Monitoring functional capacity in heart failure

Piepoli, Massimo F; Spoletini, Ilaria; Rosano, Giuseppe

doi:10.1093/eurheartj/suz216

Cited by 14 publications

(17 citation statements)

References 56 publications

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“…Sugere-se que essa faixa de carga no TMI ofereça maior segurança aos indivíduos que apresentam doenças cardiovasculares, tendo em vista que, quando realizado em intensidades elevadas esse tipo de treinamento possa causar fadiga precoce na musculatura respiratória e aumento da atividade neural simpática capaz de desencadear aumento no trabalho do miocárdio, resistência vascular periférica e pressão arterial, colocando essa população a uma exposição maior de eventos cardiovasculares agudos 43,44 A capacidade funcional de indivíduos com IC apresentase comprometida 45,46 . Resumidamente, isso se deve à sintomatologia apresentada durante o esforço, tais como a presença de fadiga e dispneia, o que dificulta a realização das atividades de vida diária, estando diretamente relacionada à fraqueza da musculatura respiratória 47,48 .…”

Section: Discussionunclassified

Efeitos do treinamento muscular inspiratório na capacidade de exercício, força muscular inspiratória e qualidade de vida em indivíduos com insuficiência cardíaca: uma revisão sistemática

Santos‐de‐Araújo¹,

Costa²,

Anselmo-e-Silva³

et al. 2022

ASSOBRAFIR Ciênc

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Artigo de RevisãoEste é um artigo publicado em acesso aberto (Open Access) e distribuído sob a licença Creative Commons Attribution NonComercial ShareAlike License, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que sem fins comerciais e que o trabalho original seja corretamente citado e de forma que não indique endosso ao trabalho feito. Adicionalmente, qualquer trabalho derivado deverá ser publicado sob a mesma licença. ResumoIntrodução: A Insuficiência Cardíaca (IC) é uma patologia que cursa com redução da força muscular periférica e da musculatura respiratória culminando em redução da capacidade funcional e impactando negativamente na qualidade de vida. Por esta razão, as diretrizes atuais recomendam exercícios como terapia adjuvante ao tratamento farmacológico, dentre eles o treinamento muscular inspiratório (TMI). Objetivo: revisar sistematicamente a literatura sobre os efeitos do TMI com carga resistiva sobre a força muscular inspiratória, qualidade de vida e capacidade funcional de indivíduos com IC. Métodos: a busca sistemática foi conduzida através dos bancos de dados LILACS, PUBMED, SciELO, COCHRANE e PEDro. Para a busca, foram utilizados os seguintes termos MeSH: ("breathing exercises" AND "heart failure"; inspiratory muscle training" AND "heart failure") e ("treinamento muscular respiratório" AND "insuficiência cardíaca"). Foram incluídos ensaios clínicos, ensaios clínicos controlados e ensaios clínicos randomizados. Resultados: foram encontrados na busca 522 artigos. Ao final, apenas 13 estudos mostravam a utilização do TMI em indivíduos com IC de acordo com os critérios de elegibilidade. Desses, doze estudos relatam melhora na força muscular inspiratória (PI max ), onze descrevem melhoria na capacidade funcional e sete na qualidade de vida. Conclusão: esta revisão sistemática apoia a ideia de que as intervenções de TMI com carga resistiva melhoram a PI max , a capacidade de exercício e a qualidade de vida em pacientes com IC. Adicionalmente, o TMI demonstra ser uma estratégia que merece ser considerada como intervenção adicional em pacientes com IC no que diz respeito a incremento significativos nessas variáveis.

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Section: Discussionunclassified

Efeitos do treinamento muscular inspiratório na capacidade de exercício, força muscular inspiratória e qualidade de vida em indivíduos com insuficiência cardíaca: uma revisão sistemática

Santos‐de‐Araújo¹,

Costa²,

Anselmo-e-Silva³

et al. 2022

ASSOBRAFIR Ciênc

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“…In addition, we observed an association of greater distance with more frequent use of beta-blockers and higher LVEF. The 6MWT has been increasingly used due to its wide availability, ease of execution and safety, in addition to having a role in the prognostic evaluation in patients with HF [7,8]. However, there are still no standardized normative values in groups division or cutoff prognostic values for the distance walked in the test, which creates discrepancies in the interpretation of its result [6,9,12].…”

Section: Discussionmentioning

confidence: 99%

“…Distance <350 meters in the 6MWT has a 71% sensitivity and 60% specificity to predict maximum oxygen consumption (VO2) <14 ml/kg/min obtained by CPET in patients with HF [6]. CPET is the gold-standard method for assessing functional capacity in cardiovascular diseases by measuring VO2 during a maximal stress test [8]. However, performing CPET routinely is expensive and requires specialized and properly trained team.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of the Six-Minute Walk Test in Heart Failure

