Claudio Gil Araujo

• MD, PhD
• Dean of Research and Education at CLINIMEX - Clínica de Medicina do Exercício (Exercise Medicine Clinic), Rio de Janeiro, Brazil

Purpose Given the rising burden of heart failure (HF), stratification of patients at increased risk for adverse events is critical. We aim to compare the predictive value of various maximal and submaximal cardiopulmonary exercise test (CPET) variables for adverse events in patients with HF. Methods 237 patients with HF (66 [58-73] years, 30% women...

Objectives Flexibility is recognized as one of the components of physical fitness and commonly included as part of exercise prescriptions for all ages. However, limited data exist regarding the relationship between flexibility and survival. We evaluated the sex‐specific nature and magnitude of the associations between body flexibility and natural a...

This PDF file include all evaluation maps for assessing the maximal passive range of motion in the 20 joint movements in included on the FLEXITEST. In each one of the 20 evaluation maps there is a description of the positioning of the evaluator and the individual's being evaluated & some hints to improve the scoring by the evaluator

Introduction: We assessed the cardiorespiratory optimal point (COP) - the minimal VE/VO2 in a given minute of an incremental cardiopulmonary exercise test - in patients with heart failure (HF) and aimed to determine 1) its association with patient and disease characteristics, 2) changes following an exercise-based cardiac rehabilitation program (C...

Purpose: The cardiorespiratory optimal point (COP) is the minimum ventilatory equivalent for oxygen. The COP can be determined during a submaximal incremental exercise test. Reflecting the optimal interaction between the respiratory and cardiovascular systems, COP may have prognostic utility. The aim of this investigation was to determine the rela...

Objectives Balance quickly diminishes after the mid-50s increasing the risk for falls and other adverse health outcomes. Our aim was to assess whether the ability to complete a 10- s one-legged stance (10-second OLS) is associated with all-cause mortality and whether it adds relevant prognostic information beyond ordinary demographic, anthropometri...

Introduction: Early childhood is the most critical period of healthy motor and cognitive development in human life and increased physical activity may provide health benefits across childhood and adolescence. Objective: The aim of this study was to quantify the relationship between non-aerobic physical fitness and cognitive development in preschool...

Background: Cardiorespiratory optimal point (COP) during exercise, a potentially useful submaximal cardiopulmonary exercise testing (CPET) variable, may be an independent risk factor for cardiovascular disease outcomes. However, the relationship of COP with risk of sudden cardiac death (SCD) has not been previously investigated. We sought to evalu...

Cardiorespiratory optimal point (COP) during exercise may be a potentially clinically useful cardiopulmonary exercise testing (CPET) variable, but its prognostic relevance for adverse cardiovascular disease (CVD) outcomes is unknown. We aimed to assess the association of COP during exercise with fatal mortality outcomes and the extent to which COP...

Purpose: Medically supervised exercise programs (MSEPs) are equally recommended for men and women with cardiovascular disease (CVD). Aware of the lower CVD mortality in women, we hypothesized that among patients attending a MSEP, women would also have better survival. Methods: Data from men and women, who were enrolled in a MSEP between 1994 and...

Background and Objective: The COVID-19 pandemic has heavily hit Brazil and, in particular, our Clinic's current location in Copacabana, Rio de Janeiro city, where, as of mid-February 2021, resulting in one 1 death per 266 inhabitants. After having recently updated the vital status and mortality data in our exercise population (CLINIMEX cohort), we...

Impairments in heart rate (HR) reserve and HR recovery are associated with mortality, and the combination of these two, termed exercise HR gradient (EHRG), is a better predictor than either alone. However, the confounding effect of beta-blockade on chronotropic impairment to exercise has not been fully explored; the aim of the present study was to...

The inverse association between physical activity and arterial thrombotic disease is well established. Evidence on the association between physical activity and venous thromboembolism (VTE) is divergent. We conducted a systematic review and meta-analysis of published observational prospective cohort studies evaluating the associations of physical a...

Purpose: We aimed to assess the associations of handgrip strength (HS) with cardiovascular and all-cause mortality and whether adding data on HS to cardiovascular disease (CVD) risk factors is associated with improvement in CVD mortality prediction. Design: Handgrip strength was assessed in a population-based sample of 861 participants aged 61-74 y...

