Abstract INTRODUCTION: We evaluated the effects of a cardiac rehabilitation program on quality of life. METHODS This secondary analysis of a single-arm study included 12 patients with Chagas heart failure. The cardiac rehabilitation program comprised exercise training and nutritional and pharmaceutical counseling. Quality of life was assessed using the SF-36 questionnaire. RESULTS: The program promoted improved physical functioning (β= +5.7; p=0.003), role-physical (β= +1.9; p=0.03), and bodily pain (β= +3.5; p=0.02) scores. Moreover, the summary physical health score (β= +1.4; p=0.001) improved. CONCLUSION: The cardiac rehabilitation program significantly improved the physical quality of life of patients with Chagas heart failure.

Abstract: INTRODUCTION: The benefit of a cardiac rehabilitation (CR) program for patients with Chagas heart failure (CHF) remains unclear. Therefore, we aimed to investigate the effects of CR for CHF patients. METHODS: A single-arm pilot study, including 12 patients with CHF, was performed. Patients participated in an 8-month physical exercise intervention, comprising aerobic, strength, and stretching exercises (3 times per week, 60 minutes per session). Nutritional and pharmaceutical counseling were also performed. Functional capacity (cardiopulmonary exercise test), muscle respiratory strength (manovacuometry), and body composition (anthropometry and skinfolds) were evaluated at baseline, and after 4 and 8 months of intervention. Cardiac function (echocardiography), biomarkers (lipid profile, glucose, and glycated hemoglobin) and quality of life (Minnesota Living with Heart Failure Questionnaire) were assessed at baseline and at the end of the intervention. RESULTS: Seven of 12 patients included in the study completed the 8-month follow-up period. Only 2 moderate adverse events occurred during the exercise training. Functional capacity improved after 4 months of CR, while left ventricular ejection fraction (LVEF) and respiratory strength improved after 8 months. Patients with right ventricular (RV) dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV) diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Conversely, those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. CONCLUSIONS: CR was feasible, safe, and has important clinical benefits for patients with CHF, specifically for cardiac function and muscle respiratory strength.

OBJETIVO: Comparar, retrospectivamente, os valores de freqüência cardíaca máxima (FCM) e o descenso da freqüência cardíaca no primeiro minuto da recuperação (dFC), obtidos em teste de exercício (TE) realizados em dois ergômetros e momentos distintos. MÉTODOS: Sessenta indivíduos (29 a 80 anos de idade), submetidos a TE cardiopulmonar em ciclo de membros inferiores (CMI) em nosso laboratório e que possuíam TE prévio (até 36 meses) em esteira (EST) em outros laboratórios, nas condições idênticas de medicações de ação cronotrópica negativa. RESULTADOS: FCM foi semelhante no CMI: 156±3 e EST: 154±2 bpm (p=0,125), enquanto o dFC foi maior em CMI: 33±2, EST: 26±3 bpm (média ± erro padrão da média) (p<0,001). Nas variáveis hemodinâmicas estudadas, a pressão arterial sistólica e o duplo produto foram maiores no TE-CMI (p<0,001). O eletrocardiograma (ECG) foi semelhante nos dois TEs, exceto por arritmias supraventriculares mais freqüentes no CMI. CONCLUSÃO: a) É possível, com empenho do examinador e conhecimento prévio do resultado de FCM em um TE anterior, obter níveis altos de FCM em um TE-CMI; b) interromper o TE baseado em FCM prevista por equações tende a levar a esforços submáximos; c) o dFC difere nas recuperações ativa e passiva; d) novas formas de analisar o comportamento da FC no exercício, que não apenas o valor da FCM, são necessárias para caracterizar um TE como máximo.

