INTRODUÇÃO: A forma cardíaca da doença de Chagas causa modificações orgânicas e funcionais, sendo o exercício físico aeróbio uma alternativa de proposta terapêutica. OBJETIVO: avaliar o exercício físico aeróbio em mulheres com doença de Chagas crônica. MATERIAIS E MÉTODOS: Quatorze mulheres com doença de Chagas na faixa etária entre 40 e 60 anos, classe I da New York Heart Association (NYHA) foram divididas em dois grupos. Sete no G1 que realizaram exercício físico, com duas sessões diárias semanais por seis semanas e sete no G2 sem tal intervenção. O efeito do exercício físico foi avaliado por 27 variáveis fisioterapêuticas e ergoespirométricas no tempo zero (T0) e após seis semanas (T6). RESULTADO: No T6 em relação ao T0 a avaliação fisioterapêutica mostrou diferenças significativas na pressão arterial sistólica, no pico do fluxo expiratório, nas pressões inspiratória e expiratória máximas e na frequência cardíaca. Na ergoespirometria houve aumento significativo no DP máximo, no MET máximo, no estágio do protocolo de Bruce, no VO2 máximo, na duração do teste e na distância percorrida para as participantes de G1 e apenas na duração do teste para G2. Para G1 foi ainda observada em T6 uma diminuição significativa do duplo produto na intensidade moderada e alta na mesma carga de esforço. CONCLUSÃO: O treinamento aeróbio de curto período, de simples aplicação e com supervisão pode ser realizado com segurança, aumentando a tolerância ao exercício em pacientes com doença de Chagas crônica classe I da NYHA.

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Objective: Early reports showed a high incidence of postoperative morbidity and mortality after coronary endarterectomy, and its value is still controversial. With technical improvement the role of coronary endarterectomy has been reviewed. In this study we evaluate our results of coronary endarterectomy, and show our strategy for patients with diffuse coronary artery disease. Method: We retrospectively reviewed 278 patients who underwent coronary artery bypass grafting, between January 2000 and December 2001, separated in two groups. The endarterectomy group-32 patients (11.5%) who underwent coronary endarterectomy and the control group of patients characteristics similar to the first group. Results: The mean follow-up time was 9.9 months. Both groups only demonstrated a statistical difference in the number of previous myocardial infarctions. The coronary endarterectomy was performed on 38 vessels, 78.75% in the left coronary system, and 21.05% in the right system. In the postoperative follow-up no significant differences were detected, but in the coronary endarterectomy group the incidence of intra-aortic balloon pump insertion was higher. Conclusions: We demonstrated that coronary endarterectomy should be used to achieve complete revascularization in patients with diffuse coronary disease, and the results are similar to conventional surgical treatment. A long-term follow up is necessary to demonstrate the future performance of these vessels and grafts.

Objective: Minimally invasive heart surgeries are approaches used to reduce trauma, to give better cosmetic results and to reduce hospital costs with the same safety as conventional surgery. This study was designed to compare the operative results from patients who underwent minimally invasive aortic valve replacement with those who were submitted to the standard procedure.Method: The operative and immediate postoperative results of 12 consecutive patients who received minimally invasive isolated aortic valve replacements from June 2002 to February 2003 were compared to 12 patients who underwent to traditional approach in the same institution. The minimally invasive access used was superior median hemisternotomy where cardiopulmonary bypass was established through ascending aorta and right atrium cannulation, similar to the traditional technique.Results: The demographics of the patients were similar in both groups. There were no significant differences between aortic clamping time, total bypass time and operating time. The skin incision length was statistically shorter in the minimally invasive group. In the postoperative course, the mechanical ventilation time and the total hospital stay were shorter, but not statistically significant, in the minimally invasive group. The morbidity was the same in two groups.Conclusions: This surgical approach provides adequate exposure of the cardiac structures necessary to perform a safe valve replacement. With the same instruments used in the traditional surgery we can offer the benefits of a less invasive access with the same efficiency as in the conventional approach without adding any risks to our patients. Descriptors

