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Inicio Revista Colombiana de Cardiología Impacto de la rehabilitación cardiaca en pacientes con falla cardiaca de origen...
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Vol. 18. Núm. 1.
Páginas 10-24 (enero - febrero 2011)
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Vol. 18. Núm. 1.
Páginas 10-24 (enero - febrero 2011)
Open Access
Impacto de la rehabilitación cardiaca en pacientes con falla cardiaca de origen isquémico
Impact of heart rehabilitation in patients with heart failure of ischemic origin
Visitas
4945
Carlos A. Quiroz1,
Autor para correspondencia
calquiro7@yahoo.com

Correspondencia: Dr. Carlos Alberto Quiroz Romero, Fundación Abood Shaio, Diagonal 115A No. 70C-30, Bogotá, DC.
, Juan Sarmiento1,2, Claudia Jaramillo1,2, Álvaro Sanabria1
1 Universidad El Bosque, Facultad de Medicina, Bogotá, DC., Colombia
2 Fundación Abood Shaio, Departamento de Cardiología, Bogotá, DC., Colombia
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Información del artículo
Objetivo

Establecer el impacto de la rehabilitación cardiaca en pacientes con falla cardiaca de origen isquémico con fracción de eyección menor del 40% en términos de síntomas, a través de la percepción subjetiva de la escala de Borg, VO2, MET y distancia en millas antes y al finalizar la terapia de rehabilitación cardiovascular.

Diseño

Estudio de cohorte concurrente.

Población

224 pacientes que ingresaron al programa de rehabilitación cardiaca de La Fundación Clínica Abood Shaio en el periodo comprendido entre el 10 de diciembre de 2004 y el 2 de mayo de 2008.

Mediciones

Se revisó la base de datos de rehabilitación cardiaca clasificando los parámetros de actividad física al ingreso y al egreso de la terapia.

Resultados

En el impacto de la terapia de rehabilitación cardiaca al inicio, 63% de los pacientes se encontraba en las escalas uno y dos de Borg modificada, y al final 85% (p < 0,001) se ubicó en las escalas tres y cuatro; el VO2 al inicio fue de 7,79 y al final 19,04 (p < 0,001); los MET al inicio 2,22 y al final 5,44 (p < 0,001) y la distancia en millas por hora al inicio 1,33 y al final 2,58 (p < 0,001).

Conclusiones

Se observó que la rehabilitación cardiaca tuvo un impacto significativo en los pacientes con falla cardiaca de origen isquémico con fracción de eyección del ventrículo izquierdo menor a 40% en términos de percepción de síntomas en forma subjetiva en la escala de Borg, VO2 indirecto, MET y distancia en millas por hora.

Palabras clave:
cardiopatía isquémica
rehabilitación cardiaca
Objective

To establish the impact of heart rehabilitation in patients with heart failure of ischemic origin with ejection fraction <40% in terms of symptoms by subjective perception of the Borg scale, VO2, MET and distance in miles before and at the end of cardiovascular rehabilitation therapy.

Design

Concurrent cohort study.

Population

224 patients admitted to the Abood Shaio Clinic Foundation cardiac rehabilitation program in the period from December 10, 2004 to May 2, 2008.

Measurements

It was reviewed the database of cardiac rehabilitation classifying physical activity parameters on admission and at discharge from therapy.

Results

With regard to the impact of cardiac rehabilitation therapy at baseline, 63% of patients were in the modified one and two Borg scale and at the end, 85% of patients (p <0.001) was placed on the three and four scales; VO2 at baseline was 7.79 and to the end 19.04 (p <0.001); the METS at the beginning was 2.22 and at the end 5.44 (p <0.001) and distance in miles per hour at the beginning was 1, 33 and at the end 2.58 (p <0.001).

Conclusions

It was found that cardiac rehabilitation had a significant impact in patients with ischemic heart failure with left ventricular ejection fraction <40% in terms of subjective perception of symptoms in the Borg scale, indirect VO2, METS and distance in miles per hour.

