Milad, Jorge; Mandiola Ovalle, Jorge; García, Lorena; Chiong, Mario; Castro Galvez, Pablo Federico; Lavandero, Sergio; Gabrielli Nervi, Luigi Arnaldo
    Introduction: An increased risk of atrial fibrillation (AF) has been demonstrated in high-performance athletes. Soluble vascular adhesion molecule-1 (sVCAM-1), a biomarker involved in inflammation and cardiac remodeling, is associated with the development of AF in the general population. However, the relationship between sVCAM-1 and left atrial (LA) remodeling has been poorly investigated in long-distance runners (LDR).Aim: To determine the association between LA remodeling and sVCAM-1 levels in LDR during the training period before a marathon race.Methods: Thirty-six healthy male LDR (37.0 +/- 5.3 years; 174.0 +/- 7.0 height; BMI: 23.8 +/- 2.8; V degrees O-2-peak: 56.5 +/- 7.3 mL center dot kg(-1)center dot min(-1)) were evaluated in this single-blind and cross-sectional study. The LDR were separated into two groups according to previous training levels: high-training (HT) (n = 18) >= 100 km center dot week(-1) and low-training (LT) (n = 18) >= 70 and <100 km center dot week(-1). Also, 18 healthy non-active subjects were included as a control group (CTR). In all participants, transthoracic echocardiography was performed. sVCAM-1 blood levels were measured baseline and immediately finished the marathon race in LDR.Results: HT showed increased basal levels of sVCAM-1 (651 +/- 350 vs. 440 +/- 98 ng center dot mL(-1) CTR, p = 0.002; and vs. 533 +/- 133 ng center dot mL(-1) LT; p = 0.003) and a post-marathon increase (Delta sVCAM-1) (651 +/- 350 to 905 +/- 373 ng center dot mL(-1); p = 0.002), that did not occur in LT (533 +/- 133 to 651 +/- 138 ng center dot mL(-1); p = 0.117). In LDR was a moderate correlation between LA volume and sVCAM-1 level (rho = 0.510; p = 0.001).Conclusions: In male long-distance runners, sVCAM-1 levels are directly associated with LA remodeling. Also, the training level is associated with basal sVCAM-1 levels and changes after an intense and prolonged exercise (42.2 km). Whether sVCAM-1 levels predict the risk of AF in runners remains to be established.
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    Determination of the Respiratory Compensation Point by Detecting Changes in Intercostal Muscles Oxygenation by Using Near-Infrared Spectroscopy
    (MDPI, 2022) Contreras Briceño, Felipe; Espinosa Ramírez, Maximiliano; Keim Bagnara, Vicente; Carreño Roman, Matías Ignacio; Rodríguez Villagra, Rafael Alejandro; Villegas Belmar, Fernanda; Viscor, Gines; Gabrielli Nervi, Luigi Arnaldo; Andia, Marcelo E.; Araneda, Oscar F.; Hurtado, Daniel E.
    This study aimed to evaluate if the changes in oxygen saturation levels at intercostal muscles (SmO2 m.intercostales) assessed by near-infrared spectroscopy (NIRS) using a wearable device could determine the respiratory compensation point (RCP) during exercise. Fifteen healthy competitive triathletes (eight males; 29 +/- 6 years; height 167.6 +/- 25.6 cm; weight 69.2 +/- 9.4 kg; (V) over dotO(2)-max 58.4 +/- 8.1 mL.kg(-1).min(-1)) were evaluated in a cycle ergometer during the maximal oxygen-uptake test ((V) over dotO(2)-max), while lung ventilation ((V) over dotE), power output (watts, W) and SmO2 mantercostales were measured. RCP was determined by visual method (RCPvisual : changes at ventilatory equivalents ((V) over dotE.CO2-1, (V) over dotE.(V) over dotO(2)(-1)) and end-tidal respiratory pressure (PetO(2), PetCO(2)) and NIRS method (RCP NIRS : breakpoint of fall in SmO2 m.intercostales). During exercise, SmO2 m.intercostales decreased continuously showing a higher decrease when (V) over dotE increased abruptly. A good agreement between methods used to determine RCP was found (visual vs NIRS) at %(V) over dotO(2)-max, (V) over dotO(2), (V) over dotE, and W (Bland-Altman test). Correlations were found to each parameters analyzed (r = 0.854; r = 0.865; r = 0.981; and r = 0,968; respectively. p < 0.001 in all variables, Pearson test), with no differences (p < 0.001 in all variables, Student's t-test) between methods used (RCPvisual and RCPNIRS). We concluded that changes at SmO2 m.intercostales measured by NIRS could adequately determine RCP in triathletes.
