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Objective: Patients with COPD are prone to cardiac remodeling; however, little is known about cardiac function in patients recovering from an acute exacerbation of COPD (AECOPD) and its association with exercise capacity. The aim of this study was to evaluate the cardiac function and structure and to compare their relationship with exercise capacity in patients with a recent AECOPD and patients with clinically stable COPD. Methods: This was a cross-sectional study including 40 COPD patients equally divided into two groups: recent AECOPD group (AEG) and clinically stable COPD group (STG). Echocardiography was performed to assess cardiac function and chamber structure. The six-minute walk distance (6MWD) and the Duke Activity Status Index (estimated Vo2) were used in order to assess exercise capacity. Results: No significant differences in cardiac function and structure were found between the groups. The 6MWD was associated with early/late diastolic mitral filling velocity ratio (r = 0.50; p < 0.01), left ventricular posterior wall thickness (r = −0.33; p = 0.03), and right atrium volume index (r = −0.34; p = 0.04), whereas Vo2 was associated with right atrium volume index (r = −0.40; p = 0.02). Conclusions: Regardless of the clinical condition (recent AECOPD vs. stable COPD), the cardiac function and structure were similar between the groups, and exercise capacity (determined by the 6MWD and Vo2) was associated with cardiac features. RESUMO Objetivo: Pacientes com DPOC são propensos a remodelamento cardíaco; no entanto, pouco se sabe sobre a função cardíaca em pacientes em recuperação de exacerbação aguda da DPOC (EADPOC) e sua associação com a capacidade de exercício. O objetivo deste estudo foi avaliar a função e estrutura cardíaca e comparar sua relação com a capacidade de exercício em pacientes com EADPOC recente e pacientes com DPOC clinicamente estável. Métodos: Estudo transversal com 40 pacientes com DPOC divididos igualmente em dois grupos: grupo EADPOC recente (GEA) e grupo DPOC clinicamente estável (GCE). Realizou-se ecocardiografia para avaliar a função cardíaca e a estrutura das câmaras. A distância percorrida no teste de caminhada de seis minutos (DTC6) e o Duke Activity Status Index (Vo2 estimado) foram utilizados para avaliar a capacidade de exercício. Resultados: Não foram encontradas diferenças significativas na função e estrutura cardíaca entre os grupos. A DTC6 apresentou associação com a razão entre as velocidades de enchimento diastólico mitral precoce e tardia (r = 0,50; p < 0,01), a espessura da parede posterior do ventrículo esquerdo (r = −0,33; p = 0,03) e o índice de volume do átrio direito (r = −0,34; p = 0,04), enquanto o Vo2 apresentou associação com o índice de volume do átrio direito (r = −0,40; p = 0,02). Conclusões: Independentemente da condição clínica (EADPOC recente vs. DPOC estável), a função e estrutura cardíaca eram semelhantes entre os grupos, e a capacidade de exercício (determinada pela DTC6 e pelo Vo2) apresentou associação com as características cardíacas.

Patrícia Faria Camargo,1 Luciana Ditomaso-Luporini,1 Luiz Carlos Soares de Carvalho Jr,2 Cássia da Luz Goulart,1 Rayane Sebold,1,3 Polliana Batista dos Santos,1 Meliza Goi Roscani,4 Audrey Borghi–Silva1 1Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Paulo, Brazil; 2Center for Science and Technology in Energy and Sustainability of Federal University of Reconcavo da Bahia, Feira de Santana, Bahia, Brazil; 3Course of Physiotherapy, Central Paulista University Center, Sao Carlos, Sao Paulo, Brazil; 4Medicine Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, BrazilCorrespondence: Audrey Borghi–Silva Email audrey@ufscar.brBackground: The heart rate (HR) kinetics as well as other predictors of functional capacity such as the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT), the Duke Activity Status Index (DASI) and the handgrip strength (HGS) represent important tools in assessing the impact of COPD on exercise performance and health status of individuals with COPD.Purpose: To verify the relationship between functional capacity, measured using the six-minute walking test (6MWT), with the HR off-kinetics, HGS and the DASI and CAT scores.Methods: For this cross-sectional study, 29 subjects with COPD underwent body composition, pulmonary function and cardiac function tests. Subsequently, the DASI and CAT questionnaires and HGS test were performed. The beat-to-beat R-R intervals (IRR) were collected in rest, during the test and in recovery after the 6MWT. The HR off-kinetics was obtained during a 360-second period in post-exercise recovery through the HR mono-exponential decay.Results: Moderate correlations were observed between: 1) walked distance (WD) in the 6MWT and the CAT and DASI scores (r= − 0.58, p=0.001 and r= 0.58, p=0.001, respectively); 2) WD and HGS (r=0.37, p=0.05); 3) and WD and HR off-kinetics (τ; r= − 0.54, p=0.002 and MRT; r= − 0.55, p=0.002, respectively).Conclusion: The 6MWT performance is a direct measurement to evaluate functional capacity. Additionally, it is related to other direct and indirect markers for functional evaluation in patients with COPD. These results suggest the application of these tools in clinical practice, based on the accessibility, non-invasive character and easy applicability of these methods.Keywords: COPD, questionnaires, exercise, kinetics

Made available in DSpace on 2022-04-29T07:14:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-12-01 Heart failure (HF) is a complex clinical syndrome, characterized by an impair the ability of the left ventricle to fill or eject blood. This is an important public health problem and the most prevalent cause of hospital admissions for cardiovascular disease, being associated with poor prognosis in more than 40% of cases. The diagnosis of this syndrome involves the history, physical examination and laboratory tests such as echocardiography and measurement of BNP. The treatment is based on non-pharmacological and pharmacological therapeutic, with great benefits in the natural history of the disease. The purpose of this review is to provide for the general physician an approach of the diagnosis and the treatment of heart failure. © Copyright Moreira Jr. Editora. Assistente da Disciplina de Cardiologia Faculdade de Medicina-Botucatu-UNESP Assistente da Disciplina de Cardiologia Faculdade de Medicina-Botucatu-UNESP