The aim of this study was to compare the values of O 2max directly determined by an ergospirometry system, with values indirectly predicted by the ErgoPC system during maximal exercise test underwent by female runners. Twenty trained female runners participated in the study ( 42.7 ± 6.4 years-old, height 1.64 ± 0.04m, body mass 58.3 ± 5.8kg, body mass index (BMI) 21.7 ± 1.9kg/m 2 and body fat percentage 22.3 ± 3.5. The subjects were evaluated for body composition and underwent a progressive exercise test on treadmill (Inbrasport, Porto Alegre, RS, Brazil) to measure the aerobic fitness ( O 2max ). The initial speed was 7km/h with increments of 1km/h every three minutes and constant inclination of 1% was kept throughout the test. The participants were encouraged to remain in the test as long as possible until voluntary exhaustion. The gas analyzer VO2000 Inbrasport Spirometer, Porto Alegre, Brazil was used for the direct measurement of O 2max , while for the indirect measurement of O 2max the ErgoPC program with the prediction formula from Foster (1996) was used. Statistical analysis was performed by Student's t test for the comparison of the values of O 2max obtained in the direct and indirect test, and Pearson's correlation was applied to correlate these two variables. Direct measurement of O 2max showed a value of 51.8 ± 6.8ml/kg/min and indirect one of 42.8 ± 3.7ml/kg/min. The comparison between both results was significantly different. The correlation between the values of O 2max was r = 0.67. Thus, the results show that the obtained O 2max by an indirect way underestimates the value of the direct measurement.

RESUMOIntrodução: testes diretos são considerados "padrão ouro" para determinar variáveis fisiológicas, porém o seu custo financeiro é elevado e há a necessidade de mão de obra especializada para sua operacionalização. Sendo assim, os testes indiretos são utilizados pela maioria dos profissionais de Educação Física como uma alternativa acessível à falta da medida direta. Objetivo: comparar os valores de consumo máximo de oxigênio (VO 2máx ) determinados diretamente por um sistema de espirometria com valores determinados a partir de protocolos indiretos. Métodos: participaram 15 pessoas do gênero masculino (27,4 ± 3,5 anos), fisicamente ativas, que realizaram o teste incremental em esteira rolante para determinação direta do VO 2máx com analisador de gases. Os testes para predição do VO 2máx foram: ErgoPC; Polar Fitness Test; testes do banco e de Cooper. Foi utilizada a estatística descritiva (média ± desvio padrão -DP); a esfericidade foi testada pelo teste de Mauchly, os métodos foram comparados por ANOVA de medidas repetidas com o ajuste de Bonferroni para comparações múltiplas. A normalidade dos dados foi aferida pelo teste de Shapiro-Wilk e também foi aplicado o teste coeficiente de correlação de Pearson, adotando-se p<0,05. Resultados: o valor médio de VO 2máx direto foi de 55,8 ± 6,1 ml•kg -1•min -1 e os valores para os testes indiretos, percentual de subestimação e coeficiente de correlação, foram, respectivamente: ErgoPc 33,7 ± 4,5 ml•kg -1•min -1 (39,6%; r = 0,71; p<0,001); Polar Fitness Test 53,2 ± 6,4 ml•kg -1•min -1 (4,6%; r = 0,64; p = 0,774); teste do banco 48,8 ± 6,3 ml•kg -1•min -1 (12,5%; r = 0,60; P=0,001) e de Cooper 43,9 ± 7,9 ml•kg -1•min -1 (21,4%; r = 0,65; p<0,001). Conclusão: os métodos indiretos podem sugerir sobrecarga de treino inferior ou superior para adaptações fisiológicas pretendidas por subestimarem o direto, sendo o Polar Fitness Test o mais indicado para uso diário, pois apresentou valores mais próximos ao valor direto. Palavras

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Few studies verified the reliability of the lactate threshold determined by Dmax method (LT) in runners and it remains unclear the effect of the regression model and the final speed on the reliability of LT. This study aimed to examine the test-retest reliability of the speed at LT in runners, considering the effects of the regression models (exponential-plus-constant vs third-order polynomial) and final speed criteria (complete vs proportional). Seventeen male, recreational runners performed 2 identical incremental exercise tests, with increments of 1 km·h each for 3 min on treadmill to determine peak treadmill speed (V) and lactate threshold. Earlobe capillary blood samples were collected during rest between the stages. The V was defined as the speed of the last complete stage (complete final speed criterion) and as the speed of the last complete stage added to the fraction of the incomplete stage (proportional final speed criterion). Lactate threshold was determined from exponential-plus-constant and from third-order polynomial regression models with both complete and proportional final speed criteria and from fixed blood lactate level of 3.5 mmol·L (LT). The LT obtained from the exponential-plus-constant regression model presented higher reliability (coefficient of variation (CV) ≤ 3.7%) than the LT calculated from the third-order polynomial regression model (CV ≤ 5.8%) and LT (CV = 5.4%). The proportional final speed criterion is more appropriate when using the exponential-plus-constant regression model, but less appropriate when using the third-order polynomial regression model. In conclusion, exponential-plus-constant using the proportional final speed criterion is preferred over LT and over third-order polynomial regression model to determine a reliable LT.