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COMPARATIVE EFFECTS OF A CARDIOVASCULAR REHABILITATION PROGRAM ON FUNCTIONAL CAPACITY IN PATIENTS WITH CHRONIC CHAGASIC CARDIOMYOPATHY WITH OR WITHOUT HEART FAILURE
Chagas disease
Cardiomyopathy
Cardiopulmonary exercise test
Exercise
Author
Viana, Aline Maria Nunes
Vieira, Marcelo Carvalho
Mazzoli-Rocha, Flavia
Silva, Rudson Santos
Frota, Aline Xavier
Costa, Henrique Silveira
Borges, Juliana Pereira
Silva, Gilberto Marcelo Sperandio da
Silva, Paula Simplicio da
Hasslocher-Moreno, Alejandro Marcel
Sousa, Andrea Silvestre de
Mendes, Fernanda de Souza Nogueira Sardinha
Mediano, Mauro Felippe Felix
Vieira, Marcelo Carvalho
Mazzoli-Rocha, Flavia
Silva, Rudson Santos
Frota, Aline Xavier
Costa, Henrique Silveira
Borges, Juliana Pereira
Silva, Gilberto Marcelo Sperandio da
Silva, Paula Simplicio da
Hasslocher-Moreno, Alejandro Marcel
Sousa, Andrea Silvestre de
Mendes, Fernanda de Souza Nogueira Sardinha
Mediano, Mauro Felippe Felix
Affilliation
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Veiga de Almeida University. Health Center. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Aloysio de Castro State Institute of Cardiology. Center for Cardiology and Exercise. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Jequitinhonha and Mucuri Valleys. Physical Therapy Department. Diamantina, MG, Brazil.
State University of Rio de Janeiro. Laboratory of Physical Activity and Health Promotion. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / National Institute of Cardiology. Department of Research and Education. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Aloysio de Castro State Institute of Cardiology. Center for Cardiology and Exercise. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Jequitinhonha and Mucuri Valleys. Physical Therapy Department. Diamantina, MG, Brazil.
State University of Rio de Janeiro. Laboratory of Physical Activity and Health Promotion. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / National Institute of Cardiology. Department of Research and Education. Rio de Janeiro, RJ, Brazil.
Abstract
Purpose: The aim of the present study was to evaluate the effects of cardiovascular rehabilitation (CR) on functional capacity of patients with chronic chagasic cardiomyopathy (CCC) and to compare the responses between CCC patients without and with heart failure (HF).
Materials and methods: A longitudinal observational retrospective study was carried out including 36 patients with CCC without HF (stage B2 [n = 7]) and with HF (stage C [n = 29]), who participated in a CR program. Functional capacity was assessed by a maximal progressive cardiopulmonary exercise test performed on a treadmill. The longitudinal effects of the CR on functional capacity were determined by linear mixed models that included an interaction term to evaluate the differential responses between patients without and with HF.
Results: Significant improvements in peak oxygen consumption, resting heart rate and blood pressure, and maximum pulmonary ventilation were observed for the overall study sample, with no apparent differential effects according to the presence of HF.
Conclusions: CR significantly improved functional capacity of patients with CCC. The responses to CR appear to be similar among patients without and with HF, reinforcing the need for its inclusion as a standard treatment strategy of CCC.Implications for rehabilitationExercise-based cardiovascular rehabilitation (CR) is a safe strategy that improves functional capacity, cardiac function, and quality of life in patients with several cardiovascular diseases, and recent studies also suggested a potential beneficial effect of CR in chronic chagasic cardiomyopathy (CCC).In this observational study, CR seems to equally improve exercise capacity, resting heart rate, resting blood pressure, and maximum pulmonary ventilation in patients with CCC without (stage B2) and with heart failure (stage C).Cardiovascular rehabilitation should be included as a standard treatment strategy for patients with CCC, regardless the severity of cardiomyopathy.
Keywords
Cardiac rehabilitationChagas disease
Cardiomyopathy
Cardiopulmonary exercise test
Exercise
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