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    Fichas clínicas simuladas en kinesiología
    (2019) Contreras Briceño, Felipe; Rojas Muñoz, Cynthia Teresa; Passalacqua Rubio, Jaime Patricio; Garcia Valdes, Patricio Hernan; Espinosa Ramirez, Maximiliano Andres; Lopez Fuenzalida, Antonio Eduardo; Fuentes Cimma, Javiera Carolina; Gabrielli Nervi, Luigi Arnaldo
    Introducción: la normativa actual de docencia clínica regula el desarrollo de actividades curriculares disminuyendo el tiempo de contacto estudiante-paciente, requiriendo entre otras destrezas del estudiante la lectura eficiente de información clínica. La simulación permite desarrollar competencias clínicas en los estudiantes de ciencias de la salud. El objetivo de este estudio es describir la experiencia de talleres de fichas clínicas simuladas (FCS) en estudiantes curriculares y reportar indicadores de logro de objetivos de aprendizaje relacionados al reconocimiento de las partes de la ficha clínica e identificación y extracción de información relevante. Metodología: en una asignatura de carácter mínimo previo al encuentro de estudiantes con pacientes reales, se desarrollaron cuatro talleres de FCS en grupo pequeño. Un académico guió la actividad consistente en responder cuestionarios de ubicación de información presente en las FCS. Al finalizar la asignatura, se evaluó la percepción de la didáctica educativa y logro de objetivos de aprendizaje en tutores clínicos y estudiantes mediante encuesta. Resultados: los estudiantes reportaron alta satisfacción con la metodología, facilidad para extraer información relevante y mayor tiempo de contacto clínico con pacientes reales. Los tutores clínicos informaron que los estudiantes logran reconocer las partes de la ficha clínica. Ambos consideran que el tiempo ideal para lectura de ficha clínica es de 10 a 20 minutos. Conclusión: la incorporación de talleres de fichas clínicas simuladas desarrolló habilidades clínicas de reconocimiento de las partes que componen la ficha clínica, optimizando el tiempo necesario para identificar y extraer información relevante a diferentes escenarios clínicos.
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    Intercostal Muscles Oxygenation and Breathing Pattern during Exercise in Competitive Marathon Runners
    (Wiley, 2021) Contreras Briceño, Felipe; Espinosa Ramirez, Maximiliano Andres; Moya Gallardo, Eduardo Sebastián; Fuentes Kloss, Rodrigo Alejandro; Gabrielli Nervi, Luigi Arnaldo; Araneda, Oscar F.; Viscor, Gines
    The study aimed to evaluate the association between the changes in ventilatory variables (tidal volume (Vt), respiratory rate (RR) and lung ventilation (VE)) and deoxygenation of m.intescostales (Delta SmO2-m.intercostales) during a maximal incremental exercise in 19 male high-level competitive marathon runners. The ventilatory variables and oxygen consumption (VO2) were recorded breath-by-breath by exhaled gas analysis. A near-infrared spectroscopy device (MOXY (R)) located in the right-hemithorax allowed the recording of SmO2-m.intercostales. To explore changes in oxygen levels in muscles with high demand during exercise, a second MOXY (R) records SmO2-m.vastus laterallis. The triphasic model of exercise intensity was used for evaluating changes in SmO2 in both muscle groups. We found that ASmO(2)-m.intercostales correlated with VO2-peak (r = 0.65; p = 0.002) and the increase of VE (r = 0.78; p = 0.001), RR (r = 0.54; p = 0.001), but not Vt (p = 0.210). The interaction of factors (muscles x exercise-phases) in SmO2 expressed as an arbitrary unit (a.u) was significant (p = 0.005). At VT1 there was no difference (p = 0.177), but SmO2-m.intercostales was higher at VT2 (p < 0.001) and VO2-peak (p < 0.001). In high-level competitive marathon runners, the m.intercostales deoxygenation during incremental exercise is directly associated with the aerobic capacity and increased lung ventilation and respiratory rate, but not tidal volume. Moreover, it shows less deoxygenation than m.vastus laterallis at intensities above the aerobic ventilatory threshold.
