Publications by authors named "Dario Celestino Sobral Filho"

17 Publications

  • Page 1 of 1

Beautiful death: point of view.

Rev Assoc Med Bras (1992) 2021 04;67(4):481-484

Univervidade Federal de Pernambuco, Programa de Pós-Graduação em Ciências da Saúde - Recife (PE), Brazil.

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http://dx.doi.org/10.1590/1806-9282.20200999DOI Listing
April 2021

Triggering receptor expressed on myeloid cells-1 as pediatric sepsis biomarker.

Rev Assoc Med Bras (1992) 2021 Mar;67(3):449-453

Universidade Federal de Pernambuco, Postgraduate Program in Therapeutic Innovation - Recife (PE), Brazil.

Objective: Triggering receptor expressed on myeloid cells-1 concentration can be used as a predictive, diagnostic, and prognostic marker in patients with sepsis. The objective of this study was to determine the validity of triggering receptor expressed on myeloid cells-1 levels as a biomarker of sepsis in pediatric patients.

Methods: This was an integrative literature review. PubMed, ScienceDirect, LILACS, MEDLINE, and VHL databases were searched for papers published between 2015 and 2020, using the keywords triggering receptor expressed on myeloid cells-1, sepsis, and child.

Results: The review included ten studies, of which four used triggering receptor expressed on myeloid cells-1 as a predictive biomarker; four, as a diagnostic biomarker; and two, as a prognostic biomarker. A total of 1,409 and 1,628 patients were included in primary and review studies, respectively. There was a predominance of significant results for the validity of triggering receptor expressed on myeloid cells-1 levels in the prediction, diagnosis, and prognosis of sepsis in pediatric patients.

Conclusions: Triggering receptor expressed on myeloid cells-1 is a valid predictive, diagnostic, and prognostic biomarker of sepsis with good sensitivity and specificity in the pediatric population.
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http://dx.doi.org/10.1590/1806-9282.20200765DOI Listing
March 2021

The complication of left internal jugular vein puncture.

Eur Heart J Case Rep 2021 May 14;5(5):ytab182. Epub 2021 May 14.

Universidade de Pernambuco, Rua dos Palmares, S/N, Santo Amaro, Recife-Pernambuco, Brazil.

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http://dx.doi.org/10.1093/ehjcr/ytab182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184263PMC
May 2021

How Can Galectin-3 as a Biomarker of Fibrosis Improve Atrial Fibrillation Diagnosis and Prognosis?

J Clin Med Res 2020 Oct 21;12(10):647-654. Epub 2020 Sep 21.

Postgraduate Program in Therapeutic Innovation, Federal University of Pernambuco (PPGIT/UFPE), Recife, PE, Brazil.

Galectin-3 (Gal-3) is a biomarker of fibrosis that has been associated with atrial remodeling. Acknowledging the presence of a biomarker in patients with atrial fibrillation (AF) can allow for a better clinical treatment. The aim of this study was to assess the association of Gal-3 with atrial fibrosis in patients with AF. This is a systematic review study. From the total number of studies analyzed, 12 demonstrated a relation between atrial fibrosis and Gal-3 in patients with AF and presented statistically significant association values. We conclude that Gal-3 is associated with atrial fibrosis in patients with AF in all types, as well as after the arrhythmia treatment by ablation.
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http://dx.doi.org/10.14740/jocmr4313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524564PMC
October 2020

Mortality due to congenital heart disease in Pernambuco from 1996 to 2016.

Rev Assoc Med Bras (1992) 2020 Jul 24;66(7):931-936. Epub 2020 Aug 24.

Programa de Pós-graduação em Ciências da Saúde, Faculdade de Ciências Médicas e Instituto de Ciências Biológicas, Universidade de Pernambuco, Recife, PE, Brasil.

BACKGROUND To determine the magnitude and temporal trends of deaths due to congenital heart disease (CHD) in Pernambuco between 1996 and 2016. METHODS This was an ecological, time-series study, involving all cases of deaths from congenital cardiovascular malformations in the state of Pernambuco, from 1996 to 2016, using data from DATASUS, SINASC and SIM. RESULTS There were 3,584 deaths from congenital cardiovascular malformations amongst individuals aged 0 to 14 years, of which 81.94% were concentrated in children aged under one year. The infant mortality rate (IMR) presented a linear growth trend of 0.4645 per year (p <0.01). The cause-of-death code Q24 (other congenital malformations of the heart) was present in 72.54% of the death records and 48.17% of the deaths occurred in infants aged between 28 and 364 days of life. The highest occurrence of deaths was identified in children with low birth weight (500 and 1,499g), male, premature, children of mothers without schooling, in deliveries at home (p <0.05). CONCLUSIONS Congenital heart disease still represents a public health problem as a cause of death, particularly in the first year of life, with IMR in a linear growth trend. Deaths from CHD were more prevalent in male children, born prematurely, with low birth weight, born to mothers with low schooling and deliveries without medical care.
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http://dx.doi.org/10.1590/1806-9282.66.7.931DOI Listing
July 2020

Carbohydrate antigen 125 for mortality risk prediction following acute myocardial infarction.

