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2.
Précoma, Dalton Bertolim; Oliveira, Gláucia Maria Moraes de; Simão, Antonio Felipe; Dutra, Oscar Pereira; Coelho, Otávio Rizzi; Izar, Maria Cristina de Oliveira; Póvoa, Rui Manuel dos Santos; Giuliano, Isabela de Carlos Back; Filho, Aristóteles Comte de Alencar; Machado, Carlos Alberto; Scherr, Carlos; Fonseca, Francisco Antonio Helfenstein; Filho, Raul Dias dos Santos; Carvalho, Tales de; Avezum Jr, Álvaro; Esporcatte, Roberto; Nascimento, Bruno Ramos; Brasil, David de Pádua; Soares, Gabriel Porto; Villela, Paolo Blanco; Ferreira, Roberto Muniz; Martins, Wolney de Andrade; Sposito, Andrei C; Halpern, Bruno; Saraiva, José Francisco Kerr; Carvalho, Luiz Sergio Fernandes; Tambascia, Marcos Antônio; Coelho-Filho, Otávio Rizzi; Bertolami, Adriana; Filho, Harry Correa; Xavier, Hermes Toros; Neto, José Rocha Faria; Bertolami, Marcelo Chiara; Giraldez, Viviane Zorzanelli Rocha; Brandão, Andrea Araújo; Feitosa, Audes Diógenes de Magalhães; Amodeo, Celso; Souza, Dilma do Socorro Moraes de; Barbosa, Eduardo Costa Duarte; Malachias, Marcus Vinícius Bolívar; Souza, Weimar Kunz Sebba Barroso de; Costa, Fernando Augusto Alves da; Rivera, Ivan Romero; Pellanda, Lucia Campos; Silva, Maria Alayde Mendonça da; Achutti, Aloyzio Cechella; Langowiski, André Ribeiro; Lantieri, Carla Janice Baister; Scholz, Jaqueline Ribeiro; Ismael, Silvia Maria Cury; Ayoub, José Carlos Aidar; Scala, Luiz César Nazário; Neves, Mario Fritsch; Jardim, Paulo Cesar Brandão Veiga; Fuchs, Sandra Cristina Pereira Costa; Jardim, Thiago de Souza Veiga; Moriguchi, Emilio Hideyuki; Moriguchi, Emilio Hideyuki; Schneider, Jamil Cherem; Assad, Marcelo Heitor Vieira; Kaiser, Sergio Emanuel; Lottenberg, Ana Maria; Magnoni, Carlos Daniel; Miname, Marcio Hiroshi; Lara, Roberta Soares; Herdy, Artur Haddad; Araújo, Cláudio Gil Soares de; Milani, Mauricio; Silva, Miguel Morita Fernandes da; Stein, Ricardo; Lucchese, Fernando Antônio; Nobre, Fernando; Griz, Hermilo Borba; Magalhães, Lucélia Batista Neves Cunha; Borba, Mario Henrique Elesbão de; Pontes, Mauro Ricardo Nunes; Mourilhe-Rocha, Ricardo.
Arq. bras. cardiol ; 116(4): 855-855, abr. 2021.
Article in Portuguese | LILACS | ID: biblio-1285194
6.
Arq. bras. cardiol ; 114(5): 943-987, maio 2020. tab, graf
Article in English, Portuguese | Sec. Est. Saúde SP, CONASS, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1146965

