Efecto de un programa de rehabilitación cardiaca basado en ejercicio sobre la capacidad física, la función cardiaca y la calidad de vida, en pacientes con falla cardiaca

Article information

Antecedentes

La rehabilitación cardiaca basada en ejercicio es una estrategia de tratamiento para los pacientes con falla cardiaca. En la actualidad hay controversia sobre su efecto en parámetros centrales y hemodinámicos de la función ventricular.

Objetivo

Evaluar el efecto de un programa de rehabilitación cardiaca basada en ejercicio sobre la capacidad física, la función cardiaca y la calidad de vida en pacientes con falla cardiaca.

Diseño y métodos

Estudio de intervención en pacientes con falla cardiaca estadio C, clase funcional NYHA II-III, a quienes se les hicieron pruebas funcionales, ecocardiografía y concentración sérica de la porción NT-proPNC y, además, se les aplicó un cuestionario de calidad de vida, antes de un programa de rehabilitación cardiaca basada en ejercicio y doce semanas después de éste.

Resultados

Se incluyeron 22 pacientes con una edad promedio de 59 ± 9 años. De ellos, 17 (77,3%) fueron hombres y 20 (90,9%) tenían enfermedad coronaria. El consumo de oxígeno máximo indirecto (VO2) aumentó de 26,4 ± 6,4mL.kg-1.min-1 a 34,5 ± 7,7mL.kg-1.min-1 en promedio (p<0,001) y la distancia alcanzada en la prueba de caminata de los seis minutos se incrementó de 438 ± 67,9 metros a 513 ± 83,4 metros en promedio (p<0,001). La fracción de expulsión aumentó de 32,68 ± 8,8% a 38,82 ± 9,16% (p<0,001). Hubo mejoraría en la calidad de vida en el dominio de “cambio de salud en el tiempo” (p<0,05).

Conclusión

Los pacientes con falla cardiaca que se intervienen con un programa de rehabilitación cardiaca basada en ejercicio durante doce semanas, mejoran su capacidad funcional, la función sistólica y la calidad de vida.

Palabras clave:

falla cardiaca

rehabilitación cardiaca

ejercicio

capacidad física

función cardiaca

calidad de vida

Background

Exercise-based cardiac rehabilitation is a strategy treatment in patients with heart failure. Currently there is controversy about its effect on central and hemodynamic parameters of ventricular function.

Objective

To evaluate the effect of an exercise-based cardiac rehabilitation program on physical capacity, cardiac function and quality of life in patients with heart failure.

Design and methods

Intervention study in patients with heart failure stage C, NYHA functional classes II-III that were submitted to functional tests, echocardiography and plasma levels of NT-pro- BNP, and also answered a questionnaire on quality of life before and twelve weeks after a cardiac rehabilitation program based on exercise.

Results

22 patients with mean age 59 ± 9 years old were included. 17 (77,3%) were men and 20 (90,9%) had coronary heart disease. The indirect maximum oxygen consumption (VO2) increased on average from 26.4 ± 6.4mL.kg-1.min-1 to 34.5 ± 7.7mL.kg-1.min-1 (p<0.001) and the distance reached in the 6–minute walking test increased on average from 438 ± 67.9 meters to 513 ± 83.4 meters (p<0.001). The ejection fraction increased from 32.68 ± 8.8% to 38.82 ± 9.16% (p<0.001). There was improvement in the quality of life in the domain of «health change over time» (p<0.05).

Conclusions

Patients with heart failure who are involved in a cardiac rehabilitation program based on exercise for twelve weeks improve their functional capacity, systolic function and quality of life.

Key words:

heart failure

cardiac rehabilitation

exercise

physical capacity

cardiac function

quality of life

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