Home-based training program in patients with chronic heart failure and reduced ejection fraction: a randomized pilot study.

OBJECTIVES: We aimed to compare the effects of home-and center-based exercise training programs on functional capacity, inspiratory muscle strength, daily physical activity level, and quality of life (QoL) in patients with chronic heart failure (CHF) over a 12-week period. METHODS: This study included 23 patients with CHF (left ventricular ejection fraction 31±6%) randomized to a home-based (n=11) or center-based (n=12) program. Patients underwent 12 weeks of aerobic training (60%-70% heart rate reserve): walking for the home-based and supervised cycling for the center-based group, both combined with resistance training (50% of 1 maximum repetition). At baseline and after 12 weeks of training, we assessed cardiopulmonary test variables, 6-min walk test distance (6 MWD), steps/day with accelerometry, and QoL (Minnesota Living with Heart Failure questionnaire). Maximal inspiratory pressure and handgrip strength were measured at baseline and after 4, 8, and 12 weeks of training. ClinicalTrials.gov: NCT03615157. RESULTS: There were no adverse events during training in either group. The home- and center-based training groups obtained similar improvements in peak oxygen uptake, maximal ventilation, and 6 MWD. However, there were significant between-group differences: center-based training was more effective in improving maximal inspiratory pressure (p=0.042), number of steps/day (p=0.001), and QoL (p=0.039). CONCLUSIONS: Home-based training is safe and can be an alternative to improve the exercise capacity of patients with stable CHF. However, center-based training was superior in improving inspiratory muscle strength, QoL, and daily physical activity.

Home-based training program in patients with chronic heart failure and reduced ejection fraction: a randomized pilot study

OBJECTIVES: We aimed to compare the effects of home-and center-based exercise training programs on functional capacity, inspiratory muscle strength, daily physical activity level, and quality of life (QoL) in patients with chronic heart failure (CHF) over a 12-week period. METHODS: This study included 23 patients with CHF (left ventricular ejection fraction 31±6%) randomized to a home-based (n=11) or center-based (n=12) program. Patients underwent 12 weeks of aerobic training (60%-70% heart rate reserve): walking for the home-based and supervised cycling for the center-based group, both combined with resistance training (50% of 1 maximum repetition). At baseline and after 12 weeks of training, we assessed cardiopulmonary test variables, 6-min walk test distance (6 MWD), steps/day with accelerometry, and QoL (Minnesota Living with Heart Failure questionnaire). Maximal inspiratory pressure and handgrip strength were measured at baseline and after 4, 8, and 12 weeks of training. ClinicalTrials.gov: NCT03615157. RESULTS: There were no adverse events during training in either group. The home- and center-based training groups obtained similar improvements in peak oxygen uptake, maximal ventilation, and 6 MWD. However, there were significant between-group differences: center-based training was more effective in improving maximal inspiratory pressure (p=0.042), number of steps/day (p=0.001), and QoL (p=0.039). CONCLUSIONS: Home-based training is safe and can be an alternative to improve the exercise capacity of patients with stable CHF. However, center-based training was superior in improving inspiratory muscle strength, QoL, and daily physical activity.

Smoking load reduction is insufficient to downregulate miR-301b, a lung cancer promoter.

Several circulating miRNAs identified in the plasma of smokers have been implicated as promoters of nasopharyngeal and lung carcinoma. To investigate the plasma profile of miRNAs in subjects who reduces the number of smoked cigarettes and who quit after six months. We accompanied 28 individuals enrolled in a Smoking Cessation Program over 6 months. At Baseline, clinical characteristics, co-morbidities, and smoking history were similar among subjects. After 6 months, two groups were defined: who successfully quitted smoking (named "quitters", n = 18, mean age 57 years, 11 male) and who reduced the number of cigarettes smoked (20-90%) but failed to quit smoking (named "smokers", n = 10, mean age 52 years, 3 male). No significant clinical changes were observed between groups at baseline and after a 6-month period, however, quitters showed significant downregulations in seven miRNAs at baseline: miR-17 (- 2.90-fold, p = 0.029), miR-20a (- 3.80-fold, p = 0.021); miR-20b (- 4.71-fold, p = 0.027); miR-30a (- 3.95-fold, p = 0.024); miR-93 (- 3.63-fold, p = 0.022); miR-125a (- 1.70-fold, p = 0.038); and miR-195 (- 5.37-fold, p = 0.002), and after a 6-month period in 6 miRNAs: miR-17 (- 5.30-fold, p = 0.012), miR-20a (- 2.04-fold, p = 0.017), miR-20b (- 5.44-fold, p = 0.017), miR-93 (- 4.00-fold, p = 0.041), miR-101 (- 4.82-fold, p = 0.047) and miR-125b (- 3.65-fold, p = 0.025). Using time comparisons, only quitters had significant downregulation in miR-301b (- 2.29-fold, p = 0.038) after 6-month. Reductions in the number of smoked cigarettes was insufficient to change the plasma profile of miRNA after 6 months. Only quitting smoking (100% reduction) significantly downregulated miR-301b related to hypoxic conditions, promotion of cell proliferation, decreases in apoptosis, cancer development, and progression as increases in radiotherapy and chemotherapy resistance.