Sci Rep 2020 07 3;10(1):11016. Epub 2020 Jul 3.

Pronto Socorro Cardiológico de Pernambuco (PROCAPE-UPE), Recife, PE, Brazil.

Carbohydrate antigen 125 (CA125) is a congestion and inflammation biomarker and has been proved to be related to a worse prognosis in heart diseases. However, the precise relationship between elevated CA125 in patients with ST-segment elevation myocardial infarction (STEMI) has not yet been sufficiently studied. We set out to determine the association of CA125 with all-cause mortality at 6 months in STEMI. CA125, N-terminal pro brain natriuretic peptide (NTproBNP) and high sensitive C-reactive protein (hs-CRP) were measured in 245 patients admitted consecutively with STEMI undergoing coronary angioplasty. The mean age in our sample was 63.7 years, 64.9% were males, 28.3% had diabetes and 17.7% presented with acute heart failure (Killip ≥ 2). The median serum level of CA125 was 8.1 U/ml. At 6 months, the rate of all-cause mortality was 18% (44 patients). Receiver operating characteristic curve analysis demonstrated that CA125 presented similar performance to predict mortality as NTproBNP and hs-CRP. Patients with CA125 ≥ 11.48 had a higher rate of mortality (Hazard Ratio = 2.07, 95% confidence interval = 1.13-3.77, p = 0.017) than patients with CA125 < 11.48. This study suggests that elevated CA125 levels might be used to identify patients with STEMI with a higher risk of death at 6 months. CA125 seems to be a similar predictor of mortality compared to NTproBNP and hs-CRP.
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http://dx.doi.org/10.1038/s41598-020-67548-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335179PMC
July 2020

Demographic and clinical characteristics of pulmonary arterial hypertension caused by schistosomiasis are indistinguishable from other etiologies.

Rev Soc Bras Med Trop 2020 7;53:e20190418. Epub 2020 Feb 7.

Universidade de Pernambuco, Programa de Pós-Graduação em Ciências da Saúde, Recife, PE, Brasil.

Introduction: Pulmonary arterial hypertension (PAH) is a serious pulmonary circulation disease caused by several etiologies, including schistosomiasis. The present study retrospectively evaluated the clinical and hemodynamic characteristics of patients with schistosomal PAH (PAH-Sch) compared to those of non-Sch PAH patients (non-Sch PAH).

Methods: Patients treated at the Pronto-Socorro Cardiológico de Pernambuco and diagnosed by right cardiac catheterization were divided into PAH-Sch and non-Sch PAH groups. Their socio-demographic and clinical characteristics, N-terminal-pro B-type natriuretic peptide (NT-proBNP), and echocardiography and hemodynamic parameters were retrospectively reviewed.

Results: Among the included 98 patients (mean age, 45 ± 14 years; 68 women [69.4%]), we found 56 PAH-Sch and 42 non-Sch PAH. The age distribution was heterogeneous in the PAH-Sch group, with patients predominantly ranging from 50-59 (p <0.004). Dyspnea was the most common symptom, reported by 92 patients (93.8%), and commonly present for over two years prior to diagnosis. Clinical symptoms were similar in both groups, with no differences in functional class, pulmonary artery systolic pressure (p = 0.102), 6-minute walk test score (p = 0.234), NT-proBNP serum levels (p = 0.081), or hemodynamic parameters.

Conclusions: Patients with PAH-Sch present clinical, laboratory, and hemodynamic profiles similar to those with PAH resulting from other etiologies of poor prognosis. PAH is an important manifestation of schistosomiasis in endemic regions that is often diagnosed late.
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http://dx.doi.org/10.1590/0037-8682-0418-2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083352PMC
March 2020

Polymorphisms of and genes related to time in therapeutic range in patients with atrial fibrillation using warfarin.

Appl Clin Genet 2019 2;12:151-159. Epub 2019 Aug 2.

Pronto Socorro Cardiológico Professor Luiz Tavares - PROCAPE/UPE , Recife, Brazil.

