Lidiane Sousa

A randomized trial of the effects of exercise training in Chagas cardiomyopathy

The effects of exercise training in chronic heart failure are well established, however, they have not been evaluated in Chagas cardiomyopathy (ChC). We sought to determine the effects of exercise training on functional capacity, health‐related quality of life (HQoL), and brain natriuretic peptide (BNP) levels in patients with ChC.

Health-Related Quality of Life in Brazilian Pacemaker Patients

Background: Most quality of life (QoL) studies of pacemaker patients have been conducted in either North America or Europe and their applicability to Latin American populations is largely unknown. Our aim is to study health‐related QoL indices in Brazilian pacemaker patients and their determinants using both a generic (SF‐36) and a disease‐specific questionnaire (AQUAREL).

Depressive symptoms and disability in chagasic stroke patients: Impact on functionality and quality of life

INTRODUCTION Chagas disease (CD) is associated with stroke, which can result in significant long-term disability. Stroke has also been associated with depressive symptoms, which affect functional performance and quality of life (QOL). Few data are available on the effect of chagasic stroke on functional performance and QOL. OBJECTIVES This study aimed to investigate the correlation of stroke disability and depressive symptoms with functional performance and QOL in chagasic stroke patients. METHODS In this cross-sectional study, stroke sequelae were assessed using the Modified Rankin Stroke Scale (MRSS), depressive symptoms using the Beck Depression Inventory (BDI), functional performance using the Barthel Index (BI), and QOL using the WHOQOL-BREF. RESULTS Twenty-one patients with CD and a previous diagnosis of stroke were included. There was a correlation between the MRSS score and the BI score (r=-0.663, p=0.003), but not the scores of the WHOQOL-BREF subscales. The BDI score was correlated with the WHOQOL-BREF subscale scores (Physical: r=-0.733, p=0.001; Psychological: r=-0.581, p=0.012; Social: r=-0.713, p=0.001; Environmental: r=-0.659, p=0.003). However, the BDI score was not associated with the BI score (r=0.279, p=0.262). CONCLUSIONS QOL in patients with CD appears to be influenced more by depressive symptoms than by the motor-associated consequences of stroke. Conversely, motor sequelae impair the functionality of the patient more than depressive symptoms.

Improvement of the functional capacity is associated with BDNF and autonomic modulation in Chagas disease

35%) [2] must be considered. The power of these findings are limited by thesmall numberof patientswithmoderate airways reversibility (n=4). However,we take some reassurance from the goodproportionof patients diagnosed with asthma recruited to the study. Despite the limitation, we believe our study provides important hypothesis-generating data that contributes to a paucity of relevant literature in this area. A larger long-term study is required to provide definitive data regarding the effect of nebivolol on CHF patients withmoderate reversibility airways disease.

The portuguese version, cross-cultural adaptation and validation of specific quality-of-life questionnaire - AQUAREL - for pacemaker patients

OBJECTIVE To translate, to make the cultural adaptation and to evaluate reproducibility and validity of the Portuguese version of the AQUAREL (Assessment of QUAlity of life and RELated events) questionnaire, which is a specific tool to assess quality of life in pacemaker patients. METHODS We evaluated 202 pacemaker patients: 63 patients during the cross-cultural adaptation stage and 139 during the reproducibility and validity evaluation stages. The questionnaire translation was reviewed repeatedly until > or = 85% of patients correctly understood the questions. Reproducibility of the final version was tested in 69 patients in whom the interview was performed twice by the same researcher. Validity was checked by the correlation between scores obtained in AQUAREL domains and those obtained in SF36 domains, in the functional class and the distance walked in the six-minute test. RESULTS The internal consistency of AQUAREL was adequate, with Cronbachs alpha coefficient varying between 0.59 and 0.85. Reproducibility was good, with high correlation coefficients (0.68-0.89) and random distribution of data in Bland and Altman plots, without systematic bias. A significant association was observed among AQUAREL domains and those obtained in SF36 domains and the functional class (p<0.01), although significant correlations with the distance walked in the six-minute test were not found. CONCLUSION The Portuguese version of the AQUAREL questionnaire is easy and rapid to apply, and could be used as a specific questionnaire to assess quality of life in pacemaker patients.

Chagas disease alters the relationship between heart rate variability and daily physical activity

Regular exercise training is considered to be capable of beneficially modifying the autonomic balance in healthy subjects. We studied the association between vagal HRV indexes and the level of physical activity in Chagas disease patients and control subjects. Although in controls habitual physical activity was closely associated with vagal HRV indexes, no relationship was found between IPAQ scores and HRV indexes in a Chagas disease group, suggesting that Chagas dysautonomia disrupted this potentially beneficial association.

Six-minute walk test in patients with permanent cardiac pacemakers.

