Cardiac rehabilitation program in patients with Chagas heart failure: a single-arm pilot study

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Mauro Felippe Felix Mediano, Fernanda de Souza Nogueira Sardinha Mendes, Vivian Liane Mattos Pinto, Gilberto Marcelo Sperandio da Silva, Paula Simplício da Silva, Fernanda Martins Carneiro, Luiz Henrique Conde Sangenis, Roberto Magalhães Saraiva, Sergio Salles Xavier, Pedro Emmanuel Alvarenga Americano do Brasil, Alejandro Marcel Hasslocher-Moreno, Andrea Silvestre de Sousa
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2016
• Subjects: Chagas disease; Physical activity; Cardiac rehabilitation; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0083-2016; https://doaj.org/article/ba1901c23e2a4bc9a87edb5e6be0ac84

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.