Introduction: Warfarin continues to be the most widely used anticoagulant in clinical practice around the world for the prevention of thromboembolic events in patients with atrial fibrillation (AF). The evaluation of the quality of anticoagulation control, estimated by time in therapeutic range (TTR), is accepted as a good method to evaluate the quality of anticoagulation. The variability of TTR can be explained by the presence of variants of the and genes.

Methods: This study examined the association between polymorphisms of the  and  genes and control of oral anticoagulation, through TTR, in patients with AF. A cross-sectional study was conducted within a cohort follow-up. The study comprised of 317 patients with AF, using warfarin, who were followed up for one year. The genotyping of genes (rs1057910), (rs1799853) and (rs923231) was performed by PCR in real time, using TaqMan probes.

Results: Patients who had variant genotypes for the gene (rs1057910) presented higher TTR (TTR 81-100%) when compared to when compared to the <45% and 46-60% TTR groups (=0.005 and =0.002, respectively). Regarding (rs923231), patients who had the variant genotype for the (rs923231) gene also presented a higher TTR (TTR 81-100%), when when compared to the <45% and 46-60% TTR groups (=0.005 and =0.004, respectively). In a multivariate model, (rs923231) remained associated for comparisons with the TTR groups (<45% vs 81-100% groups, =0.01; and 46-60% vs 81-100% groups, =0.01).

Conclusion: The genotypes of the (AA) and -1639 (GG) genes were associated with the worst quality of anticoagulation control (TTR) in patients with AF using warfarin in the northeast of Brazil.
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http://dx.doi.org/10.2147/TACG.S197316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6684853PMC
August 2019

Expression of microRNAs (133b and 138) and Correlation with Echocardiographic Parameters in Patients with Alcoholic Cardiomyopathy.

Microrna 2020 ;9(2):112-120

Faculdade de Ciencias Medicas/ Universidade de Pernambuco - FCM/UPE, Recife, Pernambuco, Brazil.

Introduction: Alcoholic Cardiomyopathy (ACM) is a disease with a difficult diagnosis. The real mechanisms related to its pathophysiology are not fully understood.

Objective: The aims of this study were to investigate whether miR-133b and miR-138 could be associated with ACM.

Methods: Forty-four patients were included comprising 24 with ACM and 20 with cardiomyopathies of different etiologies (control group). Real-time PCR was performed to verify the relative expression among the studied groups. In the statistical analysis, the quantitative variables t-student Mann- Whitney and correlation of Pearson tests were carried out, while the qualitative variable comprised the chi-square test, with p<0.05 being considered statistically significant.

Results: There was no association between clinical and sociodemographic characteristics of the groups. The patients with ACM presented downregulation of miR-133b in comparison with control patients (p=0.004). On the other hand, for the miR-138, there was no association when the ACM group was compared with the control group. The presence of miR-133b among cases and controls was not correlated with any of the echocardiographic parameters. However, the increase in the expression of miR-138 was correlated with an increase in the ejection fraction (r=0.28, p=0.01) and the diameter of the left atrium (r=0.23, p=0.04) in patients with ACM.

Conclusion: The downregulation of miR-133b might be a marker for ACM and, in addition, miR- 138 could be used to correlate the increase in ejection fraction with and normalization of the diameter of the left atrium diameter in patients with this disease.
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http://dx.doi.org/10.2174/2211536608666190716151900DOI Listing
May 2021

Hematological Parameters as Prognostic Biomarkers in Patients with Cardiovascular Diseases.

Curr Cardiol Rev 2019 ;15(4):274-282

University of Pernambuco, Recife, Pernambuco, Brazil.

Cardiovascular diseases are the major causes of preventable health loss from disease in the world and lead to functional disturbances including hematological parameters. The inflammatory and hypoxemic nature of cardiovascular diseases causes a stimulus in the bone marrow and, depending on the intensity of this stimulus, there is a release of immature cells or increase of other cells in the bloodstream. Therefore, their presence in the circulation is an important variable used to diagnose, stratify and predict diseases. In the last five decades, with the advent of automated counting of immature cells in the peripheral blood, the hemogram was transformed into a clinical tool of great importance in hospital surveillance for demonstrating this daily variability in the hematopoietic response according to the existing injury in the patient. Studies have shown that the presence of nucleated red blood cells and increases in mean platelet volume, immature granulocytes and neutrophil to lymphocyte ratio in the systemic circulation are independent prognostic biomarkers. This review article has as main objective to demonstrate the association of these hematological parameters to cardiovascular diseases, emphasizing their importance in clinical decision making.
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http://dx.doi.org/10.2174/1573403X15666190225123544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823671PMC
November 2019

Impact of surgical aortic root enlargement on the outcomes of aortic valve replacement: a meta-analysis of 13 174 patients.