Cardiovascular disease (CVD) is the leading cause of death worldwide and in Brazil, leading to increased morbidity and disability-adjusted life year (DALY). Despite the decrease in mortality rates and DALY standardized by age in Brazil, possibly as a result of successful health policies, their total number is increasing, mainly due to aging and ill...

Background/objective: Obesity is a chronic disease, a risk factor for other chronic conditions and for early mortality, and is associated with higher health care utilization. Annual spending among obese individuals is at least 30% higher vs. that for normal-weight peers. In contrast, higher cardiorespiratory fitness (CRF) is related to many health...

Background Physical inactivity has been shown to be associated with all-cause mortality in both healthy and unhealthy middle-aged and older individuals. While regular exercise is equally recommended for men and women, it is virtually unknown if sex influences the long-term survival among participants of a medically-supervised exercise program (MSEP...

Background: Cardiorespiratory (aerobic) fitness is strongly and directly related to major health outcomes, including all-cause mortality. Maximum oxygen uptake (VO2max), directly measured by maximal cardiopulmonary exercise test (CPET), represents the subject’s aerobic fitness. However, as CPET is not always available, aerobic fitness estimation to...

The use of technology has increased tremendously, by means of more reliable, smaller, more accessible and specially more user-friendly devices, which provide a wider range of features, and promote significant benefits for the population and health professionals. It is in this context that monitors and apps for heart rate (HR) measurement have emerg...

Objectives. The inverse and independent association between cardiorespiratory fitness (CRF) and arterial thrombotic disease is well established. However, the potential association between CRF and venous thromboembolism (VTE) is not well known. We aimed to assess the prospective association of CRF with the risk of VTE. Design. Cardiorespiratory fitn...

Objective: Sauna bathing is becoming a common activity in many countries and it has been linked to favorable health outcomes. However, there is limited data on the heart rate (HR) and heart rate variability (HRV) responses to an acute sauna exposure. Design: We conducted a single-group, longitudinal study utilizing a pre-post design to examine a...

This brief research letter presents sex- and age-reference data for the sitting-rising test (SRT), a good predictor of survival in middle-aged and older subjects, derived from 6141 adult men and women (16 to 98 years of age). Results are presented in several charts For free download go to journal's DOI link https://doi.org/10.1177/204748731984700...

BACKGROUND: There is limited evidence regarding the use of exercise training in the treatment of panic disorder. OBJECTIVE: To describe the role of psychological and cardiorespiratory variables in the therapeutic effect of a 12-week exercise training in panic disorder patients. METHODS: Eleven symptomatic panic disorder patients completed 24 sessio...

Background: Maximal oxygen consumption (VO2max) and ventilatory threshold (VT) obtained during a cardiopulmonary exercise test (CPX) are used in the evaluation of athletes. However, the identification of these variables may sometimes be unreliable, which limits their use. In contrast, the cardiorespiratory optimal point (COP) is a submaximal variab...

BACKGROUND: Cardiac vagal index (CVI) is supposedly higher in athletes and may differ between sports and/or between field positions. OBJECTIVE: To compare CVI: a) between elite football players vs. non-athletes and b) according to five football positions. METHOD: 242 football players of the first Brazilian/Angolan division were divided in five po...

Background Maximal oxygen uptake (VO 2 max) is a powerful predictor of health outcomes. Valid and portable reference values are integral to interpreting measured VO 2 max; however, available reference standards lack validation and are specific to exercise mode. This study was undertaken to develop and validate a single equation for normal standards...

Background Preliminary evidence suggests that peak exercise oxygen pulse – peak oxygen uptake/heart rate-, a variable obtained during maximal cardiopulmonary exercise testing and a surrogate of stroke volume, is a predictor of mortality. We aimed to assess the associations of peak exercise oxygen pulse with sudden cardiac death, fatal coronary hear...

The purpose was to analyze the effect of the ingestion of two amounts of water in the autonomic modulation. A total of 26 men aged 18-30 years under went 2 days of intervention and evaluation with 24 hours in between. The protocol consisted of the intake of 250 or 500 mL of water in a random order. To assess the initial transient HR during dynamic...

Background: Exercise-based cardiac rehabilitation tends to reduce mortality. However, it requires medium/long-term adherence to regular physical exercise. It is relevant to identify the variables that affect adherence to an supervised exercise program (SEP). Objective: To evaluate the influence of pre-participation levels of aerobic and non-aerobi...

The cardiorespiratory optimal point (COP) is a novel index, calculated as the minimum oxygen ventilatory equivalent (VE/VO2) obtained during cardiopulmonary exercise testing (CPET). In this study we demonstrate the prognostic value of COP both independently and in combination with maximum oxygen consumption (VO2max) in community-dwelling adults.

Introduction and aim: The cardiorespiratory optimal point (COP) is a novel index, calculated as the minimum oxygen ventilatory equivalent (VE/VO2) obtained during cardiopulmonary exercise testing (CPET). In this study we demonstrate the prognostic value of COP both independently and in combination with maximum oxygen consumption (VO2max) in commun...

Cardiopulmonary exercise test (CPET) has been gaining importance as a method of functional assessment in Brazil and worldwide. In its most frequent applications, CPET consists in applying a gradually increasing intensity exercise until exhaustion or until the appearance of limiting symptoms and/or signs. The following parameters are measured: venti...

OBJECTIVE To assess the influence of central obesity on the magnitude of the error of estimate of maximal oxygen uptake in maximal cycling exercise testing. METHOD A total of 1,715 adults (68% men) between 18-91 years of age underwent cardiopulmonary exercise testing using a progressive protocol to volitional fatigue. Subjects were stratified by c...

Introdução: A flexibilidade corporal é um dos componentes da aptidão física relacionada com a saúde e desempenho físico. Esse componente tende a diminuir com o envelhecimento, sendo passível de modificação por treinamento específico; por outro lado, essas adaptações favoráveis tendem a desaparecer com destreinamento. Objetivo: Avaliar a influência...

According to cognitive behavioral models (CBT), panic attacks (PA) arise from distorted and catastrophic interpretations of bodily symptoms. As exercising involves exposure to physiological stimuli similar to those experienced during PAs, patients often experience anxiety and avoid exercising. Exercise avoidance and low levels of everyday physical...

Objective: To assess the influence of age on the error of estimate (EE) of maximal oxygen uptake (VO2max) using sex and population specific-equations in cycle ergometer exercise testing, since estimated VO2 max is associated with a substantial EE, often exceeding 20%, possibly due to intrinsic variability of mechanical efficiency. Methods: 1850...

Sexual activity (SA) encompasses several behaviors such as kissing (Ki), touching (T), oral (O) stimulation, masturbation (M), and vaginal/anal intercourse (I). The acronym KiTOMI is proposed here to represent these behaviors. SA, particularly coitus, is a major aspect of health-related quality of life and is often considered the most pleasant and...

Background: Aerobic fitness, assessed by measuring VO2max in maximum cardiopulmonary exercise testing (CPX) or by estimating VO2max through the use of equations in exercise testing, is a predictor of mortality. However, the error resulting from this estimate in a given individual can be high, affecting clinical decisions. Objective: To determine...

Physiological reflexes modulated primarily by the vagus nerve allow the heart to decelerate and accelerate rapidly after a deep inspiration followed by rapid movement of the limbs. This is the physiological and pharmacologically validated basis for the 4-s exercise test (4sET) used to assess the vagal modulation of cardiac chronotropism. To present...

Inspiratory muscle training (IMT) has been shown to generate significant benefits in different clinical conditions, however, there is scarce information regarding acute clinical and hemodynamic effects. To evaluate clinical, hemodynamic and electrocardiographic responses during a single short inspiratory muscle training (IMT) session in patients en...

Panic disorder (PD) patients often report respiratory symptoms and tend to perform poorly during maximal cardiopulmonary exercise testing (CPX), at least partially, due to phobic anxiety. Thus, we hypothesized that a submaximal exercise variable, minimum VE/VO2 - hereafter named cardiorespiratory optimal point (COP) -, may be useful in their clinic...

In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR). In the context of the implementation of a regional and national health policy i...