ABSTRACT

INTRODUÇÃO: Está cientificamente comprovado, sendo algo incorporado ao senso comum, que ser fisicamente ativo contribui para preservar e recuperar a boa saúde do corpo e da mente. Os efeitos favoráveis da reabilitação cardiovascular (RCV) com ênfase nos exercícios físicos têm sido consistentemente documentados, inclusive em meta-análises de estudos clínicos randomizados, que demonstram significativas reduções da morbimortalidade cardiovascular e global,1 bem como da taxa de hospitalização,1,2 com expressivo ganho de qualidade de vida,1,2 justificando a sua consensual e enfática recomendação pelas principais sociedades médicas mundiais.3-6 O sedentarismo, que apresenta elevada prevalência no Brasil e no mundo, está fortemente relacionado às doenças cardiovasculares (DCV) e à mortalidade precoce.7,8 Em contrapartida, maiores volumes de atividade física são positivamente associados à melhor qualidade e à maior expectativa de vida,9-13 existindo uma forte e inversa associação dos diferentes componentes da aptidão física com a mortalidade por todas as causas e com a ocorrência de eventos cardiovasculares desfavoráveis. Ou seja, quanto menor o nível de aptidão física, maior tende ser a taxa de mortalidade.14-21 Portanto, o principal objetivo da RCV com ênfase nos exercícios físicos é propiciar uma melhora dos componentes da aptidão física, tanto aeróbico quanto não aeróbicos (força/ potência muscular, flexibilidade, equilíbrio), algo que exige a combinação de diferentes modalidades de treinamento. Assim, a RCV deve proporcionar os mais elevados níveis de aptidão física passíveis de obtenção, de modo a reduzir o risco de eventos cardiovasculares e promover todos os outros benefícios a serem auferidos pela prática regular de exercícios físicos, culminando com a redução da mortalidade geral.


Subject(s)
Rehabilitation , Cardiovascular Diseases , Physical Fitness , Cardiac Rehabilitation , Motor Activity
7.
Arq Bras Cardiol ; 113(5): 988-998, 2019 11.
Article in English, Portuguese | MEDLINE | ID: mdl-31800725

ABSTRACT

Spontaneous coronary artery dissection (SCAD) is considered an often underdiagnosed acute coronary syndrome, with few cases described in literature. Its association with physical exercise among young patients without risk factors or atherosclerotic disease (CAD) is even rarer. For this reason, a study was conducted on the subject, describing the clinical conditions, conduct and evolution regarding the suspicion of spontaneous exercise-related coronary artery dissection in three young patients without risk factors or CAD. Clinical conditions varied, with predominant recurrent chest pain. Age range from 20 to 31 years. All patients underwent coronary angiography, which showed no CAD but suggested SCAD. Investigations concerning other causes of coronary obstruction were negative. The right coronary artery was affected in two cases, and the anterior descending artery was affected in one case. Only one of the three patients had recurrent events within five years from the primary event. Technological advances will enable increased dissection identification in acute coronary syndromes. Improving the knowledge about the related clinical conditions is necessary, as an attempt to provide warnings and improve the suspicion of spontaneous exercise-related coronary artery dissection among those who have symptoms of coronary insufficiency, thus reducing the frequent underdiagnosis. The best treatment and prognosis for this disease remains uncertain.


Subject(s)
Coronary Vessel Anomalies/diagnostic imaging , Exercise , Vascular Diseases/congenital , Adult , Cardiac Catheterization , Chest Pain/etiology , Coronary Angiography , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/surgery , Diagnosis, Differential , Electrocardiography , Humans , Male , Risk Factors , Vascular Diseases/complications , Vascular Diseases/diagnostic imaging , Vascular Diseases/surgery , Young Adult
8.
Précoma, Dalton Bertolim; Oliveira, Gláucia Maria Moraes de; Simão, Antonio Felipe; Dutra, Oscar Pereira; Coelho, Otávio Rizzi; Izar, Maria Cristina de Oliveira; Póvoa, Rui Manuel dos Santos; Giuliano, Isabela de Carlos Back; Filho, Aristóteles Comte de Alencar; Machado, Carlos Alberto; Scherr, Carlos; Fonseca, Francisco Antonio Helfenstein; Filho, Raul Dias dos Santos; Carvalho, Tales de; Avezum Jr, Álvaro; Esporcatte, Roberto; Nascimento, Bruno Ramos; Brasil, David de Pádua; Soares, Gabriel Porto; Villela, Paolo Blanco; Ferreira, Roberto Muniz; Martins, Wolney de Andrade; Sposito, Andrei C; Halpern, Bruno; Saraiva, José Francisco Kerr; Carvalho, Luiz Sergio Fernandes; Tambascia, Marcos Antônio; Coelho-Filho, Otávio Rizzi; Bertolami, Adriana; Filho, Harry Correa; Xavier, Hermes Toros; Neto, José Rocha Faria; Bertolami, Marcelo Chiara; Giraldez, Viviane Zorzanelli Rocha; Brandão, Andrea Araújo; Feitosa, Audes Diógenes de Magalhães; Amodeo, Celso; Souza, Dilma do Socorro Moraes de; Barbosa, Eduardo Costa Duarte; Malachias, Marcus Vinícius Bolívar; Souza, Weimar Kunz Sebba Barroso de; Costa, Fernando Augusto Alves da; Rivera, Ivan Romero; Pellanda, Lucia Campos; Silva, Maria Alayde Mendonça da; Achutti, Aloyzio Cechella; Langowiski, André Ribeiro; Lantieri, Carla Janice Baister; Scholz, Jaqueline Ribeiro; Ismael, Silvia Maria Cury; Ayoub, José Carlos Aidar; Scala, Luiz César Nazário; Neves, Mario Fritsch; Jardim, Paulo Cesar Brandão Veiga; Fuchs, Sandra Cristina Pereira Costa; Jardim, Thiago de Souza Veiga; Moriguchi, Emilio Hideyuki; Schneider, Jamil Cherem; Assad, Marcelo Heitor Vieira; Kaiser, Sergio Emanuel; Lottenberg, Ana Maria; Magnoni, Carlos Daniel; Miname, Marcio Hiroshi; Lara, Roberta Soares; Herdy, Artur Haddad; Araújo, Cláudio Gil Soares de; Milani, Mauricio; Silva, Miguel Morita Fernandes da; Stein, Ricardo; Lucchese, Fernando Antônio; Nobre, Fernando; Griz, Hermilo Borba; Magalhães, Lucélia Batista Neves Cunha; Borba, Mario Henrique Elesbão de; Pontes, Mauro Ricardo Nunes; Mourilhe-Rocha, Ricardo.
Arq. bras. cardiol ; 113(4): 787-891, Oct. 2019. tab, graf, ilus
Article in English | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1150799
9.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 362-367, July-Aug. 2019. graf, tab
Article in English | LILACS | ID: biblio-1012350

