O ensino de ressuscitação cardiopulmonar para jovens: quais os benefícios e as metodologias empregadas? / Teaching cardiopulmonary resuscitation to young people: what are the benefits and methodologies used?

Doenças cardiovasculares constituem a principal causa de mortalidade no mundo, sendo que a parada cardiorrespiratória (PCR) representa cerca de 320 mil mortes por ano no Brasil. Estima-se que metade das PCRs ocorram em ambiente extra-hospitalar, sendo 80% presenciados exclusivamente por pessoas leigas. Sabe-se que o tempo entre a PCR e o início da ressuscitação cardiopulmonar (RCP) é um fator crítico, visto que a cada minuto há uma redução em até 10% das chances de sobrevivência da vítima. A partir disso, constata-se que é de suma importância a capacitação de leigos para realizarem RCP, especialmente, a população jovem, que além de estar apta a realizar as manobras, representa uma importante fonte de disseminação de informação. Alguns países já adotam como obrigatório o treinamento de RCP no currículo escolar. No Brasil, contudo, ainda não existem aulas voltadas para o desenvolvimento das habilidades do suporte básico de vida (SBV). Diante disso, faz-se necessária a análise das intervenções realizadas em outros países para entender quais estratégias de ensino vêm sendo utilizadas. Dessa forma, o objetivo do presente estudo foi realizar uma revisão bibliográfica acerca das metodologias e resultados alcançados em processos de capacitação de alunos do ensino médio sobre SBV. Para isso, realizou-se uma revisão narrativa, na base de dados PubMed, resultando ao total 10 artigos, de acordo com os critérios empregados. Tais estudos demonstram que o ensino da RCP para alunos do ensino médio parece apresentar boa resposta, especialmente quando as intervenções são de longo prazo e abordam mais de uma metodologia de ensino.

Cardiovascular diseases are the main cause of mortality in the world, and cardiorespiratory arrest (CRP) represents about 320 thousand deaths per year in Brazil. It is estimated that half of the CRP occur outside the hospital, and among these cases, 80% are seen exclusively by laypeople. It is believed that the time between CRP and the onset of cardiopulmonary resuscitation (CPR) is the most critical factor, since every minute there is a reduction of up to 10% in the victim's chances of survival. From this, it appears that the training of laypeople to perform CPR is of utmost importance, especially the young population, who are able to perform the maneuvers and are a source of information dissemination. Some countries have already adopted the mandatory insertion of CPR training in the school curriculum. In Brazil, there are still no classes aimed at developing the skills of basic life support (BLS). In view of this, it is of utmost importance to analyze the interventions carried out in other countries to understand which teaching strategies are being used. Thus, the objective of the present study was to carry out a bibliographic review about the methodologies and results achieved in processes of training high school students on BLS. For this, a bibliographic review was carried out on the PubMed platform and 10 articles were included. Studies have shown that teaching CPR to high school students is effective, especially those who address more than one teaching methodology and make long-term interventions.

Teleophthalmology Screening for Diabetic Retinopathy in Brazil: Applicability and Economic Assessment.

Introduction: Early diagnosis and prompt therapy of diabetic retinopathy (DR) are essential to prevent visual loss, but access of the diabetic population to regular fundus examination by an ophthalmologist remains a challenge. Methods: This prospective comparative study, including two referral health centers in the state of Minas Gerais, Southeastern Brazil, assesses applicability and economic viability of fundus photography-based teleophthalmology screening for DR. Results: A total of 2,662 eyes of 1,331 patients were examined at both health centers. Mean age was 57 years, with 836 (62.8%) females. Quality of fundus photographs was acceptable for 2,398 eyes (90.1%). The presence of DR was disclosed in 394 patients (29.6%), with 28 patients (2.1%) presenting evidence of advanced disease (severe nonproliferative or proliferative DR). Economic assessment revealed cost reduction of 28.76 US$ per patient, with a calculated break-even point of 112 exams/month or 1,344 exams/year. Conclusions: For the situation studied under the perspective of public health service, teleophthalmology was viable and cost effective when compared with ordinary ophthalmology examination. In addition, teleophthalmology allowed rapid resolution of repressed demand for fundus examination of diabetic patients locally at the two sites, with early DR diagnoses and referrals. Fundus photography-based teleophthalmology was a viable, effective, and significantly cheaper strategy for the screening of DR.

Implementation of a text message intervention to promote behavioural change and weight loss among overweight and obese Brazilian primary care patients.

