Due to the lack of information in the literature about the role of cardiac rehabilitation on Chagas heart failure, the aim of the present study was to evaluate the effects of a cardiac exercise program on functional capacity, cardiac function, respiratory muscle strength, body composition, biomarkers and quality of life among Chagas heart failure patients.
The present study consisted in a pre/post single-arm intervention study conducted at the Evandro Chagas National Institute of Infectious Disease (INI), located on Rio de Janeiro, Brazil. INI is a national reference center for treatment and research in infectious diseases and tropical medicine in Brazil, which follows a large cohort of patients with Chagas disease, all of them diagnosed by two simultaneously positive serological tests (enzyme-linked immunosorbent assay and indirect immunofluorescence). Patients included in the study were submitted to a physical exercise intervention protocol performed three times per week, 60 minutes per session, during an 8-month period. Nutritional and pharmaceutical counseling were also monthly provided during the follow-up and consisted on general guidance about adequate eating habits for patients with heart failure, mainly sodium and water intake, and medication usage, particularly drug dosage and compliance.Patients included in the study were followed during an 8-month period in which evaluations of functional capacity (maximal progressive cardiopulmonary exercise test), muscle respiratory strength (manovacuometry) and body composition (anthropometry and skinfolds) were performed at baseline, after four months and at the end of follow-up. Assessments of cardiac function (bidimensional echocardiography), biomarkers (lipid profile, glucose and glycated hemoglobin) and quality of life (Minnesota Living with Heart Failure questionnaire) were taken at baseline and after eight months of follow-up.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Physical exercise intervention protocol was performed three times per week, 60 minutes per session, during 8 months. Exercise sessions consisted of 30 minutes of aerobic exercise on a treadmill or on a cycle ergometer, 20 minutes of strength exercises for the major muscle groups (sit-ups, push-ups, and pull-ups), and 10 minutes of stretching exercises. Nutritional and pharmaceutical consisted on general guidance about adequate eating habits for patients with heart failure, mainly sodium and water intake, and medication usage, particularly drug dosage and compliance.
Evandro Chagas National Institute of Infectious Disease
Rio de Janeiro, Rio de Janeiro, Brazil
Functional Capacity (VO2 max)
VO2 max (ml/kg/min)
Time frame: Change from baseline at 4 and 8 months
Muscle respiratory strength (maximal inspiratory pressure and maximal expiratory pressure)
Maximal inspiratory pressure and maximal expiratory pressure (cm H2O)
Time frame: Change from baseline at 4 and 8 months
Body composition (body fat percentage)
Body fat percentage (%)
Time frame: Change from baseline at 4 and 8 months
Cardiac function (mainly ejection fraction)
Ejection fraction (%)
Time frame: Change from baseline at 8 months
Biomarkers (lipid profile and glucose)
Total cholesterol, Triacylglycerol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol (mg/dl) and glucose (mg/dl)
Time frame: Change from baseline at 8 months
Biomarkers (glycated hemoglobin)
Glycated hemoglobin (%)
Time frame: Change from baseline at 8 months
Quality of life by Minnesota Living with heart failure questionnaire (MLHFQ)
MLHFQ Score ranging from 0 to 105
Time frame: Change from baseline at 8 months
Anthropometry
Body weight (kg)
Time frame: Change from baseline at 4 and 8 months
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Anthropometry
Waist and hip circumference (cm)
Time frame: Change from baseline at 4 and 8 months