PURPOSE The 6-minute walk test (6MWT) is a simple and reliable method routinely used in the evaluation of many conditions including cardiac diseases. However, it is rarely performed in patients with pacemakers (PMs), and the applicability and safety in this group is not established. The purpose of this study was to verify the applicability and safety of the 6MWT in the evaluation of functional capacity of patients with PMs, considering the ergometry test (ET) as the criterion standard. METHODS Twenty-four patients with rate-responsive PMs underwent a treadmill ET, using the Chronotropic Assessment Exercise Protocol, and a 6MWT, performed twice with a rest interval of 20 minutes. Functional capacity, heart rate, and blood pressure in each test were recorded. RESULTS The distance covered during the 6MWT significantly correlated with the oxygen uptake estimated from the treadmill ET (r = 0.709, P < .001). Peak heart rates and systolic blood pressure levels reached during the 2 tests were also significantly correlated. No adverse events or malignant arrhythmias were observed during the 6MWT. The distance walked during the 6MWT accurately predicted the patient performance on the ET (area under the receiver operating characteristic curve = 0.921). The ability to walk more than 538 m in the 6MWT predicted, with a sensitivity of 90% and a specificity of 79%, an estimated oxygen uptake above 10 metabolic equivalents (METs) on the ET. CONCLUSIONS The 6MWT can be considered safe to assess the submaximal functional capacity and can be used as an alternative test to evaluate the results of interventions in patients with permanent cardiac PMs.

Is autonomic function associated with left ventricular systolic function in Chagas heart disease patients undergoing treatment for heart failure

INTRODUCTION The association between cardiac autonomic and left ventricular (LV) dysfunction in Chagas disease (ChD) is controversial. METHODS A standardized protocol that includes the Valsalva maneuver, a respiratory sinus arrhythmia (RSA) test, and an echocardiographic examination was used. Spearman correlation coefficients (rho) were used to investigate associations. RESULTS The study population consisted of 118 ChD patients undergoing current medical treatment, with an average LV ejection fraction of 51.4±2.6%. The LV ejection fraction and diastolic dimension were correlated with the Valsalva index (rho=0.358, p<0.001 and rho=-0.266, p=0.004, respectively) and the RSA (rho=0.391, p<0.001 and rho=-0.311, p<0.001, respectively). CONCLUSIONS The impairment of LV function is directly associated with a reduction of cardiac autonomic modulation in ChD.

Overweight, physical activity and atherosclerotic disease risk in Brazilian adolescents

paclitaxel-eluting stent implantation for acute ST-elevation myocardial infarction: 3-year follow-up of the PROSIT trial. Int J Cardiol doi:10.1016/j.ijcard.2009.09.466. [6] Lee CW, Park DW, Lee SH, et al. Comparison of the efficacy and safety of zotarolimus-, sirolimus-, and paclitaxel-eluting stents in patients with ST-elevation myocardial infarction. Am J Cardiol 2009;104:1370–6. [7] Pittl U, Kaiser C, Brunner-La Rocca HP, et al. Safety and efficacy of drug eluting stents versus bare metal stents in primary angioplasty of patients with acute ST-elevation myocardial infarction -a prospective randomized study. Eur Heart J 2006;27:650 (Abstract Suppl). [8] Coats AJ. Ethical authorship and publishing. Int J Cardiol 2009;131:149–50.

Balance and motor coordination in abstinent alcoholics

Introduction: Alcoholism is defined as a chronic, multifactorial syndrome. It is commonly associated with cerebellar degeneration and polyneuropathy, resulting in coordination and balance dysfunctions that represent the most disabling consequences associated with alcohol consumption. Objective: to describe the profile of abstinent alcoholics who participate in a center for living and to investigate the association between alcohol consumption and disorders of balance and motor coordination. Methods: Demographic data were collected followed by assessment of patients’ balance and motor coordination. Descriptive statistics was used to present the variables studied. The relationship between alcohol consumption and balance was investigated by means of multiple linear regression and the relationship between alcohol consumption and coordination was analyzed using the Mann-Whitney test and independent sample T-test. Results: Patients were mostly men; some also used other psychoactive drugs. There was no significant association between alcohol consumption and balance or between alcohol consumption and motor coordination (p>0.05). Although it was not the objective of this study, the regression model revealed a significant association between age and balance. Conclusion: Findings show the prevalence of chronic alcohol use in men and the concomitant use of other psychoactive drugs. The lack of association between alcohol consumption and deficits in balance Balance and motor coordination in abstinent alcoholics Aline Cristina de Souza1, Ediene Fernandes Gomes2, Tereza Cristina Pereira Vale2, Vivian Rodrigues Patrocinio2, Lidiane Aparecida Pereira de Sousa3 1 Professor Adjunto I do Centro Universitario Newton Paiva. Belo Horizonte, MG – Brasil. 2 Fisioterapeutas. Pontificia Universidade Catolica de Minas Gerais. Betim, MG – Brasil. 3 Professor Titular I do Centro Universitario Newton Paiva. Belo Horizonte, MG – Brasil. Equilibrio e coordenacao motora em alcoolicos abstinentes DOI: 10.5935/2238-3182.20130026