INTRODUCTION: Mobile-technology-based interventions are promising strategies for promoting behavioural change in obese patients. The aims of this study were to evaluate the feasibility of implementing a text message intervention, and to assess the effects of the intervention on body mass index (BMI) and self-reported behavioural change. METHODS: TELEFIT was a three-phase feasibility study comprising the following stages: (a) the development of text messages; (b) testing; and (c) a quasi-experimental pilot study in which patients who were engaged in obesity/overweight educational groups in public primary care centres in Belo Horizonte, Brazil, were recruited. A bank of text messages was drafted and reviewed by an expert panel, text message delivery software was developed and tested, and a pilot study assessed patients before and after receiving the intervention using validated questionnaires and body measures. The data were analysed using the Wilcoxon test. RESULTS: A total of 46 patients completed the follow-up; 93.5% were women and the median age was 42 years (interquartile range (IQR) 34-52 years). At four months, participants had a significant reduction in BMI (median 31.3 (IQR 28.2-34.6) vs. 29.9 (IQR 27.2-34.6) kg/m2, p < 0.001), systolic (median 125 (IQR 120-132) vs. 120 (IQR 110-130) mmHg, p = 0.013) and diastolic blood pressure (median 80 (IQR 70-100) vs. 80 (IQR 70-80) mmHg, p = 0.006), when compared to baseline. All patients reported to be satisfied and willing to continue receiving the intervention, and 93.3% felt that the intervention helped them change their behaviours. DISCUSSION: This study has shown that a text message intervention to promote behavioural change and weight loss was feasible and effective in a short-term period. Participants were satisfied and willing to continue receiving the SMS messages.

Como aferir corretamente a pressão arterial

Aferir a pressão arterial é um método simples e rápido, mas requer uma série de cuidados e atenção para que a avaliação seja confiável. Este infográfico tem como objetivo auxiliar na técnica correta da aferição da pressão arterial.

The Impact of a Clinical Decision Support System in Diabetes Primary Care Patients in a Developing Country.

BACKGROUND: Telehealth strategies have the potential to improve diabetes care, but there is a lack of evidence about the impact of these strategies in developing countries. Our objective was to analyze the feasibility, usability, and clinical impact of a decision support system (DSS) in Brazilian primary care diabetes patients. MATERIALS AND METHODS: This was a quasi-experimental study that included type 2 diabetes primary care patients >40 years of age. Patients were assessed before (during 6 months) and after the implementation of the DSS application (4 months). The DSS application, used by health professionals, included clinical evaluations and blood glucose measurements and generated specific recommendations based on the data entered. RESULTS: In total, 145 patients were included (mean age, 62.0 ± 9.9 years), 62.1% were female, and 70.0% had been diagnosed with diabetes more than 5 years ago. Overall, there was no decrease in median hemoglobin A1c (HbA1c), from 7.7% (range, 6.5-9.8%) to 7.4% (range, 6.5-9.2%) (P for slope = 0.347). Subgroup analysis showed that patients with an HbA1c level of ≥9% at baseline had a significant reduction in median HbA1c level, from 10.5% (range, 9.9-11.3%) to 10.0% (range, 8.9-10.9%) (P for difference of slope between subgroups = 0.004). The reduction occurred in the first phase of the study, before the DSS use. Healthcare practitioners considered the DSS easy to use (99%) and believed that it provided useful information for patient care (100%). CONCLUSIONS: In this study the improvement of glycemic control before the application in more decompensated patients (HbA1c ≥9%) probably reflects the systematization of diabetes care. The DSS use did not improve the HbA1c level, possibly because of the short follow-up and/or infrequent use by the healthcare practitioners.

Clinical Quality Control of a Large-Scale Teleconsultation Service.

The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that assists 722 municipalities in the state of Minas Gerais. As a large-scale teleconsultation service, it was important to implement clinical quality control to guarantee the quality of the service. Our aim is to describe the audit of the teleconsultation responses performed by TNMG. A random sample was selected from teleconsultations performed by the specialists from the TNMG between January and February 2014. The responses were evaluated regarding size, objectivity, quality, ethics, courtesy and grammar. A total of 640 teleconsultation responses were assessed, and the mean scores were ≥2.45. Objectivity and quality had the lowest scores in the different specialities. The methodology was useful for evaluating the teleconsultation service and for identifying the areas to improve.

Factors associated with the use of a teleconsultation system in Brazilian primary care.