Key words:
ischemic heart disease
cardiac rehabilitation
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Bibliografía
[1.]
Situación de Salud en Colombia. Indicadores básicos de Salud 2001. Boletín del Ministerio de Salud. República de Colombia.
[2.]
R. Taylor, A. Brown, S. Ebraim, et al.
Exercise based rehabilitation for patients with coronary heart disease: systematic review and meta analysis of randomized controlled trials.
Am J Med, 116 (2004), pp. 682-692
[3.]
M. Jessup, S. Brozena.
Heart failure.
N Engl J Med, 348 (2003), pp. 2007-2018
[4.]
A.H. Sharon, W.T. Chair, A.H. Marshall, Chin, ACC/AHA Guidelines Update for the Diagnosis and Management of Chronic Heart Failure in the Adult. Summary Article. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Writing Committee to Update the 2001 guidelines for the evaluation and management of heart failure) developed in collaboration with the International Society for Heart and Lung Transplantation endorsed by the Heart Rhythm Society, et al.
Circulation, 112 (2005), pp. 1-28
[5.]
P.F. Kokkinos, W. Choucair, P. Graves, et al.
Chronic heart failure and exercise.
Am Heart J, 140 (2000), pp. 21
[6.]
A.S. Leon, B.A. Franklin, F. Costa, G.J. Balady, K.A. Berra, AHA Scientific Statement Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease. An American Heart Association Scientific Statement From the Council Clinical Cardiology and Council on Nutrition, physical activity and Metabolism, in Collaboration With the American Association of Cardiovascular end Pulmonary Rehabilitation, et al.
Circulation, 111 (2005), pp. 369-376
[7.]
American heart Association.
Heart Disease and Stroke Statistics: 2005 update.
American Heart Association, (2005),
[8.]
A.M. Clark, L. Hartling, B. Vandermeer, F.A. McAlister.
Meta analysis secondary prevention programs for patients with coronary artery disease.
Ann Intern Med, 143 (2005), pp. 659
[9.]
R.S. Taylor, A. Brown, S. Ebrahim, et al.
Exercise based rehabilitation for patients with coronary heart disease: systematic review and meta analysis of randomized controlled trials.
[10.]
A. Mosterd, J.W. Deckers, A.W. Hoes, et al.
Classification of heart failure in populationbased research; an assessment of six heart failure scores.
Eur J Epidemiol, 13 (1997), pp. 491-502
[11.]
J.M. Gardin, D. Siskovick, H. Culver, et al.
Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free living elderly; the Cardiovascular Health Study.
Circulation, 91 (1995), pp. 1739-1748
[12.]
W.H. Gaash.
Diagnosis and treatment of heart failure based on left ventricular systolic o diastolic function.
JAMA, 271 (1994), pp. 1276-1280
[13.]
G.M. Felker, L.K. Shaw, C.M. O’Connor.
A standardized definition of ischemic cardiomyopathy for use in clinical research.
J. Am Coll Cardiol, 39 (2002), pp. 210
[14.]
M. Gheorghiade, R.O. Bonow.
Chronic heart failure in the United States: a manifestation of coronary artery disease.
Circulation, 97 (1998), pp. 282-289
[15.]
T.A. McDonagh.
Morrison et al. Symptomatic and asymptomatic left ventricular dysfunction in an urban population.
[16.]
A.V. Chobanian, G.L. Bakris, H.R. Black, et al.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report.
JAMA, 289 (2003), pp. 2560-2571
[17.]
M.A. Pfeffer, J.J. McMurray, E.J. Velázquez, et al.
Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both.
N Engl J Med, 349 (2003), pp. 1893-1906
[18.]
M. Packer, A.J. Coats, M.B. Fowler, et al.
Effect of carvedilol on survival in severe chronic heart failure.
N Engl J Med, 344 (2001), pp. 1651-1658
[19.]
B. Pitt, F. Zannad, W.J. Remme, et al.
The effect of spironolactone on morbidity and mortality in patients with severe heart failure.
N Engl J Med, 341 (1999), pp. 709-717
[20.]
The Digitalis Investigation Group.
The effect of digoxin on mortality and morbidity in patients with heart failure.
N Engl J Med, 336 (1997), pp. 525-533
[21.]
S.S. Rathore, Y. Wang, H.M. Krumholz.
Sex-based differences in the effect of digoxin for the treatment of heart failure.
N Engl J Med, 347 (2002), pp. 1403-1411
[22.]
