Atividade física amiga do peito

A prática regular de exercícios físicos é comprovadamente capaz de contribuir na prevenção de doenças cardiovasculares, do câncer e de outras doenças crônicas. Envolver-se em atividades físicas, que promovam gasto energético acima do exigido pelas atividades da vida diária, traz muitos benefícios à saúde. O Sedentarismo é reconhecido pela Organização Mundial de Saúde como a quarta causa de morte em todo o mundo. Aumentar o tempo dedicado ao exercício traz maiores benefícios à saúde em geral, além de aumentar a sensação de bem-estar

Heart failure impairs cerebral oxygenation during exercise in patients with COPD

Fed Univ São Paulo UNIFESP, Pulm Funct & Clin Exercise Physiol Unit SEFICE, Dept Med, Div Resp Dis, São Paulo, BrazilUniv Fed Sao Carlos, Cardiopulm Physiotherapy Lab, BR-13560 Sao Carlos, SP, BrazilUniversidade Federal de São Paulo, Dept Med, Div Cardiol, São Paulo, BrazilQueens Univ, Lab Clin Exercise Physiol LACEP, Dept Med, Div Resp & Crit Care Med, Kingston, ON K7L 2V6, CanadaFed Univ São Paulo UNIFESP, Pulm Funct & Clin Exercise Physiol Unit SEFICE, Dept Med, Div Resp Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Div Cardiol, São Paulo, BrazilWeb of Scienc

Atividade física para a população adulta com e sem doenças crônicas

Desde 1953 existem evidências mostrando que a atividade física habitual está relacionada à saúde cardiovascular. Vários autores já conseguiram demonstrar também que a falta de atividade física é causa de várias doenças crônicas. Esta videoaula teve como objetivo divulgar para profissionais da saúde as indicações da atividade física para a população adulta com e sem doenças crônicas

Assessment of functional capacity in chagas heart disease by incremental shuttle walk test and its relation to quality-of-life

Background: The cardiopulmonary exercise test (CPET) is considered to be the gold standard to evaluate functional capacity (FC) in patients with heart failure. However, field tests such as the 6-min walk test (6MWT) and the incremental shuttle walk test (ISWT) are simple and effective in evaluating the same. Despite the increasing use of ISWT, no studies that used the test in patients with Chagas heart disease (CHD) were found and only few studies have evaluated the health-related quality-of-life (HRQoL) in this population. The objective of this study was to correlate the distance walked in the ISWT with distance walked by 6MWT and peak oxygen uptake (VO 2peak ) by CPET and HRQoL in patients with CHD. Methods: A total of 35 patients with CHD were evaluated according to the FC and HRQoL. The FC was assessed by CPET, 6MWT and ISWT. HRQoL was assessed by the generic short-form health survey (SF-36) and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive data were shown as mean and standard deviation or median and interquartile range. The correlation was carried out with Pearson or Spearman correlation test. A receiver operating characteristic (ROC) curve was constructed to investigate the accuracy of ISWT for predicting low values of VO 2peak . Results: The distance walked in ISWT correlated with VO 2peak (r = 0.587; P < 0.001), distance walked in 6MWT (r = 0.484; P = 0.003), MLWHFQ scores (r = −0.460; P = 0.006) and physical functioning and role physical domains of the SF-36 scores (r = 0.435, P = 0.009; r = 0.477, P = 0.008, respectively). There was no significant difference between the distances walked in field tests (P = 0.694). The area under the ROC curve was 0.871 for ISWT in predicts a VO 2peak value of, at least, 25 mL/kg/min. Conclusions: The ISWT showed to be effective in evaluating the FC in CHD and in demonstrate the impact of disease on some aspects of the HRQoL of these patients

Physiological and sensory consequences of exercise oscillatory ventilation in heart failure-COPD