BACKGROUND: The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service that provides support to primary healthcare in Minas Gerais, Brazil, performing teleconsultation and tele-electrocardiography. The aim of this study was to assess teleconsultation requests received by the TNMG and to investigate the factors associated with low teleconsultation utilization in most municipalities. MATERIALS AND METHODS: A cross-sectional study was carried out including 214 municipalities. Indicators were defined to analyze teleconsultation requests. A structured questionnaire was used to investigate factors associated with teleconsultation utilization, which were analyzed by multivariate analysis through a decision tree algorithm (chi-squared automatic interaction detector) to the entire population of the study and logistic regression for municipalities that had used the system during the analyzed period. RESULTS: From May to September 2009, 1,954 teleconsultations were performed. The average number (±standard deviation) of teleconsultations per municipality was 1.71 (±1.50) per month. The majority of the users were located in remote regions with a low Human Development Index. The decision tree showed "conduction of sufficient training" (p=0.0015) as the factor with the greatest positive impact on teleconsultation utilization, followed by "ability to discuss clinical cases outside the teleconsultation system" (p=0.0192). Logistic regression analysis revealed two factors associated with increased use of the system: "complexity of the system" (odds ratio=3.35; 95% confidence interval [CI], 1.58-7.09) and whether they considered that the "service helps to solve everyday problems" (odds ratio=4.37; 95% CI, 1.14-16.69). CONCLUSIONS: The study of factors associated with the low use of the teleconsultation system of the TNMG may help policy makers define strategies to improve the use of teleconsultation services.

[Telehealth support for primary health care in remote municipalities in the state of Minas Gerais, Brazil]. / Teleconsultorias no apoio à atenção primária à saúde em municípios remotos no estado de Minas Gerais, Brasil.

OBJECTIVE: To analyze the use, effectiveness, and resolubility of teleconsultation services provided to primary care units by the Telehealth Network of Minas Gerais, a public service providing teleconsultation and telediagnosis in cardiology to 821 health care sites. METHODS: This observational retrospective study included teleconsultations carried out between April 2007 and December 2012. Teleconsultations performed from January to May 2010 and January to March 2012 were analyzed regarding the type of query asked by professionals using the service. A survey was carried out to evaluate resolubility and level of satisfaction with teleconsultations. RESULTS: During the study period, 47 689 teleconsultations were carried out. They were most often requested by nurses (53.2%) and physicians (34.3%), and were answered mainly by the following professionals: family physicians (23.3%), dermatologists (19.8%), gynecologists (10,7%), internal medicine physicians (8.8%), pediatricians (6.6%), and nurses (12.2%). The median population in the municipalities that requested teleconsultations was 6 778 (interquartile range [IQR]: 4 425 - 10 805). The median human development index (HDI) was 0.645 (IQR: 0.577 - 0.690). The most frequent queries regarded pharmacological treatment, non-pharmacological treatment, and etiology. Teleconsultations prevented potential referrals in 80% of the cases, and 94% of the health providers reported satisfaction with the service. CONCLUSIONS: The results show that the Telehealth Network of Minas Gerais can help overcome physical barriers in the access to health care and that it may be an important and effective tool for continued health education.

Teleconsultorias no apoio à atenção primária à saúde em municípios remotos no estado de Minas Gerais, Brasil / Telehealth support for primary health care in remote municipalities in the state of Minas Gerais, Brazil

OBJETIVO: Analisar a utilização, efetividade e resolutividade das teleconsultorias realizadas pela Rede de Teleassistência de Minas Gerais (RTMG, um serviço público de telessaúde que presta serviços de teleconsultoria e telediagnóstico em cardiologia a 821 pontos de atenção à saúde) na atenção primária à saúde. MÉTODOS: Estudo observacional e retrospectivo, que incluiu as teleconsultorias realizadas de abril de 2007 a dezembro de 2012. Uma amostragem das teleconsultorias realizadas de janeiro a maio de 2010 e janeiro a março de 2012 foi analisada quanto ao tipo de dúvida dos profissionais que fizeram a consulta. A satisfação e a resolutividade do serviço de teleconsultoria foram verificadas por meio de pesquisa de satisfação. RESULTADOS: No período do estudo, 47 689 teleconsultorias foram realizadas. Enfermeiros (53,2%) e médicos (34,3%) foram os profissionais que solicitaram teleconsultorias com maior frequência. Os especialistas que mais frequentemente as responderam foram das seguintes áreas: medicina de família e comunidade (23,3%), dermatologia (19,8%), ginecologia (10,7%), clínica médica (8,8%), pediatria (6,6%) e enfermeiros (12,2%). A mediana de população dos municípios que enviaram teleconsultorias foi de 6 778 habitantes (intervalo interquartil [IQR] 4 425 a 10 805). A mediana de índice de desenvolvimento humano (IDH) foi 0,645 (IQR 0,577 a 0,690). As dúvidas mais frequentes foram sobre tratamento farmacológico, tratamento não farmacológico e etiologia. As teleconsultorias evitaram potenciais encaminhamentos em 80% dos casos e 94% dos profissionais de saúde relataram estar satisfeitos com o serviço. CONCLUSÕES: Os resultados mostram que a RTMG foi capaz de quebrar barreiras físicas no acesso à assistência e constitui-se como ferramenta importante e eficiente de educação permanente em serviço.