J.N. Cohn, D.G. Archibald, S. Ziesche, et al.
Effect of vasodilator therapy on mortality in chronic congestive heart failure: Results of a Veterans Administration Cooperative Study.
N Engl J Med, 314 (1986), pp. 1547-1555
[23.]
T. Lenz, N. Lenz, M. Faulkner.
Potential interactions between exercise and drug therapy.
Sports Med, 34 (2004), pp. 293-306
[24.]
Task Force of the Italian Working Group on Cardiac Rehabilitation Prevention.
Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation. Part I.
Eur J Cardiovascr Prev Rehab, 13 (2006), pp. 150-164
[25.]
R. McKelvie, K. Teo, R. Roberts, N. McCartney, D. Humen, T. Montague, et al.
Effect of exercise training in patient with heart failure: The Exercise Rehabilitation Trial (EXERT).
Am Heart J, 144 (2002), pp. 23-30
[26.]
M.C. Iliou.
Beneficios del ejercicio físico en pacientes con insuficiencia cardiaca crónica.
Cardiología del ejercicio. Cap. 11, Editorial Científica Universitaria, (2005), pp. 243-261
[27.]
P.A. Ades.
Cardiac rehabilitation and secondary prevention of coronary heart disease.
N Engl J Med, 345 (2001), pp. 892-902
[28.]
R. Hambrecht, C. Walther, S. Mobius-Winkler, et al.
Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial.
[29.]
P. Giannuzzi, L. Temporelli, U. Corra, for the ELVD study group. Attenuation of favorable remodeling by exercise training in postinfarction patients with left ventricular dysfunction, et al.
Results of the Exercise in Left Ventricular Dysfunction (ELVD) Trial.
Circulation, 96 (1997), pp. 1790
[30.]
L.F. Berkman, J. Blumenthal, M. Burg, et al.
Effect treating depression and low perceived social support on clinical events and myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial.
[31.]
J. Blumenthal, A. Sherwood, M. Babyak, et al.
Effect of exercise and stress management training of markers of cardiovascular risk in patients with ischemic heart disease: a randomized controlled trial.
[32.]
R.V. Milani, C.J. Lavie, M.R. Mhera.
Reduction in C reactive protein through cardiac rehabilitation and exercise training.
J Am Coll Cardiol, 43 (2004), pp. 1056
[33.]
S. Lear, J.J. Spinelli, W. Linden, et al.
The Extensive Lifestyle Management Intervention (ELMI) after cardiac rehabilitation: a 4 year randomized controlled trial.
Am Heart J, 152 (2006), pp. 333
[34.]
N. Smart, T.H. Marwick.
Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity.
Am J Med, 116 (2004), pp. 693-706
[35.]
J. Myers, M. Prakash, V. Froelicher, et al.
Exercise capacity and mortality among men referred for exercise testing.
N Engl J Med, 346 (2002), pp. 793-801
[36.]
M.R. Cowie, D.A. Wood, A.J. Coats, et al.
Survival of patients with a new diagnosis of heart failure: a population based study.
Heart, 83 (2000), pp. 505-510
[37.]
P. Jong, E. Vowinckel, P.P. Liu, et al.
Prognosis and determinants of survival in patients newly hospitalized for heart failure: a population-based study.
Arch Intern Med, 162 (2002), pp. 1689-1694
[38.]
A. Michalsen, G. Konig, W. Thimme.
Preventable causative factor leading to hospital admission with decompensated congestive heart failure.
Heart, 80 (1998), pp. 437
[39.]
C. Opasich, C. Rapezzi, D. Lucci, et al.
Precipitating factor and decision–making processes of short term worsening heart failure despite «optimal» treatment.
Am J Cardiol, 88 (2001), pp. 382
[40.]
F.A. Mclister, F.M. Lawson, K.K. Teo, P.W. Armstrong.
A systematic review of randomized trials of disease management programs in heart failure.
Am J Med, 110 (2001), pp. 378-384
[41.]
Guías ALAD de diagnóstico, control y tratamiento de la diabetes mellitus tipo 2.
Rev Asoc Latin Diabet, (2000), pp. 101-168
[42.]
S.M. Grundy, J.I. Cleeman.
Implication of recent clinical trials for the National Education Program Adult Treatment Panel III Guidelines.
[43.]
C. Giannatasio, A.A. Mongoni, M.L. Stella, et al.
Acute effects of smoking on radial artery compliance in humans.
J Hypertens, 12 (1994), pp. 691-696
Copyright © 2011. Sociedad Colombiana de Cardiología y Cirugía Cardiovascular
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