OBJECTIVES: The anxiolytic effect of regular aerobic exercise in panic disorder patients is well known. However, a protocol for aerobic exercise intervention as an adjunct non-pharmacologic treatment for panic disorder is still lacking. Our aim was to propose and present a pilot study about an aerobic training protocol that could be replicable, saf...

In their professional practices, physicians often face unexpected situations or chance on innovative proposals and ideas. As a result of their training and competence, they usually come up with hypotheses to be tested and research is conducted. This research is completed and their results submitted for presentations at conferences as free communica...

Number of subjects currently participating in high-endurance aerobic exercise training regimens and competitions has substantially increased in recent years. While there is no doubt that regular exercise practice is fundamental for the maintenance of a good health, there have been reports of cardiac structural changes of subjects exposed to strenuo...

Artigo recebido em 24/07/13; revisado em 09/08/13; aceito em 12/08/13. Palavras-chave Artigo de Revista; Redação; Metodologia; Bibliometria. DOI: xxx/abc.2013xxxx No exercício profissional, o médico se depara frequentemente com situações inéditas ou propostas e ideias inovadoras. Muitas vezes, como fruto do seu treinamento e competência, surgem hip...

Although substantial evidence relates reduced exercise heart rate (HR) reserve and recovery to a higher risk of all-cause mortality, a combined indicator of these variables has not been explored. Our aim was to combine HR reserve and recovery into a single index and to assess its utility to predict all-cause mortality. Retrospective cohort analysis...

Introducción y objetivos: el cobre (Cu) es un oligoelemento muy estudiado, pero poco se sabe de su evolución en los pacientes alimentados por gastrostomía endoscópica (GEP). Pretendemos evaluar la evolución del Cu sérico desde la gastrostomía hasta 12 semanas después de la intervención en estos pacientes alimentados con preparaciones domésticas. Mé...

Treinamento para disfunção vagal cardíaca com repetições da transição repouso-exercício Título em inglês: Training for cardiac vagal dysfunction with repetitions of rest-exercise transition Resumo Disfunção vagal cardíaca está associada com um pior prognóstico clínico e um dos potenciais benefícios do exercício físico regular é aumentar o tônus vag...

Resumo Fundamentos: A ansiedade cardíaca (AC) é o medo de sensações cardíacas, caracterizado por sintomas recorrentes de ansiedade em pacientes com ou sem doença cardiovascular. O Questionário de Ansiedade Cardíaca (QAC) é uma ferramenta para avaliar a AC, já adaptado, mas não validado em português. Objetivo: Este trabalho apresenta as três fases d...

Hypertension, or the chronic elevation in resting arterial blood pressure (BP), is a significant risk factor for cardiovascular disease and estimated to affect ~1 billion adults worldwide. The goals of treatment are to lower BP through lifestyle modifications (smoking cessation, weight loss, exercise training, healthy eating and reduced sodium inta...

Cardiac Anxiety (CA) is the fear of cardiac sensations, characterized by recurrent anxiety symptoms, in patients with or without cardiovascular disease. The Cardiac Anxiety Questionnaire (CAQ) is a tool to assess CA, already adapted but not validated to Portuguese. This paper presents the three phases of the validation studies of the Brazilian CAQ....

Análise da estabilidade de uma variável submáxima em teste cardiopulmonar de exercício: ponto ótimo cardiorrespiratório Analysis of the stability of a submaximal variable in the cardiopulmonary exercise testing: Cardiopulmonary optimal point Resumo O presente estudo teve por objetivo investigar a estabilidade do ponto ótimo cardiorrespiratório (POC...

Background: The heart rate (HR) achieved at the end of an exercise test (ET) is called maximal HR and is known to have clinical and epidemiological relevance. For its correct measurement, it is necessary that the ET be truly maximal. Objective: To evaluate the influence of a history of intense physical activity and/or participation in sports com...

Although aging is commonly linked to a reduction in joint range of motion, it is unclear if all body joints behave similarly. To address this issue, the main purpose of this study was to compare age-related loss of mobility of seven body joints. A total of 6,000 participants (3,835 men and 2,165 women) aged 5 to 92 years took part in this study. Th...