Background: Exercise oscillatory ventilation (EOV) is associatedwith poor ventilatory efficiency and higher operating lung volumes in heart failure. These abnormalitiesmay be particularly deleterious to dyspnea and exercise tolerance in mechanically-limited patients, e.g. those with coexistent COPD. Methods: Ventilatory, gas exchange and sensory responses to incremental exercise were contrasted in 68 heart failure-COPD patients (12 EOV+). EOV was established by standard criteria. Results: Compared to EOV-, EOV+ had lower exercise capacity, worse ventilatory inefficiency and higher peak dyspnea scores (p < 0.05). Peak capillary PCO2 (PcCO2) was higher and end-tidal CO2 (PETCO2) was lower in EOV+. Thus, greater (i.e., more positive) P(c-ET) CO2 and dead space/tidal volume values were found in these patients compared to EOV- (p < 0.05). Ventilatory inefficiency was related to increased dead space/tidal volumein EOV+ (r = 0.74p < 0.01). Owing to higher operating lung volumes, inspiratory reserve volume (IRV) decreased to a greater extent in EOV+. Tidal volume oscillations consistently ceased when a "critical" IRV was reached (similar to 0.3-0.5 L)thereafter, PcCO2 stabilized or increased and dyspnea scores rose sharply. Exercise capacity was closely related to IRV decrements and peak dyspnea in EOV+ (r = -0.78 and 0.84, respectivelyp < 0.01). Conclusions: Dyspnea and exercise tolerance are negatively influenced by EOV in heart failure patients presenting with COPD as co-morbidity. Pharmacological and non-pharmacological interventions known to decrease EOV might prove particularly valuable to mitigate symptomburden and exercise intolerance in this specific heart failure group. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Univ Fed Sao Paulo, Div Respirol, Pulm Funct & Clin Exercise Physiol Unit SEFICE, Sao Paulo, BrazilQueens Univ, Kingston Gen Hosp, Lab Clin Exercise Physiol, Kingston, ON, CanadaQueens Univ, Kingston Gen Hosp, Resp Invest Unit, Kingston, ON, CanadaUniv Fed Rio Grande do Sul, Div Respirol, Porto Alegre, RS, BrazilPulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, BrazilWeb of Scienc

Effects of Exercise Training on Heart Rate Variability in Chagas Heart Disease

Background: Heart rate variability (HRV) is a marker of autonomic dysfunction severity. The effects of physical training on HRV indexes in Chagas heart disease (CHD) are not well established. Objective: To evaluate the changes in HRV indexes in response to physical training in CHD. Methods: Patients with CHD and left ventricular (LV) dysfunction, physically inactive, were randomized either to the intervention (IG, N = 18) or control group (CG, N = 19). The IG participated in a 12-week exercise program consisting of 3 sessions/week. Results: Mean age was 49.5 ± 8 years, 59% males, mean LVEF was 36.3 ± 7.8%. Baseline HRV indexes were similar between groups. From baseline to follow-up, total power (TP): 1653 (IQ 625 - 3418) to 2794 (1617 - 4452) ms, p = 0.02) and very low frequency power: 586 (290 - 1565) to 815 (610 - 1425) ms, p = 0.047) increased in the IG, but not in the CG. The delta (post - pre) HRV indexes were similar: SDNN 11.5 ± 30.0 vs. 3.7 ± 25.1 ms. p = 0.10; rMSSD 2 (6 - 17) vs. 1 (21 - 9) ms. p = 0.43; TP 943 (731 - 3130) vs. 1780 (921 - 2743) Hz. p = 0.46; low frequency power (LFP) 1.0 (150 - 197) vs. 60 (111 - 146) Hz. p = 0.85; except for high frequency power, which tended to increase in the IG: 42 (133 - 92) vs. 79 (61 - 328) Hz. p = 0.08). Conclusion: In the studied population, the variation of HRV indexes was similar between the active and inactive groups. Clinical improvement with physical activity seems to be independent from autonomic dysfunction markers in CHD