OBJECTIVE: To compare, retrospectively, the values of maximum heart rate (MHR) and the decrease of the heart rate at the first minute of recovery, which were obtained in an exercise test (ET) performed in two different ergometers and at different moments. METHODS: Sixty individuals (from 29 to 80 years old), submitted to cardiopulmonary ET in a cycle of lower limbs (CLL) in our laboratory and who had previous ET (up to 36 months) in a treadmill (TRM) in other laboratories, under identical conditions of medications of negative chronotropic action. RESULTS: MHR was similar in CLL: 156±3 and TRM: 154±2 bpm (p=0.125), whereas dHR was higher in CLL: 33±2, EST: 26±3 bpm (mean ± standard error of the mean) (p<0.001). In hemodynamic variables studied, the systolic blood pressure and the double product were higher in the ET-CLL (p<0.001). The electrocardiogram (ECG) was similar in both ETs, except due to more frequent supraventricular arrhythmias in CLL. CONCLUSION: a) With some diligence from the examiner and previous knowledge of MHR in a previous ET it is possible to obtain high levels of MHR in an ET-CLL; b) interrupting the MHR-based ET forecast through equations tends to lead to sub-maximum efforts; c) dHR differs in active and passive recoveries; d) new ways to analyze the HR behavior under exercise, which is not only the value of MHR, are necessary to characterize an ET as maximum.

OBJETIVO: Observar a influência de quatro meses de um programa domiciliar não-supervisionado de exercícios sobre a pressão arterial (PA) e aptidão física em hipertensos. MÉTODOS: Foram observados um grupo experimental com 26 homens e 52 mulheres e um grupo controle, com 9 homens e 7 mulheres, com idades entre 25 e 77 anos. O grupo experimental submeteu-se a um programa domiciliar de exercícios, com atividades aeróbias (60-80% da FC máxima para a idade, 30min de caminhadas no mínimo três vezes por semana), exercícios de flexibilidade. Orientações sobre a ficha de controle e o treinamento eram dadas a cada reavaliação. Foram acompanhados por quatro meses, com reavaliações a cada dois meses, observando-se: PA em repouso; peso corporal, relação cintura-quadril (RCQ), percentual de gordura (%G), somatório de dobras cutâneas (SOMD) e relação central e periférica de dobras (P/C); flexibilidade de tronco (FX); relação entre freqüência cardíaca e carga de trabalho durante teste submáximo em ciclo-ergômetro (FC/W), traduzida pela inclinação da curva de regressão entre ambas (a). RESULTADOS: O grupo experimental exibiu alterações significativas para o peso (-3,7 kg), RCQ (-0,03), SOMD (-12 mm), %G (-4,4%), FX (+2,3 cm), FC/W (-0,02) e PA (-6 e -9 mmHg para pressão sistólica e diastólica, respectivamente). O grupo controle teve pequenas alterações no peso (+1,3 Kg) e %G (+1,7%). CONCLUSÃO: Programas domiciliares não supervisionados de exercícios, podem exercer efeito positivo sobre a PA e aptidão física de hipertensos.

OBJECTIVE: To observe the influence of a four-month-unsupervised-exercise program performed at home on the blood pressure (BP) and physical performance in hypertensive adults. METHODS: A target group with 26 men and 52 women, and a control group with 9 men and 7 women were observed, with ages ranging from 25 to 77 years old. The target group underwent a home exercise program, basically with aerobic activity (60-80% of the estimated maximum heart rate for the age, 30min of walking at least 3 times a week), in addition to the flexibility exercises. Guidelines on the control chart and variables that could influence the treatment were given at each assessment. Patients were followed-up for four months, with assessments every 2 months observing: BP at rest; body weight, waist-hip ratio (W/HR), body fat percentage (%F), sum of skinfold measurements (SM) and central-peripheral skinfold ratio (C/P); trunk flexibility (TF); heart rate and workload ratio during submaximal test in cycle ergometer (HR/W), represented by the regression curve inclination between both (a). RESULTS: The target group demonstrated significant alterations in weight (-3.7 kg), WHR (-0.03), SM (-12 mm), %F (-4.4%), TF (+2.3 cm), HR/W (-0.02) and BP (-6 and -9 mmHg for systolic and diastolic pressure respectively). The control group presented small weight alterations (+1.3 Kg) and %F (+1.7%). CONCLUSION: Unsupervised exercise home programs, even in short term, may present positive effects on the blood pressure and physical performance in hypertensive individuals.