OBJECTIVE: To analyze the use, effectiveness, and resolubility of teleconsultation services provided to primary care units by the Telehealth Network of Minas Gerais, a public service providing teleconsultation and telediagnosis in cardiology to 821 health care sites. METHODS: This observational retrospective study included teleconsultations carried out between April 2007 and December 2012. Teleconsultations performed from January to May 2010 and January to March 2012 were analyzed regarding the type of query asked by professionals using the service. A survey was carried out to evaluate resolubility and level of satisfaction with teleconsultations. RESULTS: During the study period, 47 689 teleconsultations were carried out. They were most often requested by nurses (53.2%) and physicians (34.3%), and were answered mainly by the following professionals: family physicians (23.3%), dermatologists (19.8%), gynecologists (10,7%), internal medicine physicians (8.8%), pediatricians (6.6%), and nurses (12.2%). The median population in the municipalities that requested teleconsultations was 6 778 (interquartile range [IQR]: 4 425 - 10 805). The median human development index (HDI) was 0.645 (IQR: 0.577 - 0.690). The most frequent queries regarded pharmacological treatment, non-pharmacological treatment, and etiology. Teleconsultations prevented potential referrals in 80% of the cases, and 94% of the health providers reported satisfaction with the service. CONCLUSIONS: The results show that the Telehealth Network of Minas Gerais can help overcome physical barriers in the access to health care and that it may be an important and effective tool for continued health education.

Is autonomic function associated with left ventricular systolic function in Chagas heart disease patients undergoing treatment for heart failure?

INTRODUCTION: The association between cardiac autonomic and left ventricular (LV) dysfunction in Chagas disease (ChD) is controversial. METHODS: A standardized protocol that includes the Valsalva maneuver, a respiratory sinus arrhythmia (RSA) test, and an echocardiographic examination was used. Spearman correlation coefficients (rho) were used to investigate associations. RESULTS: The study population consisted of 118 ChD patients undergoing current medical treatment, with an average LV ejection fraction of 51.4±2.6%. The LV ejection fraction and diastolic dimension were correlated with the Valsalva index (rho=0.358, p<0.001 and rho=-0.266, p=0.004, respectively) and the RSA (rho=0.391, p<0.001 and rho=-0.311, p<0.001, respectively). CONCLUSIONS: The impairment of LV function is directly associated with a reduction of cardiac autonomic modulation in ChD.

Equilíbrio e coordenação motora em alcoólicos abstinentes / Balance and motor coordination in abstinent alcoholics

Introdução: o alcoolismo é definido como síndrome crônica e multifatorial. Comumente, associa-se à degeneração cerebelar e polineuropatia, principais responsáveis pelas alterações de coordenação e equilíbrio que representam as consequências mais incapacitantes associadas ao consumo de álcool. Objetivo: descrever o perfil dos alcoólicos em abstinência frequentadores de um centro de convivência e investigar a associação entre consumo de álcool e transtornos do equilíbrio e coordenação motora. Métodos: foram coletados os dados demográficos e, em seguida, avaliados o equilíbrio e a coordenação motora dos pacientes. Estatística descritiva foi utilizada para a apresentação das variáveis estudadas. A relação entre consumo de álcool e equilíbrio foi investigada por meio de regressão linear múltipla e a relação entre consumo de álcool e coordenação foi analisada por meio do teste Mann--Whitney e do teste T para amostras independentes. Resultados: os pacientes eram, principalmente, homens, usuários, inclusive, de outras drogas psicoativas. Não houve associação significativa entre consumo de álcool e equilíbrio ou entre consumo de álcool e coordenação motora (p>0,05). Apesar de não ter sido objetivo deste estudo, o modelo de regressão revelou associação significativa entre idade e equilíbrio. Conclusão: os achados mostram a predominância do uso crônico do álcool em homens e do uso concomitante de outras drogas psicoativas. A falta de associação entre consumo de álcool e déficits de equilíbrio ecoordenação motora pode ser devida à plasticidade cerebral subsequente à abstinência.