ABSTRACT

Maximal oxygen uptake is a powerful prognostic indicator and a reliable measure of physical conditioning. It can be measured directly by cardiopulmonary exercise testing (CPET) or indirectly by formulas derived from conventional protocols. Objective: We compared the VO2 max obtained by formula using exercise testing with Bruce protocol (BP) with the VO2 max obtained by CPET on the treadmill. Methods: We selected 41 healthy, non-obese, physically inactive young volunteers, aged between 21 and 50 years, residents of Florianópolis, Brazil. Results: Twenty-one women (52%) with mean age of 35.62 ± 8.83 years, and 20 males, with mean age of 32.5 ± 7.18 years participated in the study. Statistically significant differences were found for VO2 max between the two methods (BP - 42.31 ± 5.21 ml/kg.min vs. CPET - 30.46 ± 5.50 ml/kg.min., p < 0.0001). The Bruce formula overestimated the result by 34.1% (BP - 45.95 ± 3.94 ml/kg.min vs. CPX - 34.27 ± 4.20 ml/kg.min, p < 0.0001) for men, and by 44.8% (BP - 38.84 ± 3.72 ml/kg.min vs. CPX - 26.83 ± 3.90, p < 0.0001) for women. A moderate correlation was observed between the methods (r = 0.65). When classifying the results according to the table of aerobic capacity of the American Heart Association, the agreement was null (kappa = 0.0034; Pearson chi2 = 0.001). Conclusion: VO2 estimated by BP is not capable of demonstrating the true aerobic capacity in these individuals, while CPET is an important tool for early detection of diminished functional capacity in sedentary young men and women


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Oxygen Consumption , Adolescent , Exercise Test/methods , Cardiovascular Diseases , Body Mass Index , Sex Factors , Clinical Protocols , Physical Fitness , Risk Factors , Sedentary Behavior
14.
J Cardiopulm Rehabil Prev ; 37(4): 268-273, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28640768