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    Reverse Remodeling in Human Heart Failure after Cardiac Resynchronization Therapy Is Associated With Reduced RHO-Kinase Activation
    (2021) Ocaranza Jeraldino, Maria Paz; Jalil Milad, Jorge Emilio; Altamirano Assad, Rodrigo Patricio; De León Soto, Ana María; Moya López, Jackeline Trinidad; Lonis Álvarez, María Alejandra; Gabrielli Nervi, Luigi Arnaldo; Mac Nab, Paul; Cordova Alvestegui, Samuel Edmundo; Paredes, Alejandro; Vergara Saavedra, Ismael Antonio; Bittner Braemer, Alex Gerhard; Sabat Sarras, Karime Alejandra; Pastorini, Karla
    ["Background: Reverse remodeling is a clinically relevant endpoint in heart failure with reduced ejection fraction (HFrEF). Rho-kinase (ROCK) signaling cascade activation correlates with cardiac remodeling and left ventricular (LV) systolic dysfunction in HFrEF patients. Cardiac resynchronization therapy (CRT) is effective in HFrEF, especially when there is a left bundle block, as this treatment may stimulate reverse remodeling, thereby improving quality of life and prolonging survival for patients with this severe condition. Here, we evaluate the hypothesis that ROCK activation is reduced after effective CRT in HFrEF.", "Methods: ROCK activation in circulating leukocytes was evaluated in 28 HFrHF patients, using Western blot (myosin light chain phosphatase subunit 1 phosphorylation, MYPT1p/t), before and three months after initiation of CRT. LV systolic function and remodeling were assessed by echocardiography.", "Results: Three months after CRT, LV ejection fraction increased an average of 14.5% (p < 0.001) in 13 patients (responders), while no change was observed in 15 patients (non-responders). End-systolic diameter decreased 16% (p < 0.001) in responders, with no change in non-responders. ROCK activation in PBMCs decreased 66% in responders (p < 0.05) but increased 10% in non-responders (NS). LV end-diastolic diameter was also 5.2 mm larger in non-responders vs. responders (p = 0.058). LV ejection fraction, systolic diameter, and ROCK activation levels were similar in both groups at baseline.", "Conclusion: In HFrEF patients, 3 months of effective CRT induced reverse myocardial remodeling, and ROCK activation was significantly decreased in circulating leukocytes. Thus, decreased ROCK activation in circulating leukocytes may reflect reverse cardiac remodeling in patients with heart failure."]
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    Sex-Differences in the Oxygenation Levels of Intercostal and Vastus Lateralis Muscles During Incremental Exercise
    (Wiley, 2021) Espinosa Ramírez, Maximiliano Andrés; Moya Gallardo, Eduardo Sebastián; Araya Román, Felipe Andrés; Riquelme Sánchez, Santiago Martín; Rodríguez García, Guido Hernán Antonio; Reid, W. Darlene; Viscor, Gines; Araneda, Oscar F.; Gabrielli Nervi, Luigi Arnaldo; Contreras Briceño, Felipe
    This study aimed to examine sex differences in oxygen saturation in respiratory (SmO2-m.intercostales) and locomotor muscles (SmO2-m.vastus lateralis) while performing physical exercise. Twenty-five (12 women) healthy and physically active participants were evaluated during an incremental test with a cycle ergometer, while ventilatory variables [lung ventilation (V.E), tidal volume (Vt), and respiratory rate (RR)] were acquired through the breath-by-breath method. SmO2 was acquired using the MOXY(R) devices on the m.intercostales and m.vastus lateralis. A two-way ANOVA (sex x time) indicated that women showed a greater significant decrease of SmO2-m.intercostales, and men showed a greater significant decrease of SmO2-m.vastus lateralis. Additionally, women reached a higher level of Delta SmO2-m.intercostales normalized to V.E (L.min(-1)) (p < 0.001), whereas men had a higher level of Delta SmO2-m.vastus lateralis normalized to peak workload-to-weight (watts.kg(-1), PtW) (p = 0.049), as confirmed by Student's t-test. During an incremental physical exercise, women experienced a greater cost of breathing, reflected by greater deoxygenation of the respiratory muscles, whereas men had a higher peripheral load, indicated by greater deoxygenation of the locomotor muscles.