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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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12. Coronary Artery Disease (Chronic)
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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Predisponent fatores to good response to exercise
Session:
Painel 1 - Insuficiência Cardíaca 7
Speaker:
Bruno Miguel Delgado
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Bruno Miguel Delgado; Ivo Lopes; Sandra Machado Pereira; Luisa Carneiro ; Andre Novo
Abstract
<p>Introduction<br /> Exercise training (ET) is an excellent tool to promote functional capacity in chronic heart failure (HF) patients. Although its benefits, it needs to be demonstrated in decompensated HF patients. A way to optimize an intervention is to evaluate who are the good responders and understand the causes of no response. Knowing the determinants of good response is also important to emphasize the feasibility of an intervention.</p> <p>Purpose</p> <p>To identify the factors of good response to an aerobic ET program for decompensated HF inpatients – ERIC-HF (early rehabilitation in cardiology – heart failure)</p> <p>Methods<br /> 50 patients who performed ERIC-HF were evaluated in terms of sociodemographic, functional and physiological characteristics. The main variables used to understand the performance of the patients were 1) best Barthel index variation, 2) best LCADL score variation and 3) best variation in the distance walked in the 6-minute walking test (6MWT). It was used the Paired sample T test to compare the 6MWT distance in the beginning and at discharge and Pearson correlation test to correlate different variables and the variation of the result in the 6MWT test. It was assumed a significance level at p<0.05. Also univariate and multivariate regression was used to analyze the 25% percentil of the best patients. </p> <p>Results</p> <p>Patient’s average age was 71 (±11) years old, 34 are male, 80% are in NYHA class III, 18 have diabetes and 6 have resynchronization therapy. Patients performed a global amount of 684 sessions of exercise, with an average of 14 sessions each, for 16 (±9) days of hospitalization.</p> <p>The mean distance walked in the 6MWTinicial was 199,9 (±115,9) meters and 287,6 (±128,9) meters at 6MWTdischarge, representing a 87,7 (±170,6) meters difference, which is statistically and clinically significant to a 99% confidence interval (p=0,001).</p> <p>The distance in the 6MWTinicial do not correlates with any variables. Therefore, the initial ability to perform the test cannot be predicted by any variable. The difference distance, correlates positively with the initial and final Barthel index (72 vs 98). The patients who demonstrated greater heart rate variation during ET had the most significant improvement in the 6MWTdischarge. The 6MWTdischarge distance, correlates negatively with the final and initial LCADL, but not with the 6MWTinicial. 6MWTdischarge correlates negatively with Borg modified perceived exertion in the test (3±2). The age of the patient correlates negatively only with the 6MWTdischarge. </p> <p>Conclusions<br /> Apparently, the great functional capacity the patients have, the great improvement they will achieve. To a lower functional capacity corresponds more days of hospitalization. ERIC-HF seems to be more effective to patients that are more conditioned prior to the cardiac event. Other exercise programs need to be designed to better establish the response of deconditioned patients during stabilization phase.</p>
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