ABSTRACT

BACKGROUND: Cardiac rehabilitation (CR) programs can address the cardiovascular disease epidemic in South America. However, there are factors limiting CR access at the patient, provider, and system levels. The latter 2 have not been extensively studied. The objective of this study was to investigate cardiology administrator's awareness and knowledge of CR and perceptions regarding resources for CR. METHODS: This study was cross-sectional and observational in design. Cardiology administrators from South American and Caribbean countries were invited to participate by members of a professional association. Participants completed a questionnaire online. Descriptive analysis was performed and differences in CR knowledge, awareness, perception, and attitudes regarding CR were described overall, by institution funding source (private vs public) and presence of within-institution CR (yes vs no). RESULTS: Most of the 55 respondents from 8 countries perceived CR as important for outpatient care (mean ± SD = 4.83 ± 0.38 out of 5; higher scores indicating more positive perceptions), with benefits including reduced hospital readmissions (4.31 ± 0.48) and length of stay (4.64 ± 0.71 days), not only for cardiac patients but for those with other vascular conditions (4.34 ± 0.68 days). Those working in public institutions (50.9%) and in institutions without a CR program (25.0%) were not as aware of, and less likely to value, CR services (P < .05). Only 13.2% of programs had dedicated funding. CONCLUSIONS: Similar to findings from high-income settings, cardiology administrators and cardiologists in South America value CR as part of cardiac patient care, but funding and availability of programs restrict capacity to deliver these services.


Subject(s)
Attitude of Health Personnel , Cardiac Rehabilitation/statistics & numerical data , Health Care Surveys/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Caribbean Region , Cross-Sectional Studies , Humans , South America , Surveys and Questionnaires
15.
J Cardiopulm Rehabil Prev ; 37(3): 182-190, 2017 May.
Article in English | MEDLINE | ID: mdl-27182759

ABSTRACT

PURPOSE: Depression is 3 times more prevalent in the cardiac than the general population in high-income countries and is particularly high in middle-income countries. Comorbid depression is associated with twice the mortality after a cardiovascular event. The objectives of this study were to describe and compare depressive symptoms pre- and postcardiac rehabilitation (CR) among patients in high-income countries and middle-income countries in the Americas. METHODS: The study design was prospective and observational. A convenience sample of CR participants completed the Patient Health Questionnaire-9 (PHQ-9) at CR intake and again at program discharge. Clinical data were extracted from medical charts. RESULTS: There were 779 participants: 45 Brazilian (5.8% of sample), 214 Canadian (27.5%), 126 Colombian (16.2%), 309 American (39.7%), and 85 Venezuelan (10.9%). Pre-CR depressive symptoms significantly differed between countries (P < .05), with Colombian participants reporting higher scores than Canadians and Venezuelans. Total PHQ-9 scores significantly decreased during CR in Colombia (mean change =-2.33; P < .001), the United States (mean change =-1.12; P < .001), and Venezuela (mean change =-2.14; P < .001), but not in Brazil (where less psychosocial intervention was offered) or Canada (where pre-CR scores were low). Among the 102 (13.1%) participants with scores in the elevated range pre-CR, the mean change in PHQ-9 scores was -6.57 ± 1.09 and 40 (39.2%) participants no longer had elevated symptoms postprogram. CONCLUSIONS: Depressive symptoms are variable among patients with CR in South and North American countries. CR programs incorporating psychosocial components can reduce these symptoms.


Subject(s)
Cardiac Rehabilitation/psychology , Cardiovascular Diseases/epidemiology , Depressive Disorder/epidemiology , Aged , Brazil/epidemiology , Canada/epidemiology , Cardiovascular Diseases/psychology , Colombia/epidemiology , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Prospective Studies , Severity of Illness Index , Surveys and Questionnaires , United States/epidemiology , Venezuela/epidemiology
16.
Arq Bras Cardiol ; 107(5): 467-481, 2016 Nov.
Article in English, Portuguese | MEDLINE | ID: mdl-27982272