Introduction: Alcoholism is defined as a chronic, multifactorial syndrome. It is commonly associated with cerebellar degeneration and polyneuropathy, resulting in coordination and balance dysfunctions that represent the most disabling consequences associated with alcohol consumption. Objective: to describe the profile of abstinent alcoholics who participate in a center for living and to investigate the association between alcohol consumptionand disorders of balance and motor coordination. Methods: Demographic data were collected followed by assessment of patients' balance and motor coordination. Descriptive statistics was used to present the variables studied. The relationship between alcohol consumption and balance was investigated by means of multiple linear regression andthe relationship between alcohol consumption and coordination was analyzed using the Mann-Whitney test and independent sample T-test. Results: Patients were mostly men; some also used other psychoactive drugs. There was no significant association between alcohol consumption and balance or between alcohol consumption and motor coordination(p>0.05). Although it was not the objective of this study, the regression model revealed a significant association between age and balance. Conclusion: Findings show the prevalence of chronic alcohol use in men and the concomitant use of other psychoactive drugs. The lack of association between alcohol consumption and deficits in balance and motor coordination may be due to brain plasticity subsequent to abstinence.

Depressive symptoms and disability in chagasic stroke patients: impact on functionality and quality of life.

INTRODUCTION: Chagas disease (CD) is associated with stroke, which can result in significant long-term disability. Stroke has also been associated with depressive symptoms, which affect functional performance and quality of life (QOL). Few data are available on the effect of chagasic stroke on functional performance and QOL. OBJECTIVES: This study aimed to investigate the correlation of stroke disability and depressive symptoms with functional performance and QOL in chagasic stroke patients. METHODS: In this cross-sectional study, stroke sequelae were assessed using the Modified Rankin Stroke Scale (MRSS), depressive symptoms using the Beck Depression Inventory (BDI), functional performance using the Barthel Index (BI), and QOL using the WHOQOL-BREF. RESULTS: Twenty-one patients with CD and a previous diagnosis of stroke were included. There was a correlation between the MRSS score and the BI score (r=-0.663, p=0.003), but not the scores of the WHOQOL-BREF subscales. The BDI score was correlated with the WHOQOL-BREF subscale scores (Physical: r=-0.733, p=0.001; Psychological: r=-0.581, p=0.012; Social: r=-0.713, p=0.001; Environmental: r=-0.659, p=0.003). However, the BDI score was not associated with the BI score (r=0.279, p=0.262). CONCLUSIONS: QOL in patients with CD appears to be influenced more by depressive symptoms than by the motor-associated consequences of stroke. Conversely, motor sequelae impair the functionality of the patient more than depressive symptoms.

A randomized trial of the effects of exercise training in Chagas cardiomyopathy.

AIMS: The effects of exercise training in chronic heart failure are well established, however, they have not been evaluated in Chagas cardiomyopathy (ChC). We sought to determine the effects of exercise training on functional capacity, health-related quality of life (HQoL), and brain natriuretic peptide (BNP) levels in patients with ChC. METHODS AND RESULTS: This randomized, controlled, single-blind trial included 40 patients with ChC (age 49.5 +/- 7.8 years, 57.5% male) who did not practice regular exercise. All patients were assessed, at baseline and at the end of the study, by exercise test (VO(2) and exercise time), six-minute walk test (6MWT), Goldman Specific Activity Scale (SAS), HQoL, and BNP levels. Patients were randomized to inactive control group (ICG = 19) or exercise training group (ETG = 21). Exercise training group patients underwent 12 weeks of exercise training: walking for up to 30 min (intensity 50-70% HR reserve + HR at rest) and warm-up and cooling-down exercising, three times a week. The data were analysed for delta values (Delta= end - baseline). After intervention, compared with the ICG, the ETG had significant increases in functional parameters including, DeltaVO(2) (6.5 vs. 2.8 mL/kg/min, P = 0.001), Delta exercise time (2.9 vs.1.1 min, P < 0.001), Delta6MWT distance (83.5 vs. 2.0 m, P = 0.001) improved DeltaSAS (8 vs. 1 patient, P = 0.008), and HQoL: Delta domains vitality (7.5 vs. 0 points, P = 0.013), Delta emotional aspects (16.7 vs. 0 points, P = 0.012), and Delta mental health (16.1 vs. 0 points, P = 0.031). There was no difference in BNP levels. CONCLUSION: In patients with ChC, exercise training was associated with a major improvement in functional capacity and HQoL without any adverse effects.

