ALTERAÇÕES DA VE/VCO2 E OUES DURANTE EXERCÍCIO PROGRESSIVO EM PACIENTES COM INSUFICIÊNCIA CARDÍACA

Abstract

Introduction: Heart failure originates from several etiologies resulting in cardiorespiratory impairment during physical effort. Objective: To compare the behavior of cardiorespiratory variables, slope of oxygen uptake efficiency slope and the relationship between pulmonary ventilation and carbon dioxide production between individuals with heart failure and healthy individuals. Methods: 61 male individuals (61.2 ± 7.8 years) were evaluated, who were separated into two groups: Group CI - Patients with Cardiac Insufficiency (n = 40) and Group C - Control (n = 21). The volunteers performed assessments of the following parameters: age, height, body mass and body mass index. The ergospirometry test was also performed, consisting of performing a graded exercise testing on a treadmill with direct analysis of the respiratory gases: VE/VCO2, VO2peak, PetCO2, OUES and the hemodynamic variables: maximum heart rate, recovery heart rate after the 1st minute and the echocardiogram. The Kolmorovsminoff test for normality was performed, the data were expressed as mean and standard error and the inferential analysis performed with the Anova and Post-Hoc Tests of Scheffé, considering p≤0.05. Results: The anthropometric, hemodynamic and respiratory variables results for the CI and C groups, respectively, were: age =61,0±8,2 vs. 61,5±7,4 years (p>0,05), height= 1,72±5,8 vs. 1,72±6,8m (p>0,05), body mass = 77,3±9,9 vs. 78,3±9,0kg (p>0,05), IMC = 26,5±3,0 vs. 26,2±2,8 kg/m2 (p>0,05), ejection fraction = 31,2±4,1 vs. 64,7±3,9mL (p<0,001), maximum cardio frequency = 128,6±22,9 vs. 143,6±15,5bpm (p<0,02), recovery heart rate after the 1st minute = -17,4±5,4 vs. -25,0±4,9bpm (p<0,05), VE/VCO2slope = 38,8±5,6 vs. 28,2±3,9L/min (p<0,003), VO2peak = 20,0±4,0 vs. 36,7±5,5ml/kg/min (p<0,05), PetCO2 = 29,5±3,0 vs. 31,7±2,4mmHg (p<0,05) and OUES = 1,81±0,4 vs. 2,3±0,3 (p<0,05). Conclusion: Patients with heart failure showed high values of VE/VCO2 and low values of OUES, which limits functional capacity and leads to the early onset of metabolic acidosis. Level of Evidence I; High-Quality Prospective Study.