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The goal of the present study was to compare pulmonary function test (PFT) and cardiopulmonary exercise test (CPET) performance in COVID-19 survivors with a control group (CG). This was a cross-sectional study. Patients diagnosed with COVID-19, without severe signs and symptoms, were evaluated one month after the infection. Healthy volunteers matched for sex and age constituted the control group. All volunteers underwent the following assessments: i) clinical evaluation, ii) PTF; and iii) CPET on a cycle ergometer. Metabolic variables were measured by the CareFusion Oxycon Mobile device. In addition, heart rate responses, peak systolic and diastolic blood pressure, and perceived exertion were recorded. Twenty-nine patients with COVID-19 and 18 healthy control subjects were evaluated. Surviving patients of COVID-19 had a mean age of 40 years and had higher body mass index and persistent symptoms compared to the CG (P<0.05), but patients with COVID-19 had more comorbidities, number of medications, and greater impairment of lung function (P<0.05). Regarding CPET, patients surviving COVID-19 had reduced peak workload, oxygen uptake ( V̇ O 2 ), carbon dioxide output ( V̇ CO 2 ), circulatory power (CP), and end-tidal pressure for carbon dioxide ( P ET CO 2 ) (P<0.05). Additionally, survivors had depressed chronotropic and ventilatory responses, low peak oxygen saturation, and greater muscle fatigue (P<0.05) compared to CG . Despite not showing signs and symptoms of severe disease during infection, adult survivors had losses of lung function and cardiorespiratory capacity one month after recovery from COVID-19. In addition, cardiovascular, ventilatory, and lower limb fatigue responses were the main exercise limitations.

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Among the most prevalent multimorbidities that accompany the aging process, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) stand out, representing the main causes of hospital admissions in the world. The prevalence of COPD coexistence in patients with CHF is higher than in control subjects, given the common risk factors associated with a complex process of chronic diseases developing in the aging process. COPD-CHF coexistence confers a marked negative impact on mechanical-ventilatory, cardiocirculatory, autonomic, gas exchange, muscular, ventilatory, and cerebral blood flow, further impairing the reduced exercise capacity and health status of either condition alone. In this context, integrated approach to the cardiopulmonary based on pharmacological optimization and non-pharmacological treatment (i.e., exercise-based cardiopulmonary and metabolic rehabilitation) can be emphatically encouraged by health professionals as they are safe and well-tolerated, reducing hospital readmissions, morbidity, and mortality. This review aims to explore aerobic exercise, the cornerstone of cardiopulmonary and metabolic rehabilitation, resistance and inspiratory muscle training and exercise-based rehabilitation delivery models in patients with COPD-CHF multimorbidities across the continuum of the disease. In addition, the review address the importance of adjuncts to enhance exercise capacity in these patients, which may be used to optimize the gains obtained in these programs.

A Doença Pulmonar Obstrutiva Crônica (DPOC) leva a repercussões cardíacas e intolerância ao exercício. A pressão positiva expiratória nas vias aéreas (EPAP) aumenta a saturação de oxigênio (SpO2) e reduz o trabalho respiratório. O objetivo foi avaliar o EPAP na tolerância ao exercício em pacientes com DPOC. Estudo cruzado randomizado, avaliou-se 19 pacientes com DPOC através do teste de caminhada de seis minutos (TC6m): sem EPAP (G1) e com EPAP (G2). Variáveis analisadas no repouso, durante o TC6m e recuperação pós teste: SpO2, frequência respiratória (FR), frequência cardíaca (FC), BORG-esforço (BORG-e), BORG-dispneia (BORG-d), pressão arterial sistólica e diastólica e duplo produto (DP). Utilizou-se análise de variância para estimar a diferença dentro dos grupos e teste t de Student para a diferença entre os grupos. Dentro e em ambos os grupos: durante o TC6m verificou-se aumento da FC, do BORG-d, do DP e redução da SpO2 que se recuperou pós teste. Somente G2 recuperou a FC pós teste. Diferenças significativas foram observadas entre os grupos: no repouso para a SpO2 e FR; na recuperação pós TC6m para a FR. O EPAP de 5cmH2O, causa efeito positivo na SpO2 e FR de repouso e proporciona atenuada melhora na recuperação da FC e SpO2 pós TC6m.

RESUMOAs doenças cardiovasculares compreendem a principal causa de morte no mundo. Estudos recentes apontam a correlação entre os distúrbios do sono e as cardiopatias. A Apneia Obstrutiva do Sono (AOS) e a Sonolência Diurna Excessiva (SDE) estão entre os distúrbios mais prevalentes entre os cardiopatas. Neste sentido, objetivou-se avaliar a probabilidade de AOS e SDE em cardiopatas inseridos na Reabilitação Cardíaca do Hospital Santa Cruz do Sul, RS. Trata-se de um estudo de casos que avaliou pacientes cardiopatas, nas condições pré e pós-cirurgia cardíaca através do questionário de Berlim que avalia a probabilidade AOS e a Escala de Sonolência de Epworth que avalia a probabilidade de SDE. Amostra composta por 06 cardiopatas, sendo 04 do sexo masculino, com idade média 61,6±10 anos, Índice de Massa Corporal 27,6±3,3 Kg/m 2 . Observou-se alta probabilidade de AOS (66,7%) e frequência elevada de SDE (50%) pré-operatória. No pós-operatório houve diminuição da frequência de SDE (33,3%) e nenhum indivíduo apresentou alta probabilidade de AOS. Desta forma, concluiu-se que os pacientes estudados apresentaram elevada frequência de AOS e SDE na condição pré-operatória com melhora destes distúrbios no pós-operatório de cirurgia cardíaca.Palavras chave: Cardiopatias. Apneia Obstrutiva do Sono. Sonolência Diurna Excessiva. Reabilitação Cardíaca. ABSTRACTCardiovascular diseases include the leading cause of death worldwide. Recent studies indicate a correlation between sleep disorders and heart disease. Obstructive Sleep Apnea (AOS) and Sleepiness Excessive Daytime (SDE) are among the most prevalent disorders among cardiac patients. In this regard, aimed to assess the likelihood of OSA and SDE in cardiac inserted in Cardiac Rehabilitation Hospital Santa Cruz do Sul, RS. This is a case study that evaluated patients with heart disease, the pre conditions andafter cardiac surgery through the Berlin questionnaire assessing OSA probability and Epworth Sleepiness Scale to assess the likelihood of SDE. ____________________________

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