Interact Cardiovasc Thorac Surg 2019 07;29(1):74-82

Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Brazil.

Objectives: This study sought to evaluate the impact of surgical aortic root enlargement (ARE) on the perioperative outcomes of aortic valve replacement (AVR).

Methods: Databases were searched for studies published until April 2018 to carry out a systematic review followed by meta-analysis of results.

Results: The search yielded 1468 studies for inclusion. Of these, 10 articles were analysed and their data extracted. A total of 13 174 patients (AVR with ARE: 2819 patients; AVR without ARE: 10 355 patients) were included from studies published from 2002 to 2018. The total rate of ARE was 21.4%, varying in the studies from 5.7% to 26.3%. The overall odds ratio (OR) [95% confidence interval (CI)] for perioperative mortality showed a statistically significant difference between the groups (among 10 studies), with a higher risk in the 'AVR with ARE' group (OR 1.506, 95% CI 1.209-1.875; P < 0.001), but not when adjusted for isolated AVR + ARE without any concomitant procedures such as mitral valve surgery, coronary artery bypass surgery, etc. (OR 1.625, 95% CI 0.968-2.726; P = 0.066-among 6 studies). The 'AVR with ARE' group showed an overall lower risk of significant patient-prosthesis mismatch among 9 studies (OR 0.472, 95% CI 0.295-0.756; P = 0.002) and a higher overall difference in means of indexed effective orifice area among 10 studies (random-effect model: 0.06 cm2/m2, 95% CI 0.029-0.103; P < 0.001).

Conclusions: Surgical ARE seems to be associated with increased perioperative mortality but with lower risk of patient-prosthesis mismatch.
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http://dx.doi.org/10.1093/icvts/ivy364DOI Listing
July 2019

Surgical aortic valve replacement and patient-prosthesis mismatch: a meta-analysis of 108 182 patients.

Eur J Cardiothorac Surg 2019 Jul;56(1):44-54

Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.

Objectives: This study sought to evaluate the impact of patient-prosthesis mismatch (PPM) on the risk of perioperative, early-, mid- and long-term mortality rates after surgical aortic valve replacement.

Methods: Databases were searched for studies published until March 2018. The main outcomes of interest were perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality.

Results: The search yielded 3761 studies for inclusion. Of these, 70 articles were analysed, and their data were extracted. The total number of patients included was 108 182 who underwent surgical aortic valve replacement. The incidence of PPM after surgical aortic valve replacement was 53.7% (58 116 with PPM and 50 066 without PPM). Perioperative mortality [odds ratio (OR) 1.491, 95% confidence interval (CI) 1.302-1.707; P < 0.001], 1-year mortality (OR 1.465, 95% CI 1.277-1.681; P < 0.001), 5-year mortality (OR 1.358, 95% CI 1.218-1.515; P < 0.001) and 10-year mortality (OR 1.534, 95% CI 1.290-1.825; P < 0.001) were increased in patients with PPM. Both severe PPM and moderate PPM were associated with increased risk of perioperative mortality, 1-year mortality, 5-year mortality and 10-year mortality when analysed together and separately, although we observed a higher risk in the group with severe PPM.

Conclusions: Moderate/severe PPM increases perioperative, early-, mid- and long-term mortality rates proportionally to its severity. The findings of this study support the implementation of surgical strategies to prevent PPM in order to decrease mortality rates.
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http://dx.doi.org/10.1093/ejcts/ezy466DOI Listing
July 2019

Prognostic value of hematological parameters in patients with acute myocardial infarction: Intrahospital outcomes.

PLoS One 2018 18;13(4):e0194897. Epub 2018 Apr 18.

University of Pernambuco, Recife, Pernambuco, Brazil.

Background: The intensity of the inflammatory response and hemodynamic repercussion in acute myocardial infarction causing the presence in the peripheral circulation of nucleated red blood cells (NRBCs), increases in mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) are associated with a poorer prognosis. The aim of this study was to assess the role of these hematological biomarkers as predictors of all causes of mortality during the hospitalization of patients with acute myocardial infarction.

Methods: Nucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio were measured daily during the hospitalization of the patients with acute myocardial infarction. We excluded patients younger than 18 years, on glucocorticoid therapy, with cancer or hematological diseases and those that were readmitted after hospital discharge. We performed a multiple logistic analysis to identify independent predictors of mortality.

