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Heart failure worsens leg muscle strength and endurance in coexistence patients with COPD and heart failure reduced ejection fraction.
Medina, Luiz Antônio Rodrigues; Oliveira, Mayron F; Santos, Rita de Cassia Lima Dos; Souza, Aline Soares de; Mazzuco, Adriana; Sperandio, Priscila Cristina de Abreu; Alencar, Maria Clara Noman de; Arbex, Flávio Ferlin; Neder, J Alberto; Medeiros, Wladimir Musetti.
Afiliação
  • Medina LAR; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
  • Oliveira MF; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
  • Santos RCLD; VO2 Care Research Group, Physiotherapy Unit, Vila Nova Star Hospital, São Paulo, SP, Brazil.
  • Souza AS; Exercise Physiology and Integrated Cardiopulmonary Research Group - EPIC group, Exercise Science, Lyon College, Batesville, AR, USA.
  • Mazzuco A; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
  • Sperandio PCA; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
  • Alencar MCN; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
  • Arbex FF; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
  • Neder JA; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
  • Medeiros WM; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
Acta Cardiol ; 79(4): 454-463, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38420970
ABSTRACT

PURPOSE:

Exercise intolerance and dyspnoea are clinical symptoms in both heart failure (HF) reduced ejection fraction (HFrEF) and chronic obstructive pulmonary disease (COPD), which are suggested to be associated with musculoskeletal dysfunction. We tested the hypothesis that HFrEF + COPD patients would present lower muscle strength and greater fatigue compared to compared to the COPD group.

METHODS:

We included 25 patients with HFrEF + COPD (100% male, age 67.8 ± 6.9) and 25 patients with COPD alone (100% male, age 66.1 ± 9.1). In both groups, COPD severity was determined as moderate-to-severe according to the GOLD classification (FEV1/FVC < 0.7 and predicted post-bronchodilator FEV1 between 30%-80%). Knee flexor-extensor muscle performance (torque, work, power and fatigue) were measured by isokinetic dynamometry in age and sex-matched patients with HFrEF + COPD and COPD alone; Functional capacity was assessed by the cardiopulmonary exercise test, the 6-min walk test (6MWT) and the four-minute step test.

RESULTS:

The COPD group exhibited reduced lung function compared to the HFrEF + COPD group, as evidenced by lower FEV1/FVC (58.0 ± 4.0 vs. 65.5 ± 13.9; p < 0.0001, respectively) and FEV1 (51.3 ± 17.0 vs. 62.5 ± 17.4; p = 0.026, respectively) values. Regarding musculoskeletal function, the HFrEF + COPD group showed a knee flexor muscles impairment, however this fact was not observed in the knee extensors muscles. Power peak of the knee flexor corrected by muscle mass was significantly correlated with the 6MWT (r = 0.40; p < 0.05), number of steps (r = 0.30; p < 0.05) and work ratepeak (r = 0.40; p < 0.05) in the HFrEF + COPD and COPD groups.

CONCLUSION:

The presence of HFrEF in patients with COPD worsens muscular weakness when compared to isolated COPD.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Volume Sistólico / Tolerância ao Exercício / Doença Pulmonar Obstrutiva Crônica / Força Muscular / Insuficiência Cardíaca Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Cardiol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Volume Sistólico / Tolerância ao Exercício / Doença Pulmonar Obstrutiva Crônica / Força Muscular / Insuficiência Cardíaca Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Cardiol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido