Associação entre eficiência ventilatória, consumo de oxigênio e o teste de Glittre em pacientes com insuficiência cardíaca

Abstract

Heart failure (HF) is a clinical syndrome, with a systemic characteristic, that presents with symptoms of fatigue and dyspnoea in the affected patients, which can lead to reduced functional capacity (FC). Among the existing indirect measurement CF tests, the Glittre test (TGlittre) stands out as encompassing a wide range of functions of the body, representing more globally the activities of daily living. The evaluation of ventilatory efficiency is one of the valued variables in the prognosis of HF. Therefore, the analysis of the association of these variables is important to guide the treatment plan and indicate the clinical prognosis in patients with HF. Objectives: To investigate the association between functional capacity and ventilatory variables in patients with heart failure measured during the Glittre test. Methods: We included 8 patients with HF, with NYHA functional classification between II and III, of both sexes and over 55 years of age. Patients were submitted to anamnesis, physical examination and Spirometry. In a second moment they performed the TGlittre test with a metabolic gas analyzer by means of telemetry. Before and after the test, blood pressure, heart rate, saturation, and assessment of dyspnoea and fatigue were measured using the Borg Effort Perception Scale. Results: The median TGIreter time in the studied patients was 4min39s (3min29s-5min53s), while the values before and after TGlitre for the lower limb Borg effort perception scale was 2.00 (0.00-9.00 ) And 3.00 (1.00- 10.00) (p <0.05) and for dyspnea assessment was 1.50 (1.00-3.00) and 4.00 (3.00-7.00). Regarding the hemodynamic variables, HR, SBP and DBP values after TGlittre were significantly higher than resting values (p <0.05), whereas SpO2 did not present statistical difference between the two measures (p> 0.05). The significant correlations were found between the VE / VCO2 and the time of execution of the TGlittre (r = 0.714; p = 0.047) and between the VE / VCO2 and the Borg fatigue stress perception scale (r = 0.761; p = 0.028). The other ventilatory variables did not present a significant correlation (p> 0.05). Conclusion: The results of the present study demonstrate an association between HRT measured by TGlittre and ventilatory efficiency (VE / VCO2) in patients with HF. Although this variable is not strongly influenced by other intrinsic and extrinsic factors, the TGlittre interpretation should take into account the comorbidities, age, physical conditioning, as well as the other particularities presented by the individuals evaluated. It may be suggested that the TGlittre execution time has applicability to determine ventilatory efficiency, being it directly proportional to this variable (VE / VCO2), which values its application in patients with HF in conjunction with other capacity tests To guide the treatment plan and indicate the clinical prognosis.