OBJECTIVE: To test the hypotheses that 1) coronary artery disease patients with lower aerobic fitness exhibit a lower ventilatory efficiency and 2) coronary artery disease patients with lower initial aerobic fitness exhibit greater improvements in ventilatory efficiency with aerobic exercise training. METHOD: A total of 123 patients (61.0±0.7 years) with coronary artery disease were divided according to aerobic fitness status into 3 groups: group 1 (n = 34, peak VO2<17.5 ml/kg/min), group 2 (n = 67, peak VO2>17.5 and <24.5 ml/kg/min) and group 3 (n = 22, peak VO2>24.5 ml/kg/min). All patients performed a cardiorespiratory exercise test on a treadmill. Ventilatory efficiency was determined by the lowest VE/VCO2 ratio observed. The exercise training program comprised moderate-intensity aerobic exercise performed 3 times per week for 3 months. Clinicaltrials.gov: NCT02106533 RESULTS: Before intervention, group 1 exhibited both lower peak VO2 and lower ventilatory efficiency compared with the other 2 groups (p<0.05). After the exercise training program, group 1 exhibited greater improvements in aerobic fitness and ventilatory efficiency compared with the 2 other groups (group 1: ▵ = -2.5±0.5 units; group 2: ▵ = -0.8±0.3 units; and group 3: ▵ = -1.4±0.6 units, respectively; p<0.05). CONCLUSIONS: Coronary artery disease patients with lower aerobic fitness status exhibited lower ventilatory efficiency during a graded exercise test. In addition, after 3 months of aerobic exercise training, only the patients with initially lower levels of aerobic fitness exhibited greater improvements in ventilatory efficiency.

OBJECTIVE: The purpose of this study was to evaluate the following: 1) the effects of continuous exercise training and interval exercise training on the end-tidal carbon dioxide pressure (PETCO2) response during a graded exercise test in patients with coronary artery disease; and 2) the effects of exercise training modalities on the association between PETCO2 at the ventilatory anaerobic threshold (VAT) and indicators of ventilatory efficiency and cardiorespiratory fitness in patients with coronary artery disease. METHODS: Thirty-seven patients (59.7 + 1.7 years) with coronary artery disease were randomly divided into two groups: continuous exercise training (n = 20) and interval exercise training (n = 17). All patients performed a graded exercise test with respiratory gas analysis before and after three months of the exercise training program to determine the VAT, respiratory compensation point (RCP) and peak oxygen consumption. RESULTS: After the interventions, both groups exhibited increased cardiorespiratory fitness. Indeed, the continuous exercise and interval exercise training groups demonstrated increases in both ventilatory efficiency and PETCO2 values at VAT, RCP, and peak of exercise. Significant associations were observed in both groups: 1) continuous exercise training (PETCO2VAT and cardiorespiratory fitness r = 0.49; PETCO2VAT and ventilatory efficiency r = -0.80) and 2) interval exercise training (PETCO2VAT and cardiorespiratory fitness r = 0.39; PETCO2VAT and ventilatory efficiency r = -0.45). CONCLUSIONS: Both exercise training modalities showed similar increases in PETCO2 levels during a graded exercise test in patients with coronary artery disease, which may be associated with an improvement in ventilatory efficiency and cardiorespiratory fitness.

Dieta hipocalórica e atividade física aeróbia promovem perda de peso e melhora do perfil lipídico de adultos obesos, entretanto pouco se conhece em crianças obesas, sendo este o objetivo do trabalho. Estudamos cinqüenta crianças obesas e dividimos em dois grupos pareados: Grupo D (dieta com 55% de carboidrato, 30% de gordura e 15% de proteína - 1.500 e 1.800 kcal) e Grupo DE (mesma dieta + atividade física aeróbia 1 hora por dia, três vezes por semana). Após cinco meses, avaliamos: índice de massa corpórea (IMC), triglicerídeos, colesterol total (CT) e frações. Nenhuma modificação foi observada nos triglicerídeos, CT e lipoproteína de baixa-densidade colesterol (LDL-C) em ambos os grupos. Houve, porém, aumento da lipoproteína de alta-densidade colesterol (HDL-C) apenas no grupo DE (+10,3%, p< 0,01). Selecionando pacientes com CT > 170 mg/dL, LDL-C > 110 mg/dL e HDL-C < 35 mg/dL, observou-se redução semelhante do CT nos dois grupos (-6,0% x -6,0%; p= ns), assim como da LDL-C de ambos (-14,2% x -13,5%; p= ns), e um acréscimo da HDL-C apenas no grupo DE (+10,0%; p< 0,05). Conclusões: 1) Dieta hipocalórica (DH) e atividade física aeróbia promovem aumento da HDL-C, independente do valor basal, em crianças obesas quando comparado à DH isoladamente; 2) DH isoladamente ou associada a exercício aeróbio reduz CT e LDL-C, quando estes estão em níveis acima do valor normal, em crianças obesas.

Diet and exercise help improve obese adults' lipid profile. However, their effect on obese children, the aim of the present study, is poorly known. Fifty obese children were studied into 2 paired groups: Group D (1,500 - 1,800 kcal diet: 55% carbohydrate, 30% fat, 15% protein), and Group DE (same diet + aerobic physical activity 1 hour/day 3 times a week). After 5 months BMI, triglycerides, total cholesterol (TC) and fractions were assessed. No change in triglycerides, TC and low-density lipoprotein cholesterol (LDL-C) levels were reported in both groups. However, high-density lipoprotein cholesterol (HDL-C) increased (+10.3%; p< 0.01) only in DE Group. Screening patients with TC > 170 mg/dL, LDL-C > 110 mg/dL and HDL-C < 35 mg/dL we had: similar reduction for TC in both groups (-6.0% x -6.0%; p= ns), LDL-C reduction in both groups (-14.2% x -13.5%; p= ns), and HDL-C increase only in DE Group (+10.0%; p< 0.05). Conclusions: 1) Hypocaloric diet (HD) + exercise, rather than diet only, increase obese children's HDL-C levels irrespective of baseline levels; 2) HD only and HD + exercise lead to TC and LDL-C reduction in obese children with TC and LDL-C above normal values.