Smoking load reduction is insufcient to downregulate miR­301b, a lung cancer promoter

Abstract Several circulating miRNAs identified in the plasma of smokers have been implicated as promoters of nasopharyngeal and lung carcinoma. To investigate the plasma profile of miRNAs in subjects who reduces the number of smoked cigarettes and who quit after six months. We accompanied 28 individuals enrolled in a Smoking Cessation Program over 6 months. At Baseline, clinical characteristics, co-morbidities, and smoking history were similar among subjects. After 6 months, two groups were defined: who successfully quitted smoking (named "quitters", n = 18, mean age 57 years, 11 male) and who reduced the number of cigarettes smoked (20­90%) but failed to quit smoking (named "smokers", n = 10, mean age 52 years, 3 male). No significant clinical changes were observed between groups at baseline and after a 6-month period, however, quitters showed significant downregulations in seven miRNAs at baseline: miR-17 (− 2.90-fold, p = 0.029), miR-20a (− 3.80-fold, p = 0.021); miR-20b (− 4.71-fold, p = 0.027); miR-30a (− 3.95-fold, p = 0.024); miR-93 (− 3.63-fold, p = 0.022); miR-125a (− 1.70-fold, p = 0.038); and miR-195 (− 5.37-fold, p = 0.002), and after a 6-month period in 6 miRNAs: miR-17 (− 5.30-fold, p = 0.012), miR-20a (− 2.04-fold, p = 0.017), miR-20b (− 5.44-fold, p = 0.017), miR-93 (− 4.00-fold, p = 0.041), miR-101 (− 4.82-fold, p = 0.047) and miR-125b (− 3.65-fold, p = 0.025). Using time comparisons, only quitters had significant downregulation in miR-301b (− 2.29-fold, p = 0.038) after 6-month. Reductions in the number of smoked cigarettes was insufficient to change the plasma profile of miRNA after 6 months. Only quitting smoking (100% reduction) significantly downregulated miR-301b related to hypoxic conditions, promotion of cell proliferation, decreases in apoptosis, cancer development, and progression as increases in radiotherapy and chemotherapy resistance.

Risk factors for inspiratory muscle weakness in chronic heart failure

BACKGROUND: Chronic heart failure is commonly associated with inspiratory muscle weakness. However, few studies have investigated the risk factors for inspiratory muscle weakness in individuals with chronic heart failure and systolic dysfunction (left-ventricular ejection fraction [LVEF] <40%). METHODS: Seventy subjects were recruited in a cardiac center. We assessed clinical parameters, smoking history, peripheral muscle strength, pulmonary function, echocardiographic variables, and brain natriuretic peptide. The subjects were classified with inspiratory muscle weakness when the maximum inspiratory pressure was <70% of predicted values. RESULTS: Thirty-six subjects (51%) had inspiratory muscle weakness. The subjects with inspiratory muscle weakness and the subjects with no inspiratory muscle weakness were similar in age, sex, body mass index, medication use, and physical activity. However, the subjects with inspiratory muscle weakness had lower LVEF (P = .003), systolic blood pressure (P = .01), diastolic blood pressure (P = .042), quadriceps muscle strength (P = .02), lung function (P = .035), increased brain natriuretic peptide (P = .02), smoking history (P = .01), and pulmonary hypertension incidence (P = .03). Multivariate logistic regression analysis found a lower LVEF, increased smoking history, and lower systolic blood pressure as significant independent predictors for inspiratory muscle weakness. CONCLUSIONS: The combination of lower LVEF, lower systolic blood pressure, and smoking history predicted inspiratory muscle weakness. Patients with suspected inspiratory muscle weakness should be examined and, if inspiratory muscle weakness exists, then inspiratory muscle training should be provided. Reducing inspiratory muscle weakness has the potential to improve many of the deleterious effects of chronic heart failure. (AU)

