The investigators hypothesize that chemoreflex response of muscle sympathetic nerve activity (MSNA) during hypoxia and hypercapnia will be increased in coronary artery disease (CAD) patients and that the presence of obstructive sleep apnea (OSA) will potentiate these responses. And, that the exercise training would decrease the chemoreflex response of MSNA in these patients.
Forty patients with coronary artery disease, with (n=20) and without (n=20) obstructive sleep apnea will be studied. A healthy control, age-paired group (n=10) will be also evaluated. The patients will be submitted to a polysomnography and randomized for clinical follow-up or exercise training for four months. It will evaluated the autonomic function, chemoreflex control of sympathetic activity during hypoxic and hypercapnic maneuvers, endothelial function and inflammatory markers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
The patients will be submitted to four months of aerobic exercise training, three time a week.
Heart Institute (InCor) - University of Sao Paulo
São Paulo, Brazil
RECRUITINGChemoreflex control of MSNA at rest and during exercise.
Chemoreflex control of MSNA will be measured by microneurography technique during the gas mixture known exposure at rest and during exercise
Time frame: baseline and after 4 months
Endothelial Function
Endothelial Function will be measured by markers present in blood samples.
Time frame: baseline and after 4 months
Neurovascular Control
Neurovascular Control will be measured by venous occlusion plethysmography technique during the exposure mixture of gases known at rest and during exercise.
Time frame: baseline and after 4 months
Inflammatory markers
Inflammatory markers will be measured by markers present in blood samples.
Time frame: baseline and after 4 months
Quality of Life
Quality of life will be measured by the questionnaire Short-Form Health Survey (SF-36).
Time frame: baseline and after 4 months
Anxiety Trait and State
Anxiety Trait and State will be measured by the Spielberger state trait anxiety inventory (STAI).
Time frame: baseline and after 4 months
Symptoms of Depression
The level of symptoms of depression will be measured by the Beck scale.
Time frame: baseline and after 4 months
Mood State
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Mood State will be measured by the profile of mood states (POMS) scale.
Time frame: baseline and after 4 months