Chagas disease alters the relationship between heart rate variability and daily physical activity.

Regular exercise training is considered to be capable of beneficially modifying the autonomic balance in healthy subjects. We studied the association between vagal HRV indexes and the level of physical activity in Chagas disease patients and control subjects. Although in controls habitual physical activity was closely associated with vagal HRV indexes, no relationship was found between IPAQ scores and HRV indexes in a Chagas disease group, suggesting that Chagas dysautonomia disrupted this potentially beneficial association.

Health-related quality of life in Brazilian pacemaker patients.

BACKGROUND: Most quality of life (QoL) studies of pacemaker patients have been conducted in either North America or Europe and their applicability to Latin American populations is largely unknown. Our aim is to study health-related QoL indices in Brazilian pacemaker patients and their determinants using both a generic (SF-36) and a disease-specific questionnaire (AQUAREL). METHODS: The study enrolled 139 clinically stable patients (aged 59 +/- 14, 60.4% female) without any communication or cognitive impairments who went to the Pacemaker Laboratory for postimplantation follow-up. All patients were submitted to a standard protocol, which included an interview, functional class assessment, and QoL questionnaires. Additionally, 74 patients were requested to perform a 6-minute walk test. RESULTS: Female patients and patients without a partner displayed low QoL scores in both the SF-36 mental component summary and the AQUAREL arrhythmia domain. Chagas disease patients displayed low scores only in AQUAREL domains. All health-related QoL scores were low in patients with the worst, high-numbered functional classes, the strongest determinant of low QoL scores in multivariate analysis. CONCLUSION: In this first systematic study of QoL in a Latin American pacemaker population, AQUAREL detected well-impaired health-related QoL scores in different groups of patients, particularly in those with Chagas disease. Heart failure, evaluated by functional class, was the strongest predictor of low QoL in pacemaker patients.

Six-minute walk test in patients with permanent cardiac pacemakers.

PURPOSE: The 6-minute walk test (6MWT) is a simple and reliable method routinely used in the evaluation of many conditions including cardiac diseases. However, it is rarely performed in patients with pacemakers (PMs), and the applicability and safety in this group is not established. The purpose of this study was to verify the applicability and safety of the 6MWT in the evaluation of functional capacity of patients with PMs, considering the ergometry test (ET) as the criterion standard. METHODS: Twenty-four patients with rate-responsive PMs underwent a treadmill ET, using the Chronotropic Assessment Exercise Protocol, and a 6MWT, performed twice with a rest interval of 20 minutes. Functional capacity, heart rate, and blood pressure in each test were recorded. RESULTS: The distance covered during the 6MWT significantly correlated with the oxygen uptake estimated from the treadmill ET (r = 0.709, P < .001). Peak heart rates and systolic blood pressure levels reached during the 2 tests were also significantly correlated. No adverse events or malignant arrhythmias were observed during the 6MWT. The distance walked during the 6MWT accurately predicted the patient performance on the ET (area under the receiver operating characteristic curve = 0.921). The ability to walk more than 538 m in the 6MWT predicted, with a sensitivity of 90% and a specificity of 79%, an estimated oxygen uptake above 10 metabolic equivalents (METs) on the ET. CONCLUSIONS: The 6MWT can be considered safe to assess the submaximal functional capacity and can be used as an alternative test to evaluate the results of interventions in patients with permanent cardiac PMs.

Six-minute walk test in Chagas cardiomyopathy.

We studied systematically, for the first time, the utility of the six-minute walk test (6MWT) in Chagas disease. The walked distance at 6MWT correlated negatively with the increased circulating levels of monocyte chemoattractant protein (MCP-1, r=-0.358, p=0.04) and natriuretic peptide type B (BNP, r=-0.349, p=0.04), as well as positively with ejection fraction deterioration (r=0.451, p=0.004), indicating that submaximal functional capacity of chagasic patients is related to the severity of the cardiopathy. 6MWT may constitute an auxiliary tool in the evaluation of the clinical status of Chagas disease patients.