Efeitos do tabagismo e da cessação do tabagismo sobre os mecanismos de defesa das vias aéreas e expressão de MIRnas em sangue periférico de humanos / Effects of smoking and smoking cessation on defense mechanisms of the airways and expression of mirnas in human peripheral blood

OBJETIVO: Investigar o perfil de miRNAs em indivíduos participantes de um grupo de cessação ao tabagismo. MÉTODOS: Caracterizamos os mecanismos de defesa das vias aéreas por meio do transporte mucociliar (TMC) e avaliamos a expressão de miRNAs no plasma de indivíduos que participaram do Grupo de Cessação ao Tabagismo do Instituto Dante Pazzanese de Cardiologia (n=28, idade média 56 anos), após seis meses eles foram divididos em 2 grupos: aqueles que obtiveram sucesso na cessação (Cessadores, n=18, idade média 57 anos, 11 homens) e aqueles que reduziram a exposição ao cigarro (20-90%) porém continuaram fumando (Tabagistas, n=10, três homens). RESULTADOS: Na avaliação basal, as características clínicas, co-morbidades, histórico de tabagismo e carga tabágica foram semelhantes entre os grupos. Observamos que os tabagistas apresentaram TMC prolongado e que a cessação do tabagismo induziu à normalização do TMC. Comparando os Cessadores com os Tabagistas, sete miRNAs foram regulados negativamente: miR-17 (-2. 90-fold, p=0. 029), miR-20a (-3. 80-fold, p=0. 021); miR-20b (-4. 71-fold (p=0. 027); miR-30a (-3. 95-fold, p=0. 024); miR-93 (-3. 63-fold, p=0. 022); miR-125a (-1. 70-fold, p=0. 038); and miR-195 (-5. 37-fold, p=0. 002). Após seis meses, seis miRNAs foram diferentemente expressos com regulação negativa nos Cessadores em relação aos Tabagistas: miR-17 (-5. 30-x, p=0. 012), miR-20a (-2. 04f-x, p=0. 017), miR-20b (-5. 44-x, p=0. 017), miR-93 (-4. 00-x, p=0. 041), miR-101 (-4. 82-x, p=0. 047) e miR-125b (-3. 65-x, p=0. 025). Entretanto, somente o grupo de Cessadores apresentou após 6 meses, regulação negativa significantdo miR-301b (-2. 29-x, p=0. 038). CONCLUSÃO: Muitos MiRNAs que foram identificados no plasma de tabagistas têm sido associados ao desenvolvimento de carcinoma na sofaríngeo e câncer de pulmão. A redução da carga tabágica não foi suficiente para alterar esse perfil de expressão dos miRNAs. Somente a cessação do tabagismo promoveu regulação negativa do miR-301b que está relacionado com condições de hipóxia, de promoção da proliferação celular, da inibição do apoptose e aumento da resistência à quimioterapia. Descritores: microRNAs; Fumar; Abandono do hábito de fumar; Neoplasias pulmonares; Inflamação; Biomarcadores.

Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure.