Results: We included 466 patients (mean age 64.2 ± 12.8 years, 61.6% male). The prevalence of NRBCs in the sample was 9.1% (42 patients), with levels > 200/μL in 27 patients (5.8%). The mean MPV value was 10.9 ±0,9 and the mean NLR value was 3.71 (2,38; 5,72). In a multivariate analysis of serum NRBCs (HR 2.42, 95% CI: 1.35-4.36, p = 0.003), MPV (HR 2.97, 95% CI: 1.15-7.67, p = 0.024) and NLR (HR 5.02, 95% CI: 1.68-15.0, p = 0.004). The presence in the peripheral blood of NRBCs, increased in mean platelet volume and neutrophil to lymphocyte ratio were associated with higher mortality.

Conclusions: Nucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio are independent predictors of intrahospital mortality. Therefore, an important tool in intrahospital clinical surveillance.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194897PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5905886PMC
July 2018

Nucleated Red Blood Cells as Predictors of All-Cause Mortality in Cardiac Intensive Care Unit Patients: A Prospective Cohort Study.

PLoS One 2015 29;10(12):e0144259. Epub 2015 Dec 29.

Coronary Care Unit of PROCAPE (Pernambuco Cardiac Emergency Hospital), University of Pernambuco (UPE), Recife, Pernambuco, Brazil.

Background: The presence of nucleated red blood cells (NRBCs) in the peripheral blood of critically ill patients is associated with a poorer prognosis, though data on cardiovascular critical care patients is lacking. The aim of the present study was to assess the role of NRBCs as a predictor of intensive care unit (ICU) and in hospital all-cause mortality among cardiologic patients.

Methods: NRBCs were measured daily in consecutive cardiac ICU patients, including individuals with both coronary and non-coronary acute cardiac care. We excluded patients younger than 18 years, with cancer or hematological disease, on glucocorticoid therapy, those that were readmitted after hospital discharge and patients who died in the first 24 hours after admission. We performed a multiple logistic analysis to identify independent predictors of mortality.

Results: We included 152 patients (60.6 ± 16.8 years, 51.8% female, median ICU stay of 7 [4-11] days). The prevalence of NRBCs was 54.6% (83/152). The presence of NRBC was associated with a higher ICU mortality (49.4% vs 21.7%, P<0.001) as well as in-hospital mortality (61.4% vs 33.3%, p = 0.001). NRBC were equally associated with mortality among coronary disease (64.71% vs 32.5% [OR 3.80; 95%CI: 1.45-10.0; p = 0.007]) and non-coronary disease patients (61.45% vs 33.3% [OR 3.19; 95%CI: 1.63-6.21; p<0.001]). In a multivariable model, the inclusion of NRBC to the APACHE II score resulted in a significant improvement in the discrimination (p = 0.01).

Conclusions: NRBC are predictors of all-cause in-hospital mortality in patients admitted to a cardiac ICU. This predictive value is independent and complementary to the well validated APACHE II score.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0144259PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695082PMC
July 2016

Relation between heart rate recovery after exercise testing and body mass index.

Rev Port Cardiol 2015 Jan 8;34(1):27-33. Epub 2015 Jan 8.

Departamento de Pós-Graduação em Ciências da Saúde, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.

Introduction: Impaired heart rate (HR) recovery after exercise testing is considered a predictor of cardiovascular mortality as it reflects vagus nerve dysfunction.

Objective: To assess the relationship between body mass index (BMI) and HR recovery after exercise.

Methods: We analyzed the records of 2443 patients of both sexes, aged between 20 and 59 years, in sinus rhythm, not using negative chronotropic agents and with no myocardial ischemic response to exercise testing carried out at a specialist clinic, between 2005 and 2011. BMI was categorized as normal (18.5-<25 kg/m(2)), overweight (25-≤30 kg/m(2)) or obese (>30 kg/m(2)). The different BMI groups were compared in terms of HR recovery after exercise, which was calculated as the difference between maximum HR during exercise and in the first minute of recovery. Recovery was considered impaired when the difference was ≤12 bpm.

Results: Eighty-seven (3.6%) patients presented impaired recovery, which was three times more prevalent in the obese group and twice as prevalent in the overweight group compared with the normal group (p<0.001 and p=0.010, respectively). Obese patients presented higher basal HR and lower maximum HR, as well as reduced chronotropic reserve (p<0.001). In multivariate analysis, impaired HR recovery was associated with overweight (relative risk [RR]=1.8; p=0.035), obesity (RR=2; p=0.016), number of metabolic equivalents (RR=0.82; p<0.001) and resting HR (RR=1.05; p<0.001). The hazard ratio for hypertension was 2 (p=0.083, NS).

Conclusion: Impaired HR recovery was associated with higher BMI, demonstrating that obese individuals present vagus nerve dysfunction.
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http://dx.doi.org/10.1016/j.repc.2014.07.006DOI Listing
January 2015
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