Coronary arterial bypass graft surgery (CABG) is proven safe with improved survival and greater quality of life in patients with coronary arterial disease. Evidences on the cardiovascular and gas-exchanges responses during and right after early exercise-based rehabilitation of this patients are limited. Objective: The investigators aim to analyse breath-by-breath cardiopulmonary and metabolic responses during six-minute walk test (6MWT) and shuttle walk test (SWT) in patients with or without left ventricular dysfunction (LVD) after CABG. In addition, the investigators will investigate oxygen consumption and cardiopulmonary responses during the early exercise-based rehabilitation in the first days after surgery. Methods: According to the left ventricular ejection fraction (LVEF), subjects will be allocated into two groups: with LVD (LVEF \< 45%) and without LVD (LVEF \> 45%). Patients will be submitted to the 6MWT and SWT linked to portable spirometric-telemetric device before and 6 days after CABG. During the first days after surgery, patients will be evaluated about pulmonary function and respiratory strenght at rest and oxygen consumption during the portable cycle ergometer protocol. Clinical outcomes as time to hospital discharge, pulmonary complications and occurence of arrythmias will be assessed during inpatient time until hospital discharge. Incidence of mortality, hospital readmission and angina recurrence will be evaluated in a one-year follow up.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
Patients will be submitted to a progressive and moderate exercise protocol with a portable cycle ergometer.
Universitary Hospital of Federal University of Sao Paulo
São Paulo, São Paulo, Brazil
RECRUITINGSix-minute walk test to measure functional capacity
According to the preoperative six-minute walk test linked to portable ergoespirometry device, we will evaluate the decrease in functional capacity in the sixth day after surgery.
Time frame: 6 days
Short-term complications
Incidence of arrythmias, pulmonary complications (pleural effusion, pulmonary atelectasis and pneumonia)
Time frame: Until hospital discharge, an average of 15 days
Shuttle walk test to measure functional capacity
According to the preoperative shuttle walk test linked to portable ergoespirometry device, we will evaluate the decrease in functional capacity in the sixth day after surgery.
Time frame: 6 days
Pulmonary Dysfunction
By spirometry, assessing the decrease in forced vital capacity and changes in exhaled volume forced in first second postoperativetly compare to preoperative period.
Time frame: 6 days (on the 1th, 3th and 6th day after surgery)
Respiratory weakness
By manovacuometry, assessing the change in inspiratory muscle pressure and expiratory muscle pressure postoperativetly compare to preoperative period.
Time frame: 6 days (on the 1th, 3th and 6th day after surgery)
Oxygen Consumption
Evaluate the oxygen consumption in metabolic equivalents (METS) during the cycle ergometer in post operative period by using spirometic-telemetric portable device during sessions.
Time frame: First 6 days after surgery
Mid and Long Term Complications
Complications such as angina recurrence, hospital readmission, cardiac events and all cause mortality.
Time frame: 3 months to 1 year
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