ABSTRACT

Cardiopulmonary exercise test (CPET) has been gaining importance as a method of functional assessment in Brazil and worldwide. In its most frequent applications, CPET consists in applying a gradually increasing intensity exercise until exhaustion or until the appearance of limiting symptoms and/or signs. The following parameters are measured: ventilation; oxygen consumption (VO2); carbon dioxide production (VCO2); and the other variables of conventional exercise testing. In addition, in specific situations, pulse oximetry and flow-volume loops during and after exertion are measured. The CPET provides joint data analysis that allows complete assessment of the cardiovascular, respiratory, muscular and metabolic systems during exertion, being considered gold standard for cardiorespiratory functional assessment.1-6 The CPET allows defining mechanisms related to low functional capacity that can cause symptoms, such as dyspnea, and correlate them with changes in the cardiovascular, pulmonary and skeletal muscle systems. Furthermore, it can be used to provide the prognostic assessment of patients with heart or lung diseases, and in the preoperative period, in addition to aiding in a more careful exercise prescription to healthy subjects, athletes and patients with heart or lung diseases. Similarly to CPET clinical use, its research also increases, with the publication of several scientific contributions from Brazilian researchers in high-impact journals. Therefore, this study aimed at providing a comprehensive review on the applicability of CPET to different clinical situations, in addition to serving as a practical guide for the interpretation of that test. Resumo O teste cardiopulmonar de exercício (TCPE) vem ganhando importância crescente como método de avaliação funcional tanto no Brasil quanto no Mundo. Nas suas aplicações mais frequentes, o teste consiste em submeter o indivíduo a um exercício de intensidade gradativamente crescente até a exaustão ou o surgimento de sintomas e/ou sinais limitantes. Neste exame se mensura a ventilação (VE), o consumo de oxigênio (VO2), a produção de gás carbônico (VCO2) e as demais variáveis de um teste de exercício convencional. Adicionalmente, podem ser verificadas, em situações específicas, a oximetria de pulso e as alças fluxo-volume antes, durante e após o esforço. A análise integrada dos dados permite a completa avaliação dos sistemas cardiovascular, respiratório, muscular e metabólico no esforço, sendo considerado padrão-ouro na avaliação funcional cardiorrespiratória.1-6 O TCPE permite definir mecanismos relacionados à baixa capacidade funcional, os quais podem ser causadores de sintomas como a dispneia, correlacionando-os com alterações dos sistemas cardiovascular, pulmonar e musculoesquelético. Também pode ser de grande aplicabilidade na avaliação prognóstica em cardiopatas, pneumopatas e em pré-operatório, além de auxiliar na prescrição mais criteriosa do exercício em sujeitos normais, em atletas, em cardiopatas e em pneumopatas. Assim como ocorre com o uso clínico, a pesquisa nesse campo também cresce e várias contribuições científicas de pesquisadores nacionais são publicadas em periódicos de alto fator de impacto. Sendo assim, o objetivo deste documento é fornecer uma revisão ampla da aplicabilidade do TCPE nas diferentes situações clínicas, bem como servir como guia prático na interpretação desse teste propedêutico.


Subject(s)
Exercise Test/standards , Heart Failure/diagnosis , Lung Diseases/diagnosis , Oxygen Consumption/physiology , Pulmonary Ventilation/physiology , Diagnosis, Differential , Dyspnea/diagnosis , Exercise Test/methods , Heart Failure/physiopathology , Humans , Hypertension, Pulmonary/diagnosis , Lung Diseases/physiopathology , Prognosis , Pulmonary Circulation , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/physiopathology , Spirometry , Ventricular Dysfunction, Left/physiopathology
17.
Arq. bras. cardiol ; 107(5): 467-481, Nov. 2016. graf, tab
Article in English | LILACS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-827864

ABSTRACT

ABSTRACT Cardiopulmonary exercise test (CPET) has been gaining importance as a method of functional assessment in Brazil and worldwide. In its most frequent applications, CPET consists in applying a gradually increasing intensity exercise until exhaustion or until the appearance of limiting symptoms and/or signs. The following parameters are measured: ventilation; oxygen consumption (VO2); carbon dioxide production (VCO2); and the other variables of conventional exercise testing. In addition, in specific situations, pulse oximetry and flow-volume loops during and after exertion are measured. The CPET provides joint data analysis that allows complete assessment of the cardiovascular, respiratory, muscular and metabolic systems during exertion, being considered gold standard for cardiorespiratory functional assessment.1-6 The CPET allows defining mechanisms related to low functional capacity that can cause symptoms, such as dyspnea, and correlate them with changes in the cardiovascular, pulmonary and skeletal muscle systems. Furthermore, it can be used to provide the prognostic assessment of patients with heart or lung diseases, and in the preoperative period, in addition to aiding in a more careful exercise prescription to healthy subjects, athletes and patients with heart or lung diseases. Similarly to CPET clinical use, its research also increases, with the publication of several scientific contributions from Brazilian researchers in high-impact journals. Therefore, this study aimed at providing a comprehensive review on the applicability of CPET to different clinical situations, in addition to serving as a practical guide for the interpretation of that test.