Astolpho¹,

Barbosa²,

Devens³

et al. 2020

Preprint

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Background: The 6-minute walk test (6MWT) is a simple and low-cost method that allows assessment of functional capacity in patients with heart failure (HF). However, the prognostic role of 6MWT in HF remains uncertain. Objectives: We aimed to evaluate the 6MWT as a predictor of mid-term adverse outcomes in patients with HF with mid-range and reduced ejection fraction. Methods: Prospective single-center cohort study that included patients with HF with an ejection fraction under 50% at a specialized outpatient HF service. Patients underwent the 6MWT on admission and were compared according to the distance walked: Group I walked ≥350 meters and group II <350 meters. The primary outcome was a composite of death from any cause or hospitalization for HF decompensation in one-year follow-up. Secondary outcomes were the components of the primary outcome in an isolated analysis. Results: Sixty patients were included, 43.3% male, with a mean age of 61.1 ± 12.9 years and ejection fraction 34.3 ± 10.1%. 52 patients (86.7%) were on guideline-directed triple therapy for HF. The average distance walked in the 6MWT was 395.1 ± 98.8 meters, with 40 patients (66.7%) in group I and 20 (33.3%) in group II. The primary outcome in groups I and II were, respectively, 15,0% and 35,0% (p=0.05). One-year mortality was 5.0% vs 15.0% (p=0.18) and the hospitalization rate was 10.0% vs 20.0% (p=0.28). Conclusions: There was no association of distance <350 meters in the 6MWT with the primary outcome in patients with HF. Despite the higher occurrence of outcomes in group II, the difference was not statistically significant in this analysis. On a selective basis, the 6MWT may be a useful tool for prognostic stratification in HF, if combined with other methods.

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“…It is known that regularly OHIP values are related to both physical and mental aspects of the HRQoL [38]. Generally, the increased psychological burden, especially the occurrence of depression and anxiety in patients suffering from HF [39] as well as the limited physical functional capacity [40] might be relevant factors. These limitations of daily life and wellbeing might be an influential factor for both, general and OHRQoL.…”

Section: Comparison With Published Datamentioning

confidence: 99%

Oral health-related quality of life of patients after heart transplantation and those with heart failure is associated with general health-related quality of life: a cross-sectional study

et al. 2020

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The aim of this cross-sectional study was to examine the oral health-related quality of life (OHRQoL) in patients after heart transplantation (HTx) and those with heart failure (HF). Methods In total, 186 participants (HTx: 104, HF: 82) were recruited from the University Department for Cardiac Surgery, Leipzig Heart Centre, Germany. OHRQoL was assessed with the German short form of the oral health impact profile (OHIP-G14). Health-related quality of life (HRQoL) was evaluated using the short form 36 survey (SF-36). Furthermore, the dental and periodontal treatment need was recorded. Results With an OHIP-G14 sum score of 6.58 ± 6.40 [5; 2.5-8] in the HTx group and 5.54 ± 5.47 [5; 2-7] in the HF group, no clinically relevant or statistically significant difference was apparent (p = 0.39). The SF-36 scales for physical functioning, role-physical, general health and vitality were significantly worse in the HF group compared with the HTx group (p i < 0.01). A worse SF-36 physical component summary was significantly associated with a higher OHIP-G14 sum score (HTx: p < 0.01, HF: p = 0.04). In the HTx group, a significant association was also observed for the mental component summary (p < 0.01). Multiple regression analysis revealed physical component summary (p = 0.04) and mental component summary (p < 0.01) in HTx, and physical component summary (p = 0.02), mental component summary (p = 0.02) and smoking (p < 0.01) as significant predictors for OHIP G14 in HF. Conclusion The OHRQoL in HF and HTx patients appears to be mainly associated with general HRQoL. Therefore, multidisciplinary dental care concepts may be recommended to improve oral health conditions in these patients.

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Monitoring functional capacity in heart failure

Cited by 14 publications

References 56 publications

Efeitos do treinamento muscular inspiratório na capacidade de exercício, força muscular inspiratória e qualidade de vida em indivíduos com insuficiência cardíaca: uma revisão sistemática

Efeitos do treinamento muscular inspiratório na capacidade de exercício, força muscular inspiratória e qualidade de vida em indivíduos com insuficiência cardíaca: uma revisão sistemática

Prognostic Value of the Six-Minute Walk Test in Heart Failure

Oral health-related quality of life of patients after heart transplantation and those with heart failure is associated with general health-related quality of life: a cross-sectional study

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