A Cycle Ergometer Exercise Program Improves Exercise Capacity and Inspiratory Muscle Function in Hospitalized Patients Awaiting Heart Transplantation: a Pilot Study.

Objective: The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. Methods: Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: 1) Control Group (n=11) - conventional protocol; and 2) Intervention Group (n=7) - stationary cycle ergometer exercise training. Functional capacity was measured by the six-minute walk test and inspiratory muscle strength assessed by manovacuometry before and after the exercise protocols. Results: Both groups demonstrated an increase in six-minute walk test distance after the experimental procedure compared to baseline; however, only the intervention group had a significant increase (P =0.08 and P =0.001 for the control and intervention groups, respectively). Intergroup comparison revealed a greater increase in the intervention group compared to the control (P <0.001). Regarding the inspiratory muscle strength evaluation, the intragroup analysis demonstrated increased strength after the protocols compared to baseline for both groups; statistical significance was only demonstrated for the intervention group, though (P =0.22 and P <0.01, respectively). Intergroup comparison showed a significant increase in the intervention group compared to the control (P <0.01). Conclusion: Stationary cycle ergometer exercise training shows positive results on exercise capacity and inspiratory muscle strength in patients with heart failure awaiting cardiac transplantation while on intravenous inotropic support.

A cycle ergometer exercise program improves exercise capacity and inspiratory muscle function in hospitalized patients awaiting heart transplantation: a pilot study

Abstract Objective: The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. Methods: Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: 1) Control Group (n=11) - conventional protocol; and 2) Intervention Group (n=7) - stationary cycle ergometer exercise training. Functional capacity was measured by the six-minute walk test and inspiratory muscle strength assessed by manovacuometry before and after the exercise protocols. Results: Both groups demonstrated an increase in six-minute walk test distance after the experimental procedure compared to baseline; however, only the intervention group had a significant increase (P =0.08 and P =0.001 for the control and intervention groups, respectively). Intergroup comparison revealed a greater increase in the intervention group compared to the control (P <0.001). Regarding the inspiratory muscle strength evaluation, the intragroup analysis demonstrated increased strength after the protocols compared to baseline for both groups; statistical significance was only demonstrated for the intervention group, though (P =0.22 and P <0.01, respectively). Intergroup comparison showed a significant increase in the intervention group compared to the control (P <0.01). Conclusion: Stationary cycle ergometer exercise training shows positive results on exercise capacity and inspiratory muscle strength in patients with heart failure awaiting cardiac transplantation while on intravenous inotropic support.

Padronizaçäo da dosagem de homocisteína plasmática por cromatografia líquida de alta pressäo e aplicaçäo em pacientes com doença arterial coronariana / Standardization of homocysteine determination by high pressure liquid chromatography and application on coronary artery disease patients

Doença arterial coranariana (DAC) está entre as mais importantes da atualidade por apresentar alta taxa de mortalidade e morbidade. Os fatores de risco incluem dislipidemia, hipertensäo, diabetes mellitus, tabagismo, história familiar e pouca atividade física. Recentemente, surgiram trabalhos sugerindo que a hiper-homocisteinemia seja um fator de risco independente para o desenvolvimento de DAC. O mecanismo pelo qual a homocisteína agiria ainda näo está bem esclarecido, mas as possibilidades apontam para dano endotelial direto, alteraçäo da atividade plaquetária e interaçäo com fatores da coagulaçäo. Os objetivos deste trabalho foram a padronizaçäo de metodologia para a dosagem de homociteína total e o estudo de pacientes portadores de DAC. Outros fatores de risco, como triglicerídios, colesterol, glicemia e nível de peroxidaçäo de lipídios, foram quantificados. Para a dosagem de homocisteína no plasma, foi padronizado um ensaio por cromatografia líquida de alta pressäo, com detecçäo fluriométrica. o grupo controle (n=24) apresentou os seguintes valores: 9,2 ñ 4,1 µmol/I (média ñ desvio padräo). O grupo paciente (n=35) apresentou os seguintes valores para homocisteína: 14,2 ñ 6,8 µmo;/I (média ñ desvio padräo). Näo houve correlaçäo entre a concentraçäo da homocisteína com os demais fatores de risco estudados. O intervalo de referência para o método foi entre 4,0 e 12,0 µmol/I. Houve diferença estatística significativa para os valores de homocisteína entre o grupo controle e o grupo paciente