RESUMO O teste cardiopulmonar de exercício (TCPE) vem ganhando importância crescente como método de avaliação funcional tanto no Brasil quanto no Mundo. Nas suas aplicações mais frequentes, o teste consiste em submeter o indivíduo a um exercício de intensidade gradativamente crescente até a exaustão ou o surgimento de sintomas e/ou sinais limitantes. Neste exame se mensura a ventilação (VE), o consumo de oxigênio (VO2), a produção de gás carbônico (VCO2) e as demais variáveis de um teste de exercício convencional. Adicionalmente, podem ser verificadas, em situações específicas, a oximetria de pulso e as alças fluxo-volume antes, durante e após o esforço. A análise integrada dos dados permite a completa avaliação dos sistemas cardiovascular, respiratório, muscular e metabólico no esforço, sendo considerado padrão-ouro na avaliação funcional cardiorrespiratória.1-6 O TCPE permite definir mecanismos relacionados à baixa capacidade funcional, os quais podem ser causadores de sintomas como a dispneia, correlacionando-os com alterações dos sistemas cardiovascular, pulmonar e musculoesquelético. Também pode ser de grande aplicabilidade na avaliação prognóstica em cardiopatas, pneumopatas e em pré-operatório, além de auxiliar na prescrição mais criteriosa do exercício em sujeitos normais, em atletas, em cardiopatas e em pneumopatas. Assim como ocorre com o uso clínico, a pesquisa nesse campo também cresce e várias contribuições científicas de pesquisadores nacionais são publicadas em periódicos de alto fator de impacto. Sendo assim, o objetivo deste documento é fornecer uma revisão ampla da aplicabilidade do TCPE nas diferentes situações clínicas, bem como servir como guia prático na interpretação desse teste propedêutico.


Subject(s)
Humans , Oxygen Consumption/physiology , Pulmonary Ventilation/physiology , Exercise Test/standards , Heart Failure/diagnosis , Lung Diseases/diagnosis , Prognosis , Spirometry , Pulmonary Circulation , Ventricular Dysfunction, Left/physiopathology , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/physiopathology , Diagnosis, Differential , Dyspnea/diagnosis , Exercise Test/methods , Heart Failure/physiopathology , Hypertension, Pulmonary/diagnosis , Lung Diseases/physiopathology
18.
BMC Health Serv Res ; 16: 471, 2016 09 06.
Article in English | MEDLINE | ID: mdl-27600379

ABSTRACT

BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of death globally. Cardiac rehabilitation (CR) is an evidence-based intervention recommended for patients with CVD, to prevent recurrent events and to improve quality of life. However, despite the proven benefits, only a small percentage of those would benefit from CR actually receive it worldwide. This paper by the International Council of Cardiovascular Prevention and Rehabilitation forwards the groundwork for successful CR advocacy to achieve broader reimbursement, and hence implementation. METHODS: First, the results of the International Council's survey on national CR reimbursement policies by government and insurance companies are summarized. Second, a multi-faceted approach to CR advocacy is forwarded. Finally, as per the advocacy recommendations, the economic impact of CVD and the corresponding benefits of CR and its cost-effectiveness are summarized. This provides the case for CR reimbursement advocacy. RESULTS: Thirty-one responses were received, from 25 different countries: 18 (58.1 %) were from high-income countries, 10 (32.4 %) from upper middle-income, and 3 (9.9 %) from lower middle-income countries. When asked who reimburses at least some portion of CR services in their country, 19 (61.3 %) reported the government, 17 (54.8 %) reported patients pay out-of-pocket, 16 (51.6 %) reported insurance companies, 12 (38.7 %) reported that it is shared between the patient and another source, and 7 (22.6 %) reported another source. CONCLUSIONS: Many patients pay out-of-pocket for CR. CR reimbursement around the world is inconsistent and insufficient. Advocacy campaigns forwarding the CR cause, supported by the relevant literature, enlisting sources of support in a unified manner with an organized plan, are needed, and must be pursued persistently.