Background: While cardiorespiratory fitness is strongly related to survival, there are limited data regarding musculoskeletal fitness indicators. Our aim was to evaluate the association between the ability to sit and rise from the floor and all-cause mortality. Design: Retrospective cohort. Methods: 2002 adults aged 51-80 years (68% men) perfo...

Cardiac vagal tone (CVT), a key determinant of resting heart rate (HR), is progressively withdrawn with incremental exercise and nearly abolished at maximal effort. While maximal HR decreases with age, there remains a large interindividual variability of results for any given age. In the present study, we hypothesized that CVT does not contribute t...

Objective: The purpose of this study was to establish whether flexibility influences the ability to sit and rise from the floor. Design: Subjects aged 6-92 yrs (n = 3927 [2645 men]) performed the Sitting-Rising Test (SRT) and the Flexitest on the same laboratory visit. The SRT evaluates components of musculoskeletal function by assessing the sub...

Background: At the maximal Cardiopulmonary Exercise Testing (CPET), several ventilatory variables are analyzed, including the ventilatory equivalent for oxygen (VE/VO2). The minimum VE/VO2 value reflects the best integration between the respiratory and cardiovascular systems and may be called "Cardiorespiratory Optimal Point (COP)". Objective: T...

Regular physical exercise has been shown to favorably influence mood and anxiety; however, there are few studies regarding psychiatric aspects of physically active patients with coronary artery disease (CAD). The objective of the present study was to compare the prevalence of psychiatric disorders and cardiac anxiety in sedentary and exercising CAD...

Several indicators have been used to analyze scientific journals, with the impact factor and the number of citations in a 2-yr calendar time frame (2-YRC) being the most common factors. However, considering that the Journal of Applied Physiology (JAPPL) appears monthly and that calculations of these indicators are based on citations of papers publi...

Aerobic fitness and flexibility generally present age-related decreases, yet the influence of age on these variables in soccer players is still unknown. We obtained oxygen consumption (VO2) and heart rate (HR) at 12 km · h - 1, anaerobic threshold and maximum intensities, and athletes' flexibility profiles using Flexitest (FLX). Pre-season data (20...

One of the difficulties in maintaining long-term adherence to exercise is the distance from home to the place of exercise. To determine, for a private supervised exercise program (PSEP), the influence of the home-PSEP distance on adherence. We identified 976 individuals and selected 796 who met the inclusion criteria. The home-PSEP distance was obt...

Several indicators have been used to analyze scientific journals, with the impact factor and the number of citations in a 2-yr calendar time frame (2-YRC) being the most common factors. However, considering that the Journal of Applied Physiology (JAPPL) appears monthly and that calculations of these indicators are based on citations of papers publi...

O aumento da produção científica no mundo estimulou a criação de mecanismos para a quantificação, controle, rastreamento e disseminação do conhecimento produzido. O surgimento de grandes bibliotecas e posteriormente o avanço tecnológico que permitiu o armazenamento digital dos documentos possibilitaram um melhor gerenciamento da produção científica...

The Brazilian Archives of Cardiology (ABC) is the most important and oldest scientific publication of Brazilian cardiology. Since its third volume was published in 1950, its articles have been indexed in Medline, and since then the journal has received more than 6,700 contributions (including original articles, review articles, case reports and oth...

Several methods have been used to assess cardiac vagal modulation, but there are gaps regarding the association and accuracy of these methods. To investigate the association between three valid, reproducible and commonly methods used to assess cardiac vagal modulation and compare their accuracies. Thirty healthy men (23 ± 4 years) and 15 men with c...

In the past, isometric exercises were proscribed for heart disease. However, recent evidence suggests that an isometric handgrip training (IHT) protocol - four sets of two minutes at 30% of maximum strength - produces favorable effects on the autonomic modulation and reduces resting systolic (SBP) and diastolic (DBP) blood pressure. Aiming at obtai...

INTRODUÇÃO: Há um crescente interesse e necessidade em avaliar a qualidade da produção científica dos pesquisadores. Para tal, as métricas mais importantes são: número de citações, número médio de citações por artigo indexado e o índice-H. Contudo, essas métricas apresentam limitações na avaliação do potencial de impacto das publicações de um pesqu...

During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR), and relative O2 p...