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Is the balance of patients with a ventricular ejection fraction =40% a viable metric for assessing their overall health?
Session:
Sessão de Posters 56 - Medicina Cardiovascular: a Pessoa e a Doença
Speaker:
Carina Rebelo
Congress:
CPC 2024
Topic:
P. Other
Theme:
37. Miscellanea
Subtheme:
32.3 Cardiovascular Nursing - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Carina Rebelo; Jose Bastos; Vera Afreixo; Ana Abreu
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background:</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Hospitalized patients exhibiting a reduced left ventricular ejection fraction (LVEF) encounter constraints in their daily activities and an elevation in dependency levels. Such circumstances may impede recovery, foster frailty, and elevate the susceptibility to comorbidities.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim: </strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">To evaluate the physical fitness of patients participating in a cardiac rehabilitation (CR) program aimed at improving their cardiac condition and functional capacity in patients with left ventricular ejection fraction (LVEF) issues.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Longitudinal, prospective, experimental study of inpatients with coronary artery disease. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Dynamic balance and mobility (Fullerton battery of tests), upper body strength (handgrip strength test), cardiorespiratory fitness was used to evaluate physical fitness. Also were submitted to Morisky Medication Adherence Scale, STOP-Bang scale, and IPAQ. Using R version 4.2.2, descriptive and inferential analyses were conducted, and all test results p<0.05.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">We evaluated 115 patients, with median age of 66 and interquartile range (58, 73), of whom 31% had LVEF<=40%; 83% had hypertension, 81% had dyslipidemia, 69% drank alcoholic beverages daily (30% <0.75 l/day, and 39% >0.75l/day), 35% had a prior history of smoking, and 19% were active smokers. Physical exercise, sporadic (13%), 3x/week 10% and 7% daily. For the Fullerton battery test 75% could not safely rotate 360º, requiring four or more steps in both directions; 93% could not walk independently and uninterruptedly over a straight line on the ground; 81% could not balance on one leg autonomously and maintain the position for 20 seconds. We also found that 65% were at high risk for sleep apnea.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">LVEF data were divided into classes (LVEF <=40; LVEF 41-50; LVEF >=50) and association assessment was performed using Kruskal-Wallis test, and Fisher's / Pearson's Chi-squared tests), there was a positive association (p < 0.001) between LVEF and: balance, diagnosis, 6MWT, IPAQ, LCADL and EQ 5D. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusions:</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Patients with LVEF ≤ 40% exhibit high-risk cardiovascular scores, decreased performance and increased disability. This group represents a promising population for successful CR. We hypothesise that assessing balance may serve as a future tool for quantifying the efficacy of CR, given that frailty and disability are indicators of inferior performance.</span></span></p>
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