Banca de DEFESA: AMANDA SOARES FELISMINO SILVEIRA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : AMANDA SOARES FELISMINO SILVEIRA
DATE: 02/03/2020
TIME: 08:00
LOCAL: sala 8
TITLE:

EFFECTS OF A CARDIAC REHABILITATION PROGRAM ON THE MAXIMUM EFFORT EFFICIENT VARIABLES IN PATIENTS WITH CHRONIC HEART FAILURE.

KEY WORDS:

 

Heart failure, cardiac rehabilitation, aerobic exercise.

PAGES: 54
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

The effects of Cardiac Rehabilitation (CR) in patients with chronic heart failure (HF) are assessed by changes in oxygen uptake at peak effort (VO2peak). However, it has limitations, such as the need for maximum exercise, which is not possible in severely limited patients. In this way, other variables, since they are employed independent of the maximum effort, have been studied, such as the Anaerobic Limit - LA, relationship between minute ventilation and carbon dioxide production -VE / VCO2Slope, oxygen consumption efficiency - OUES and ventilatory oscillation - OV and to assess the effects of physical exercise, in addition to the use of these variables in addition to other TECP variables that can be used together and provide important clinical data about the patient such as risk stratification. Objective: To evaluate the effects of CR in the independent variables of maximum effort (LA, VE / VCO2slope, OUES and OV), risk stratification and the metabolic equivalent of the task in patients with chronic HF. . Materials and methods: This is a retrospective analysis composed of patients with chronic HF. The individuals underwent a clinical, spirometric cardiopulmonary evaluation. Then they were submitted to an exercise protocol (aerobic and resistance), 3 times / week, for 12 weeks, being reassessed at the end of the CR period. Results: 45 patients with chronic HF with a mean age of 49.8 ± 12.97 years and an Ejection Fraction of 39.0 ± 15.8% were evaluated. An increase of 2 min and 4 seconds (p <0.001) in its mean and 24.1% in MET was identified. Regarding the metabolic analysis, we had an increase of 18.3% in VO2peak after CR, as well as an increase of 12.9% VO2 at the time of LA and 20.14% in OUES75%, in addition to the reduction in the mean VE / VCO2slope and the presence of OV, which led to an improvement in the risk stratification of 4 patients. In addition, the results of the ROC curves showed that OUES is able to identify patients with severe chronic HF with different aerobic capacities (<or> 70% predicted VO2) such as LA (ASC = 0.865, p = <0.0001; ASC = 0.800, p = 0.002 respectively), and there is no significant difference in the comparison between the receiver operating characteristic (ROC) curves. The regression analysis identified cardiovascular and pulmonary factors related to both variables. Conclusion: It is concluded that the CR with an individualized dose of exercise and readjusted whenever necessary was efficient in improving the aerobic capacity and risk stratification of the patient with chronic HF and that the independent variables of the maximum effort were effective in identifying these results. Therefore, they are an alternative for those in whom the VO2peak assessment may be impaired by their clinical condition. Among the independent variables of effort, OUES was as effective as VO2LA to identify patients with different aerobic capacities. Therefore, effort-independent variables are an alternative for those in which VO2peak assessment may be impaired by their clinical condition.

BANKING MEMBERS:
Externo à Instituição - ANTONIO JOSÉ SARMENTO DA NÓBREGA
Externa ao Programa - 2646588 - JOCELINE CASSIA FEREZINI DE SA
Externa à Instituição - NICOLE SOARES OLIVER CRUZ
Presidente - 1149619 - SELMA SOUSA BRUNO
Interna - 5566309 - VANESSA REGIANE RESQUETI FREGONEZI