Cardiovascular research in CLINICS

CLINICS is a multidisciplinary medical journal. This editorial highlights the field of cardiovascular research. We have selected papers published from 2011-2012 and focused on the concept of Continuously Variable Rating, which we have recently introduced as an alternative and hopefully superior method for evaluating published scientific papers (1). Ciolac and Greve (2) compared the heart rate response to exercise and exercise-induced improvements in muscle strength, cardiorespiratory fitness, and the heart rate response between 79 normal-weight and 76 overweight/ obese women, all of whom were postmenopausal. The overweight/obese women exhibited an impaired heart rate in response to exercise. Both groups improved in muscle strength, but only normal-weight women improved in cardiorespiratory fitness and the heart rate response to exercise. The results suggested that exercise-induced improvements in cardiorespiratory fitness and the heart rate response to exercise may be impaired in the overweight/obese group. Farinatti et al. (3) evaluated heart rate, systolic blood pressure, and the rate-pressure product during and after large and small muscle-group flexibility exercises performed simultaneously with the Valsalva maneuver. The researchers found that only systolic blood pressure and the rate-pressure product increased throughout the exercises but did not detect post-exercise hypotension. They concluded that the stretched muscle mass and the Valsalva maneuver influenced acute cardiovascular responses to multiple-set passive-stretching exercise sessions. Perim et al. (4) compared relative oxygen pulse (absolute value/body weight) curves in 180 elite soccer players at a maximal heart rate during treadmill cardiopulmonary exercise testing. The players were categorized into quartiles according to their maximal heart rate values. The authors reported that the relative oxygen pulse curve slopes, which serve as an indirect, noninvasive surrogate for stroke volume, suggested that stroke volume is similar in young, aerobically fit subjects, regardless of the maximal heart rate reached. Oliveira et al. (5) retrospectively calculated the relative O2 pulse (absolute value/body weight) of 100 adults (80 males; mean age, 59¡12 years) who underwent two cardiopulmonary exercise tests (median interval, 15 months) for clinical and exercise prescription reasons. The researchers concluded that excluding the rest-exercise transition, the relative O2 pulse exhibited a stable linear increase throughout maximal exercise in adults who were retested under the same clinical conditions at a 15-month interval. Christofoletti et al. (6) assessed the effects of physical activity on neuropsychiatric disturbances in 59 demented patients (evaluated with the Neuropsychiatric Inventory, the Mini-Sleep Questionnaire, and the Baecke Questionnaire) and the mental burden of the patients’ caregivers. The researchers observed that regular physical activity contributes to a reduction in neuropsychiatric symptoms in patients and attenuates the burden of the patients’ caregivers. Medeiros et al. (7) investigated hemodynamic responses to mental stress before and after a bout of exercise in subjects with prehypertension. The authors reported that subjects with prehypertension had an elevated blood pressure and a blunted vasodilator response during mental stress and that the subjects’ blood pressure was attenuated and vasodilator response was normalized after a single bout of maximal dynamic exercise. Casonatto et al. (8) investigated the effects of aerobic exercise on the acute blood pressure response and indicators of autonomic activity after exercise in 10 male subjects (aged 25¡1 years) who underwent four experimental exercise sessions and a control session on a cycle ergometer. Although the authors did not find decreased blood pressure, measurements of the indicators of autonomic activity revealed that in intense exercise, parasympathetic recovery tends to be slower, and sympathetic withdrawal can apparently compensate for this delay in recovery. Bombarda et al. (9) examined and compared conscious rats’ hemodynamic responses after the intrathecal administration of sildenafil, 8-bromo-cGMP (an analog of cGMP), forskolin (an activator of adenylate cyclase), or dibutyrylcAMP (an analog of cAMP) to elucidate the possible role of sympathetic preganglionic neurons in the observed hemodynamic responses (namely, an increase in both lumbar sympathetic activity and heart rate, with no change in the mean arterial pressure). The authors concluded that the cardiovascular response involves the inhibition of phosphodiesterases other than phosphodiesterase type 5, which increases the cAMP level and the activation of sympathetic preganglionic neurons. Ferreira-Melo et al. (10) investigated the influence of sildenafil on cardiac contractility and diastolic relaxation and examined the distribution of phosphodiesterase type 5 in the hearts of hypertensive rats that were treated with nitro-L-arginine methyl ester (L-NAME) and sildenafil for eight weeks. They found that the sildenafil-induced Copyright 2013 CLINICS – This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.