BACKGROUND: Chronic heart failure is commonly associated with inspiratory muscle weakness. However, few studies have investigated the risk factors for inspiratory muscle weakness in individuals with chronic heart failure and systolic dysfunction (left-ventricular ejection fraction [LVEF] <40%). METHODS: Seventy subjects were recruited in a cardiac center. We assessed clinical parameters, smoking history, peripheral muscle strength, pulmonary function, echocardiographic variables, and brain natriuretic peptide. The subjects were classified with inspiratory muscle weakness when the maximum inspiratory pressure was <70% of predicted values. RESULTS: Thirty-six subjects (51%) had inspiratory muscle weakness. The subjects with inspiratory muscle weakness and the subjects with no inspiratory muscle weakness were similar in age, sex, body mass index, medication use, and physical activity. However, the subjects with inspiratory muscle weakness had lower LVEF (P = .003), systolic blood pressure (P = .01), diastolic blood pressure (P = .042), quadriceps muscle strength (P = .02), lung function (P = .035), increased brain natriuretic peptide (P = .02), smoking history (P = .01), and pulmonary hypertension incidence (P = .03). Multivariate logistic regression analysis found a lower LVEF, increased smoking history, and lower systolic blood pressure as significant independent predictors for inspiratory muscle weakness. CONCLUSIONS: The combination of lower LVEF, lower systolic blood pressure, and smoking history predicted inspiratory muscle weakness. Patients with suspected inspiratory muscle weakness should be examined and, if inspiratory muscle weakness exists, then inspiratory muscle training should be provided. Reducing inspiratory muscle weakness has the potential to improve many of the deleterious effects of chronic heart failure.

Força muscular inspiratória e valores espirométricos como preditores de complicações e mortalidade intra-hospitalar na revascularização do miocárdio / Inspiratory muscle strength and spirometric values ​​as predictors of complications and in-hospital mortality in myocardial revascularization

INTRODUÇÃO: A cirurgia de revascularização do miocárdio (CRM) é considerada uma das escolhas de tratamento para aliviar sintomas, melhorar qualidade de vida e diminuir mortalidade de pacientes com doença arterial coronariana. O procedimento cirúrgico é considerado de alta complexidade e acomete a função pulmonar levando a complicações no pós-operatório. Com isso, o objetivo do estudo foi verificar a relação entre os valores espirométricos e a força muscular inspiratória com possíveis complicações peri e pós-operatórias da CRM. MÉTODO: Estudo observacional longitudinal com pacientes recrutados na fila de revascularização do miocárdio eletiva. Incluídos pacientes clinicamente estáveis, ambos os sexos, idade acima de 18 anos e excluídos condições psiquiátricas ou neurocognitivas que impeçam a obtenção de dados clínicos e/ou com problemas músculo-esqueléticos e aqueles que não concordaram com o termo de consentimento. A coleta de dados foi dividida em etapa pré-operatória, intra-operatória e pós-operatória. Avaliados espirometria, força muscular inspiratória, dados referente à cirurgia, e intercorrências peri e pós-operatórias. ANÁLISE ESTATÍSTICA: As variáveis quantitativas foram expressas em média e desvio padrão, e as variáveis qualitativas pela frequência absoluta e porcentagem. Para a comparação entre os grupos para as variáveis quantitativas foi usado o teste t-Student, quando houve suposição de normalidade foi utilizado o teste de Kolmogorov-Smirnov. Caso a suposição seja rejeitada foi utilizado o teste de Mann-Whitney. Para verificar a associação entre variáveis categóricas utilizou o teste exato de Fisher ou Qui-quadrado, e foi calculada a estimativa de odds ratio. O nível de significância adotado foi de 5%. RESULTADOS: Elegíveis 97 participantes e excluídos 45, restando 52 participantes, no qual 27 apresentaram algum tipo de complicação ou foram a óbito. Identificou-se como preditores de complicações e mortalidade intra-hospitalar valores espirométricos pré-operatórios abaixo do predito do volume expirado forçado no primeiro segundo (VEF1) com p=0,035 e capacidade vital forçada (CVF) com p=0,0001, e valores reduzidos de força muscular inspiratória (p=0,01). CONCLUSÃO: O presente estudo identificou como preditores de complicações e mortalidade intra-hospitalar, valores espirométricos pré-operatórios abaixo do predito (VEF1 e CVF) e valores reduzidos de força muscular inspiratória. (AU)

Efeitos de um programa de treinamento domiciliar sobre a capacidade funcional e qualidade de vida de pacientes com insuficiência cardíaca crônica / Effects of a home training program on the functional capacity and quality of life of patients with chronic heart failure

