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Patophysiologic and gender differences regarding exercise responses in decompensated heart failure patients

dc.contributor.authorDelgado, Bruno
dc.contributor.authorFroelicher, Erika
dc.contributor.authorLopes, Ivo
dc.contributor.authorSousa, Luís
dc.contributor.authorNovo, André
dc.date.accessioned2021-09-08T13:33:32Z
dc.date.available2021-09-08T13:33:32Z
dc.date.issued2021
dc.description.abstractHeart Failure patients often present impairment on their functional capacity. Exercise training is the key component of cardiac rehabilitation and must be early implemented. Knowing the characteristics that lead a patient to be a good responder to an exercise intervention would be useful to identify the ones that could benefit from this same intervention. Purpose: Identify the characteristics of good responses to an aerobic exercise training in decompensated heart failure (HF) patients and understand if there are gender differences. Methods: Cross sectional study with 76 inpatients who performed an aerobic exercise training program (AET). Functional capacity was evaluated at admission and discharge using three different tools: the London Chest of Activity of Daily Living (LCADL) scale, the Barthel Index (BI) and the 6-minute walking test (6MWT). Multivariate linear regression was performed by gender to understand which variables lead a patient to have better performance. Since it is known that men and women have different responses to exercise training, the results and analysis of the data collected were performed by gender. Results: Seventy-six patients (52 men) were included. The mean age was 67 ± 10 years, 15.8% were New York Heart Association (NYHA) class IV and 76.3% had reduced ejection fraction. The major etiology of HF was ischemic disease (35.5%). Six predictive equations were obtained, one for each functional capacity (FC) tool divided by gender. NYHA class III patients do not differ from class IV in terms of FC at discharge. However, HFreduced ejection fraction patients presented higher 6MWT distance (309,6m vs 231m) and lower LCADL score (11 vs 15) compared to non-reduced. Gender analysis showed that women had an average of 4 days longer in-hospital stay and a considerable difference in the 6MWT. At admission women walked 15 meters less than man and at discharge 69 meters less, presenting also lower score at BI and higher at LCADL. However, only the discharge 6MWT distance presents a statistical significant difference (69 meters; p = 0.01). Traditionally women are more sedentary and present less fitness level than men. The linear regression model shows that gender is a independent variable that contributes to the change in the 6MWT - favouring men. Conclusions: The AET program appears to be more effective in younger patients, with low FC at admission and who are less impaired. Those with left systolic ventricular function apparently interfered with progression during the program. Gender influences the performance of patients undergoing exercise training. Men present higher FC at discharge but the predictive models are stronger for women. These results are consistent with the idea that gender plays an important role in determine the performance of patients in exercise training programs.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationDelgado, Bruno; Froelicher, Erika; Lopes, Ivo, Sousa, Luís; Novo, André (2021). Patophysiologic and gender differences regarding exercise responses in decompensa ted heart failure patients. In European Journal of Cardiovascular Nursing. p. i81. ISSN 1873-1953pt_PT
dc.identifier.doi10.1093/eurjcn/zvab060.076pt_PT
dc.identifier.issn1873-1953
dc.identifier.urihttp://hdl.handle.net/10198/23891
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAssociation of Cardiovascular Nursing and Allied Professions (ACNAP)pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectGenderpt_PT
dc.subjectCardiac rehabilitationpt_PT
dc.subjectExercisept_PT
dc.titlePatophysiologic and gender differences regarding exercise responses in decompensated heart failure patientspt_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.endPagei81pt_PT
oaire.citation.issueSupplement_1pt_PT
oaire.citation.startPagei81pt_PT
oaire.citation.titleEuropean Journal of Cardiovascular Nursingpt_PT
oaire.citation.volume20pt_PT
person.familyNameNovo
person.givenNameAndré
person.identifierH-1386-2012
person.identifier.ciencia-id7D14-8584-AB2B
person.identifier.orcid0000-0001-8583-0406
person.identifier.scopus-author-id612710
rcaap.rightsopenAccesspt_PT
rcaap.typeconferenceObjectpt_PT
relation.isAuthorOfPublicationf17cfa22-2a97-4396-bdc6-4570baee6885
relation.isAuthorOfPublication.latestForDiscoveryf17cfa22-2a97-4396-bdc6-4570baee6885

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