RESUMO
Purpose: Exercise intolerance and dyspnoea are clinical symptoms in both heart failure (HF) reduced ejection fraction (HFrEF) and chronic obstructive pulmonary disease (COPD), which are suggested to be associated with musculoskeletal dysfunction. We tested the hypothesis that HFrEF + COPD patients would present lower muscle strength and greater fatigue compared to compared to the COPD group. Methods: We included 25 patients with HFrEF + COPD (100% male, age 67.8 ± 6.9) and 25 patients with COPD alone (100% male, age 66.1 ± 9.1). In both groups, COPD severity was determined as moderate-to-severe according to the GOLD classification (FEV1/FVC < 0.7 and predicted post-bronchodilator FEV1 between 30%-80%). Knee flexor-extensor muscle performance (torque, work, power and fatigue) were measured by isokinetic dynamometry in age and sex-matched patients with HFrEF + COPD and COPD alone; Functional capacity was assessed by the cardiopulmonary exercise test, the 6-min walk test (6MWT) and the four-minute step test. Results: The COPD group exhibited reduced lung function compared to the HFrEF + COPD group, as evidenced by lower FEV1/FVC (58.0 ± 4.0 vs. 65.5 ± 13.9; p < 0.0001, respectively) and FEV1 (51.3 ± 17.0 vs. 62.5 ± 17.4; p = 0.026, respectively) values. Regarding musculoskeletal function, the HFrEF + COPD group showed a knee flexor muscles impairment, however this fact was not observed in the knee extensors muscles. Power peak of the knee flexor corrected by muscle mass was significantly correlated with the 6MWT (r = 0.40; p < 0.05), number of steps (r = 0.30; p < 0.05) and work ratepeak (r = 0.40; p < 0.05) in the HFrEF + COPD and COPD groups. Conclusion: The presence of HFrEF in patients with COPD worsens muscular weakness when compared to isolated COPD.
RESUMO
Introdução: Programas de reabilitação cardiovascular são fundamentais para garantir uma melhor qualidade de vida (QV) em pacientes cardiopatas. Objetivos: Avaliar a QV de pacientes submetidos à reabilitação cardíaca (RC) e investigar se aspectos sociodemográficos, tipo de diagnóstico e tempo de tratamento são variáveis que influenciam a QV desses pacientes. Métodos: Realizou-se um estudo transversal com 82 pacientes, 64,52 ± 9,04 anos, que responderam dois questionários, para avaliação da QV (questionário SF-36) e para classificação do nível socioeconômico, e tiveram seu nível sociodemográfico determinado. Resultados: Maiores valores dos escores do questionário SF-36 que avaliam aspectos emocionais foram observados em todas as associações realizadas. Os aspectos do perfil da amostra abordados neste estudo não repercutiram de forma representativa na QV. Conclusão: Pacientes cardiopatas submetidos à RC apresentaram maiores valores em escores de qualidade de vida que avaliam aspectos emocionais. Os fatores estudados não influenciaram a QV desses participantes.
Introduction: Cardiovascular rehabilitation programs are fundamental to ensure a better quality of life (QL) in cardiac patients. Objective: Evaluate the QL of patients undergoing cardiac rehabilitation (CR) and investigate if demographic aspects, diagnosis and treatment time are variables that influence on these patients QL. Methods: It was conducted a cross-sectional study with 82 patients, 64,52 ± 9,04 years old, who answered two questionnaires, for QL assessment (questionnaire SF-36) and for socioeconomic level classification, and their socio-demographie profile determined. Results: Higher values of scores of SF-36 questionnaire that assess emotional aspects were observed in all associations held. The sample profile aspects addressed in this study did not represent echo in QL. Conclusion: Cardiac patients submitted to RC showed greater benefits on emotional aspects and factors studied did not influence on these patients QL.
