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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise, nutritional and pharmaceutical counseling | Behavioral | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Functional Capacity (VO2 max) | VO2 max (ml/kg/min) | Change from baseline at 4 and 8 months |
| Measure | Description | Time Frame |
|---|---|---|
| Muscle respiratory strength (maximal inspiratory pressure and maximal expiratory pressure) | Maximal inspiratory pressure and maximal expiratory pressure (cm H2O) | Change from baseline at 4 and 8 months |
| Body composition (body fat percentage) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Andrea S Sousa, PhD | Evandro Chagas National Institute of Infectious Disease | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Evandro Chagas National Institute of Infectious Disease | Rio de Janeiro | Rio de Janeiro | 21040-360 | Brazil |
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| ID | Term |
|---|---|
| D014355 | Chagas Disease |
| D002598 | Chagas Cardiomyopathy |
| ID | Term |
|---|---|
| D014352 | Trypanosomiasis |
| D056986 | Euglenozoa Infections |
| D011528 | Protozoan Infections |
| D010272 | Parasitic Diseases |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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|
Body fat percentage (%)
| Change from baseline at 4 and 8 months |
| Cardiac function (mainly ejection fraction) | Ejection fraction (%) | 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) | Change from baseline at 8 months |
| Biomarkers (glycated hemoglobin) | Glycated hemoglobin (%) | Change from baseline at 8 months |
| Quality of life by Minnesota Living with heart failure questionnaire (MLHFQ) | MLHFQ Score ranging from 0 to 105 | Change from baseline at 8 months |
| Anthropometry | Body weight (kg) | Change from baseline at 4 and 8 months |
| Anthropometry | Waist and hip circumference (cm) | Change from baseline at 4 and 8 months |
| D007239 |
| Infections |
| D000079426 | Vector Borne Diseases |
| D009202 | Cardiomyopathies |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |