Abstract
The benefit of a cardiac rehabilitation (CR) program for patients with Chagas heart failure (CHF) remains unclear. Therefore, we aimed to investigate the effects of CR for CHF patients. A single-arm pilot study, including 12 patients with CHF, was performed. Patients participated in an 8-month physical exercise intervention, comprising aerobic, strength, and stretching exercises (3 times per week, 60 minutes per session). Nutritional and pharmaceutical counseling were also performed. Functional capacity (cardiopulmonary exercise test), muscle respiratory strength (manovacuometry), and body composition (anthropometry and skinfolds) were evaluated at baseline, and after 4 and 8 months of intervention. Cardiac function (echocardiography), biomarkers (lipid profile, glucose, and glycated hemoglobin) and quality of life (Minnesota Living with Heart Failure Questionnaire) were assessed at baseline and at the end of the intervention. Seven of 12 patients included in the study completed the 8-month follow-up period. Only 2 moderate adverse events occurred during the exercise training. Functional capacity improved after 4 months of CR, while left ventricular ejection fraction (LVEF) and respiratory strength improved after 8 months. Patients with right ventricular (RV) dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV) diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Conversely, those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. CR was feasible, safe, and has important clinical benefits for patients with CHF, specifically for cardiac function and muscle respiratory strength.
Highlights
The benefit of a cardiac rehabilitation (CR) program for patients with Chagas heart failure (CHF) remains unclear
Assessments of cardiac function (2-dimensional echocardiography), biomarkers, and quality of life (Minnesota Living with Heart Failure Questionnaire) were taken at baseline and at the end of follow-up
The Portuguese version of the Minnesota Living with Heart Failure Questionnaire (MLHFQ), a 21-item questionnaire that covers HF-related physical, psychological, and social impairments during the previous month, was used to evaluate quality of life
Summary
The benefit of a cardiac rehabilitation (CR) program for patients with Chagas heart failure (CHF) remains unclear. Patients with right ventricular (RV) dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV) diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. Clinical presentation is characterized by thromboembolic events, arrhythmias, and heart failure (HF); such symptoms account for the majority of CHF treatment aims to manage symptoms, decrease mortality, and improve quality of life for the patient(9). Cardiac rehabilitation (CR) has been extensively advocated as an important coadjuvant in the treatment of HF(11) . (12) HFACTION, a major randomized controlled trial evaluating the effects of CR implementation among patients with HF, showed that after adjustment for prognostic predictors, exercise training reduced all-cause and cardiovascular mortality and hospitalizations, while simultaneously increasing maximum
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