INTRODUÇÃO: O treinamento físico melhora a capacidade funcional e a qualidade de vida em pacientes com insuficiência cardíaca crônica (IC). Entretanto, devido à baixa disponibilidade de centros de reabilitação cardíaca e limitações pessoais (custos de transporte, tempo, preferências), a inclusão e a adesão ao treinamento físico supervisionado são baixas, sendo proposto o treinamento domiciliar como alternativa. OBJETIVO: Comparar os efeitos de dois programas de treinamento: um domiciliar e um supervisionado ao longo de 12 semanas sobre a capacidade funcional, atividade física diária e qualidade de vida em pacientes com IC. MÉTODOS: Foram incluídos 23 pacientes com IC (classe funcional NYHA II e III, fração de ejeção do ventrículo esquerdo ≤40%) randomizados em Grupo Domiciliar (GD, n=11) ou Grupo Supervisionado (GS, n=12). Os pacientes realizaram, ao longo de 12 semanas exercícios aeróbios (60-70% da frequência cardíaca de reserva): caminhada para o GD e cicloergômetro para o GS combinados a exercícios resistidos (50% de uma repetição máxima). As variáveis-desfecho foram: pico de consumo de oxigênio e ventilação máxima do teste cardiopulmonar, distância percorrida no teste da caminhada de seis minutos, força muscular do quadríceps, pressão inspiratória máxima, número de passos/dia e qualidade de vida. RESULTADOS: Após 12 semanas,GD e GS apresentaram aumentos significantes (p=0,025) no pico de consumo de oxigênio (0,8 e 3,7 ml/kg/min, respectivamente), na ventilação máxima (11,5 e 15,6 l/min, respectivamente), na distância percorrida (40 e 25 m, respectivamente), na porcentagem de força muscular do quadríceps (21% e 11%, respectivamente) e na qualidade de vida avaliada por meio do questionário Minnesota Living with Heart Failure (1 e 13, respectivamente), sem diferenças entre GD e GS. Entretanto, o GS mostrou melhora na força muscular inspiratória (p=0,042), aumento no número de passos/dia (p=0,001) e no componente de saúde mental do questionário SF-36 (p=0,001) superior ao GD. CONCLUSÕES: O treinamento domiciliar pode ser uma alternativa ao treinamento supervisionado para melhorar a capacidade funcional e a qualidade de vida em pacientes com IC. Além desses benefícios, o treinamento supervisionado foi superior em aumentar a força muscular inspiratória, o número de passos/dia e melhorar os aspectos de saúde mental em pacientes com IC. (AU)

Aplicabilidade do peso ideal na titulação do volume corrente em pacientes no pós operatório imediato de cirurgia cardíaca / Ideal weight applicability in tidal volume titration in immediate postoperative cardiac surgery patients

INTRODUÇÃO: A ventilação mecânica (vm) é indispensável nas intervenções cirúrgicas; porém mesmo que por curto período de tempo, a vm pode causar prejuízo pulmonar com lesões do parênquima pulmonar por excesso de pressão e/ou volume nas vias aéreas. Na titulação do volume corrente (vc) é comum utilizar o peso (p.) real e não o p. ideal, aquele calculado baseando-se pela altura, o que poderia gerar alterações gasométricas e na mecânica pulmonar. OBJETIVO: Comparar a titulação do vc pelo p. ideal e pelo p. real durante o uso da vm no pós-operatório imediato de cirurgia cardíaca (cc). MÉTODOS: Ensaio clínico prospectivo, randomizado, aprovado pelo CEP da instituição. Incluímos pacientes (pc) de ambos os sexos, idade entre 18 e 80 anos e foram divididos em dois grupos: peso real (PR) e peso ideal (PI) e analisados em quatro grupos: PR com IMC adequado; PR com IMC alto; PI com IMC adequado e PI com IMC alto. O exame gasométrico era realizado no ato de admissão (M0), 30 minutos após a mesma (M1) e extubação (M2). Foram comparados entre os grupos resultados gasométricos, pressão platô, pressão de pico, complacência estática e complacência dinâmica...(AU)

Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial.

BACKGROUND: Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial. METHODS: Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire. RESULTS: All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class in HF patients. CONCLUSIONS: The low-intensity inspiratory and peripheral resistance muscle training improved inspiratory and peripheral muscle strength and walking distance, demonstrating that LIPRT is an efficient rehabilitation method for debilitated HF patients. In addition, the moderate-intensity resistance training also improved expiratory muscle strength and NYHA functional class in HF patients.

Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial

BACKGROUND: Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial.METHODS:Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire...

Reproducibility for Heart Rate Variability Analysis during 6-Min Walk Test in Patients with Heart Failure and Agreement between Devices.

Heart rate variability (HRV) analysis is a useful method to assess abnormal functioning in the autonomic nervous system and to predict cardiac events in patients with heart failure (HF). HRV measurements with heart rate monitors have been validated with an electrocardiograph in healthy subjects but not in patients with HF. We explored the reproducibility of HRV in two consecutive six-minute walk tests (6MW), 60-minute apart, using a heart rate monitor (PolarS810i) and a portable electrocardiograph (called Holter) in 50 HF patients (mean age 59 years, NYHA II, left ventricular ejection fraction ~35%). The reproducibility for each device was analysed using a paired t-test or the Wilcoxon signed-rank test. Additionally, we assessed the agreement between the two devices based on the HRV indices at rest, during the 6MW and during recovery using concordance correlation coefficients (CCC), 95% confidence intervals and Bland-Altman plots. The test-retest for the HRV analyses was reproducible using Holter and PolarS810i at rest but not during recovery. In the second 6MW, patients showed significant increases in rMSSD and walking distance. The PolarS810i measurements had remarkably high concordance correlation [0.86

Reproducibility for heart rate variability analysis during 6-Min walk test in patients with heart failure and agreement between devices

Heart rate variability (HRV) analysis is a useful method to assess abnormal functioning in the autonomic nervous system and to predict cardiac events in patients with heart failure (HF). HRV measurements with heart rate monitors have been validated with an electrocardiograph in healthy subjects but not in patients with HF. We explored the reproducibility of HRV in two consecutive six-minute walk tests (6MW), 60-minute apart, using a heart rate monitor (PolarS810i) and a portable electrocardiograph (called Holter) in 50 HF patients (mean age 59 years, NYHA II, left ventricular ejection fraction ~35%). The reproducibility for each device was analysed using a paired t-test or the Wilcoxon signed-rank test. Additionally, we assessed the agreement between the two devices based on the HRV indices at rest, during the 6MW and during recovery using concordance correlation coefficients (CCC), 95% confidence intervals and Bland-Altman plots. The test-retest for the HRV analyses was reproducible using Holter and PolarS810i at rest but not during recovery. In the second 6MW, patients showed significant increases in rMSSD and walking distance. The PolarS810i measurements had remarkably high concordance correlation [0.86

Teste de caminhada de seis minutos após infarto agudo do miocárdio: comparação com teste ergométrico / Six-minute walk test after acute myocardial infarction: comparison with the treadmill stress test

Objetivos: Verificar a distância do teste de caminhada de seis minutos (TC6) em pacientes após infarto agudo do miocárdio (IAM) não complicado, comparar variáveis do teste ergométrico (TE) com do TC6 e verificar quais influenciaram no TC6. Métodos: Incluímos 61 pacientes com IAM não complicado, 47 homens (78,7%), 56,38 ± 9,98 anos. O TE foi realizado após quatro a cinco dias de IAM e, um a dois dias após O TE foi realizado após quatro a cinco dias de IAM e, um a dois dias após o TE, os pacientes foram submetidos ao TC6. Utilizamos teste t de Student ou ilcoxon, correlação de Pearson ou Spearman e análise de covariância. P<0,05. Resultados: Todos os pacientes realizaram o TC6 sem complicações. A distância no TC6 foi 451,54 ± 88,30 m, consumo de oxigênio estimado pelo TE = 25,66 ± 8,78 ml/Kg/min e uma correlação fraca entre eles (r=0,353; p=0,006). Verificou-se redução da metragem com o aumento da idade (p=0,009), aumento do índice de massa corpórea (p=0,045) e sexo feminino (p < 0,001) na distância média do TC6. A frequência cardíaca e pressão arterial sistólica pico médias foram maiores no TE do que no TC6. Na recuperação, estes valores retornaram mais próximos aos valores basais no TC6 do que no TE, exceto para a pressão diastólica. Conclusão: O sexo, a idade e índice de massa corpórea influenciaram na distância média do TC6. As respostas cardiovasculares do TC6 foram menos intensas do que TE nos pacientes estudados.