Subject(s)
Ambulatory Care/methods , Cardiac Rehabilitation/methods , Cardiovascular Diseases/prevention & control , Patient Advocacy , Ambulatory Care/economics , Cardiac Rehabilitation/economics , Cardiovascular Diseases/economics , Cost-Benefit Analysis , Developed Countries , Developing Countries , Global Health , Health Expenditures , Humans , Insurance, Health , Male , Outpatients , Poverty/economics , Quality of Life , Quality-Adjusted Life Years , Reimbursement Mechanisms
19.
Arq Bras Cardiol ; 106(5): 389-95, 2016 May.
Article in English, Portuguese | MEDLINE | ID: mdl-27305285

ABSTRACT

BACKGROUND: Cardiopulmonary exercise test (CPET) is the most complete tool available to assess functional aerobic capacity (FAC). Maximum oxygen consumption (VO2 max), an important biomarker, reflects the real FAC. OBJECTIVE: To develop a cardiorespiratory fitness (CRF) classification based on VO2 max in a Brazilian sample of healthy and physically active individuals of both sexes. METHODS: We selected 2837 CEPT from 2837 individuals aged 15 to 74 years, distributed as follows: G1 (15 to 24); G2 (25 to 34); G3 (35 to 44); G4 (45 to 54); G5 (55 to 64) and G6 (65 to 74). Good CRF was the mean VO2 max obtained for each group, generating the following subclassification: Very Low (VL): VO2 < 50% of the mean; Low (L): 50% - 80%; Fair (F): 80% - 95%; Good (G): 95% -105%; Excellent (E) > 105%. RESULTS: Men VL < 50% L 50-80% F 80-95% G 95-105% E > 105% G1 < 25.30 25.30-40.48 40.49-48.07 48.08-53.13 > 53.13 G2 < 23.70 23.70-37.92 37.93-45.03 45.04-49.77 > 49.77 G3 < 22.70 22.70-36.32 36.33-43.13 43.14-47.67 > 47.67 G4 < 20.25 20.25-32.40 32.41-38.47 38.48-42.52 > 42.52 G5 < 17.54 17.65-28.24 28.25-33.53 33.54-37.06 > 37.06 G6 < 15 15.00-24.00 24.01-28.50 28.51-31.50 > 31.50 Women G1 < 19.45 19.45-31.12 31.13-36.95 36.96-40.84 > 40.85 G2 < 19.05 19.05-30.48 30.49-36.19 36.20-40.00 > 40.01 G3 < 17.45 17.45-27.92 27.93-33.15 33.16-34.08 > 34.09 G4 < 15.55 15.55-24.88 24.89-29.54 29.55-32.65 > 32.66 G5 < 14.30 14.30-22.88 22.89-27.17 27.18-30.03 > 30.04 G6 < 12.55 12.55-20.08 20.09-23.84 23.85-26.35 > 26.36 CONCLUSIONS: This chart stratifies VO2 max measured on a treadmill in a robust Brazilian sample and can be used as an alternative for the real functional evaluation of physically and healthy individuals stratified by age and sex.


Subject(s)
Cardiorespiratory Fitness/physiology , Exercise Test/classification , Oxygen Consumption/physiology , Adolescent , Adult , Age Distribution , Aged , American Heart Association , Brazil , Exercise Test/methods , Female , Humans , Male , Middle Aged , Sedentary Behavior , Sex Distribution , United States , Young Adult
20.
Arq. bras. cardiol ; 106(5): 389-395, May 2016. tab, graf
Article in English | LILACS | ID: lil-784179

