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.