Navegando por Palavras-chave "Chronic Thromboembolic Pulmonary Hypertension"

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    Influência Da Fraqueza Muscular Inspiratória Na Dispneia E Capacidade De Exercício De Pacientes Com Hipertensão Pulmonar Tromboembólica Crônica
    (Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Souza, Joao Victor Rolim De [UNIFESP]; Ramos, Roberta Pulcheri [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background. Determination Of Potentially-Reversible Factors Contributing To Exertional Dyspnea Remains An Unmet Clinical Need In Chronic Thromboembolic Pulmonary Hypertension (Cteph). Objective. To Evaluate The Influence Of Inspiratory Muscle Weakness (Imw) On Exercise Capacity And Dyspnea During Effort In Patients With Cteph. Methods. Prospective Cross-Sectional Study That Included Thirty-Nine Consecutive Patients With Cteph (48 ± 15 Yrs, 61% Female) Confirmed By Right Heart Catheterization That Underwent An Incremental Cardiopulmonary Exercise Test, 6-Minute Walk Test And Maximum Inspiratory Pressure (Mip) Measurement. Results. Mip < 70%Pred Was Found In 46% Of Patients. On A Multiple Linear Regression Analysis, Mip Was Independently Associated With 6mwd And V"O2 Peak. Patients With Mip < 70% Presented Greater "V"E/"V"Co2 Than Those With Preserved Inspiratory Muscle Strength (Pims). Additionally, They Also Presented Stronger Sensations Of Dyspnea Throughout Exercise, Even When Adjusted For Ventilation. At R
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    Respostas Fisiopatológicas Ao Teste De Caminhada De Seis Minutos Em Pacientes Com Hipertensão Pulmonar Tromboembólica Crônica
    (Universidade Federal de São Paulo (UNIFESP), 2017-08-31) Figliolino, Gabriela Assis Magalhaes [UNIFESP]; Arakaki, Jaquelina Sonoe Ota [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Patients with chronic tromboembolic pulmonary hypertension (CTEPH) have ventilatory responses and oxyhemoglobin desaturation more accentuated during incremental cardiopulmonary exercises test (CPETinc) than patients with idiopathic pulmonary arterial hypertension (IPAH). The test six minute walk test (6MWT) is a instrument more practical and easy to perform that can be used in clinical practice. The main variable obtained in the test is distance in sixminute walk test (D6MWT), however other variables can be evaluated the dyspnoea scale (BORG scale) and saturation peripheral oxygen (SpO2). In HAP, the 6MWT has an important role in the assessment of severity and therapeutic response,however in CTEPH the sensitivity of the 6MWT for intervention evaluation is questioned due to the presence of negative outcomes for D6MWT. Identifying the peculiarities of 6MWT in patients with CTEPH may open perspectives for better therapeutic management and prognosis of these patients. Objectives: 1. To compare the metabolic, cardiovascular, ventilatory and gas exchange responses in the 6MWT, as well as the quality of life, in patients with HPTEC and HAPI paired functional class; 2. Evaluate the association of quality of life measured by questionnaire SF-36 and D6MWT in patients with CTEPH; 3. Evaluate the association between responses metabolic, cardiovascular, respiratory and gas exchange in 6MWT and CPETinc in patients with CTEPH. Materials and Methods: A prospective study of 10 patients with diagnosis HAP and 20 with CTEPH. Participants performed performed incremental cycle ergometer test of legs limbs and six-minute walk test with portable metabolic system. Responses metabolic, respiratory, cardiovascular and dyspnoa (BORG scale) were evaluated throughout the test. In addition, patients answered the SF-36 quality of life questionnaire. Results: The 6MWT and BORG scale were similar in both groups, but patients with CTEPH have worse ventilatory responses and gas exchange during 6MWT, characterized by higher values of Δ E/Δ CO2, lower PEFCO2 and more pronounced decline in SpO2 at the end of the test. When comparing the CPETinc and 6MWT responses of patients with HPTEC, the oxygen consumption ( O2) was lower at the end of the 6MWT, indicating that 6MWT was considered submaximal in all patients. The SpO2 end of the 6MWT was not associated with D6MWT (absolute, % predicted and multiplied by weight). The O2 peak (L/min) of the CPETinc showed a strong association only with the D6MWT multiplied by weight, in mL/kg/min presented a moderate association with D6MWT in absoute value and % predicted. Quality of life was not associated with DC6M. Conclusion: The metabolic and cardiovascular responses in the 6MWT were similar in patients with HPTEC and IPAH, however with more pronounced alterations ventilator and gas exchange in patients with CTEPH. The 6MWT was submaximal test in patients with CTEPH, no association with quality of live. The 6MWT expressed in absolute value and % predicted presented moderate association with O2 pico (mL/kg/min) of the CPETinc.