ABSTRACT

Abstract Background: Cardiopulmonary exercise test (CPET) is the most complete tool available to assess functional aerobic capacity (FAC). Maximum oxygen consumption (VO2 max), an important biomarker, reflects the real FAC. Objective: To develop a cardiorespiratory fitness (CRF) classification based on VO2 max in a Brazilian sample of healthy and physically active individuals of both sexes. Methods: We selected 2837 CEPT from 2837 individuals aged 15 to 74 years, distributed as follows: G1 (15 to 24); G2 (25 to 34); G3 (35 to 44); G4 (45 to 54); G5 (55 to 64) and G6 (65 to 74). Good CRF was the mean VO2 max obtained for each group, generating the following subclassification: Very Low (VL): VO2 < 50% of the mean; Low (L): 50% - 80%; Fair (F): 80% - 95%; Good (G): 95% -105%; Excellent (E) > 105%. Results: Men VL < 50% L 50-80% F 80-95% G 95-105% E > 105% G1 < 25.30 25.30-40.48 40.49-48.07 48.08-53.13 > 53.13 G2 < 23.70 23.70-37.92 37.93-45.03 45.04-49.77 > 49.77 G3 < 22.70 22.70-36.32 36.33-43.13 43.14-47.67 > 47.67 G4 < 20.25 20.25-32.40 32.41-38.47 38.48-42.52 > 42.52 G5 < 17.54 17.65-28.24 28.25-33.53 33.54-37.06 > 37.06 G6 < 15 15.00-24.00 24.01-28.50 28.51-31.50 > 31.50 Women G1 < 19.45 19.45-31.12 31.13-36.95 36.96-40.84 > 40.85 G2 < 19.05 19.05-30.48 30.49-36.19 36.20-40.00 > 40.01 G3 < 17.45 17.45-27.92 27.93-33.15 33.16-34.08 > 34.09 G4 < 15.55 15.55-24.88 24.89-29.54 29.55-32.65 > 32.66 G5 < 14.30 14.30-22.88 22.89-27.17 27.18-30.03 > 30.04 G6 < 12.55 12.55-20.08 20.09-23.84 23.85-26.35 > 26.36 Conclusions: This chart stratifies VO2 max measured on a treadmill in a robust Brazilian sample and can be used as an alternative for the real functional evaluation of physically and healthy individuals stratified by age and sex.


Resumo Fundamento: O teste cardiopulmonar de exercício (TCPE) é a ferramenta disponível mais completa na avaliação da capacidade aeróbica funcional (CF) do indivíduo. O consumo máximo de oxigênio (VO2 max), importante marcador biológico, reflete a real CF. Objetivo: Elaborar uma classificação de aptidão cardiorrespiratória (ACR) baseada no VO2 max em uma amostra nacional de sujeitos saudáveis e ativos de ambos os sexos. Métodos: Selecionamos 2837 TCPE de indivíduos entre 15 e 74 anos, assim distribuídos: G1 (15 a 24); G2 (25 a 34); G3 (35 a 44); G4 (45 a 54); G5 (55 a 64) e G6 (65 a 74). A ACR boa foi a média do VO2 max obtido em cada grupo, gerando as seguintes subclassificações: Muito Fraca (MF) VO2 < 50% da média; Fraca (F): 50%-80%; Regular (R): 80%-95%; Boa (B): 95%-105%; e Excelente (E) > 105%. Resultados: Homens MF < 50% F 50-80% R 80-95% B 95-105% E > 105% G1 < 25,30 25,30-40,48 40,49-48,07 48,08-53,13 > 53,13 G2 < 23,70 23,70-37,92 37,93-45,03 45,04-49,77 > 49,77 G3 < 22,70 22,70-36,32 36,33-43,13 43,14-47,67 > 47,67 G4 < 20,25 20,25-32,40 32,41-38,47 38,48-42,52 > 42,52 G5 < 17,54 17,65-28,24 28,25-33,53 33,54-37,06 > 37,06 G6 < 15 15,00-24,00 24,01-28,50 28,51-31,50 > 31,50 Mulheres G1 < 19,45 19,45-31,12 31,13-36,95 36,96-40,84 > 40,85 G2 < 19,05 19,05-30,48 30,49-36,19 36,20-40,00 > 40,01 G3 < 17,45 17,45-27,92 27,93-33,15 33,16-34,08 > 34,09 G4 < 15,55 15,55-24,88 24,89-29,54 29,55-32,65 > 32,66 G5 < 14,30 14,30-22,88 22,89-27,17 27,18-30,03 > 30,04 G6 < 12,55 12,55-20,08 20,09-23,84 23,85-26,35 > 26,36 Conclusão: A presente tabela estratifica o VO2 max aferido em esteira em uma robusta amostra nacional e pode ser utilizada como opção para a real avaliação funcional de indivíduos ativos e saudáveis de acordo com sexo e faixa etária.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Oxygen Consumption/physiology , Exercise Test/classification , Cardiorespiratory Fitness/physiology , United States , Brazil , Sex Distribution , Age Distribution , Exercise Test/methods , Sedentary Behavior , American Heart Association
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