Avaliação da qualidade de vida, força muscular respiratória e distância percorrida no teste de caminhada de seis minutos em pacientes com hipertensão arterial pulmonar sob tratamento farmacológico específico
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Data
2012-03-12
Autores
Serrão Júnior, Nelson Francisco [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A Hipertensão Pulmonar (HP) é definida clinicamente como aumento na pressão vascular pulmonar causada por condições associadas com aumento na pressão arterial pulmonar e/ou venosa. Hemodinamicamente, é definida como aumento na pressão arterial pulmonar média (PAPm) ≥ 25mmHg no repouso, resistência vascular pulmonar (RVP) superior a 4 Unidades Wood, ou quando o gradiente transpulmonar é superior a 10-12 mmHg. Muitos pacientes e clínicos atribuem a dispnéia e fadiga ao descondicionamento físico e à fraqueza muscular global e dos músculos respiratórios, podendo levar o paciente a piora da qualidade de vida. Objetivos: Avaliar a qualidade de vida, a força muscular respiratória (FMR) e a distância percorrida no teste de caminhada de seis minutos (DTC6) em pacientes com hipertensão arterial pulmonar sob tratamento farmacológico específico. Metodologia: Estudo descritivo, prospectivo, série de casos de hipertensão pulmonar em maiores de 18 anos, avaliados no Ambulatório de Hipertensão Pulmonar no período entre fevereiro de 2007 a fevereiro de 2011. Após a consulta médica, foi aplicado o questionário SF-36 para avaliação da qualidade de vida. A seguir, os pacientes foram submetidos à avaliação da força muscular respiratória. Após descanso de 30 minutos, os pacientes realizaram DTC6. Os pacientes foram avaliados em três momentos: M0, sem tratamento farmacológico específico; M1, de dois a quatro meses após tratamento farmacológico específico; e M2, seis meses após M0. Resultados: Havia 16 mulheres e 6 homens, com idade média±DP de 48,46±15,4anos, 21 brancos e 1 não branco, 1 com classe funcional I, 10 com classe funcional II, 9 classe III e 2 classe IV segundo a NYHA modificada para HP. Em relação a qualidade de vida, todos os pacientes avaliados apresentaram...
Pulmonary Hypertension (PH) involves a group of clinical and physiopathological entities with similar characteristics that come from several main diseases. Patients show arterial pulmonary pressure ≥ 25mmHg at rest, pulmonary vascular resistance (PVR) greater than 4 Wood Units, or transpulmonary gradient above 10-12 mmHg. Dyspnea and fatigue are the main symptoms; there is also lack of physical conditioning and global muscle weakness, including respiratory muscles. There are no studies assessing respiratory muscle force (RMF) in this population under specific treatment. Aims: Evaluation of quality of life, RMF and Six Minutes Walk Distance (6MWD) in patients with PH under specific pharmacologic treatment. Patients and Method: This is a descriptive, prospective case series study, of 22 PH patients over 18 years old, from the HC-FMB-UNESP Pulmonary Hypertension Clinic, evaluated at three moments: M0, without specific pharmacologic treatment; M1, two to four months after specific pharmacologic treatment; and M2, six months after M0. In all moments patients were submitted to clinical examination by the physician, RMF was assessed and the 6MWD was performed; then questionnaire SF-36 was applied in order to estimate quality of life. Results: most patients, 16 women and 6 men, average age ± SD 48.5 ± 15.4 years-old, were classified in functional classes II (n=10) and III (n=9) according to NYHA modified for PH. Patients showed improvement in their quality of life, regarding pain (M0 x M2 e M1 x M2), emotional aspect (M0 x M1) and mental health (M0 x M2). As for RMF there was an improvement in maxIP and maxEP (M1 x M2). There was also an improvement in the distance covered in the 6MWD (M0 x M1 and M0 x M2). Correlation between RMF... (Complete abstract click electronic access below)
Pulmonary Hypertension (PH) involves a group of clinical and physiopathological entities with similar characteristics that come from several main diseases. Patients show arterial pulmonary pressure ≥ 25mmHg at rest, pulmonary vascular resistance (PVR) greater than 4 Wood Units, or transpulmonary gradient above 10-12 mmHg. Dyspnea and fatigue are the main symptoms; there is also lack of physical conditioning and global muscle weakness, including respiratory muscles. There are no studies assessing respiratory muscle force (RMF) in this population under specific treatment. Aims: Evaluation of quality of life, RMF and Six Minutes Walk Distance (6MWD) in patients with PH under specific pharmacologic treatment. Patients and Method: This is a descriptive, prospective case series study, of 22 PH patients over 18 years old, from the HC-FMB-UNESP Pulmonary Hypertension Clinic, evaluated at three moments: M0, without specific pharmacologic treatment; M1, two to four months after specific pharmacologic treatment; and M2, six months after M0. In all moments patients were submitted to clinical examination by the physician, RMF was assessed and the 6MWD was performed; then questionnaire SF-36 was applied in order to estimate quality of life. Results: most patients, 16 women and 6 men, average age ± SD 48.5 ± 15.4 years-old, were classified in functional classes II (n=10) and III (n=9) according to NYHA modified for PH. Patients showed improvement in their quality of life, regarding pain (M0 x M2 e M1 x M2), emotional aspect (M0 x M1) and mental health (M0 x M2). As for RMF there was an improvement in maxIP and maxEP (M1 x M2). There was also an improvement in the distance covered in the 6MWD (M0 x M1 and M0 x M2). Correlation between RMF... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Hipertensão pulmonar, Força muscular respiratória, Pulmonary hypertension
Como citar
SERRÃO JÚNIOR, Nelson Francisco. Avaliação da qualidade de vida, força muscular respiratória e distância percorrida no teste de caminhada de seis minutos em pacientes com hipertensão arterial pulmonar sob tratamento farmacológico específico. 2012. 56 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2012.