Medidas antropométricas e composição corporal estão relacionadas à ocorrência de sinais e sintomas em programas de reabilitação cardíaca?
Carregando...
Data
2022-03-17
Autores
Valente, Heloisa Balotari
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: sinais e sintomas são frequentes em programas de reabilitação cardíaca (PRC). As medidas antropométricas e a composição corporal têm sido relacionadas à ocorrência de eventos adversos graves. Identificar se as medidas antropométricas e a composição corporal estão relacionadas à ocorrência de sinais e sintomas pode orientar as abordagens terapêuticas e as estratégias de estratificação de risco utilizadas nos PRC, e contribuir para o aumento na segurança dos pacientes. Objetivo: investigar a relação entre as medidas antropométricas e a composição corporal com a ocorrência de sinais e sintomas em PRC, considerando sexo, idade e aptidão cardiorrespiratória. Métodos: estudo observacional de coorte longitudinal que incluiu participantes diagnosticados com doenças cardiovasculares (DCV) e/ou fatores de risco para DCV, de um PRC baseado em exercícios. Foram obtidos dados demográficos (idade e sexo) e médicos (diagnóstico, tempo de participação no PRC, fatores de risco para DCV, comorbidades e medicamentos em uso) a partir dos prontuários do PRC de cada participante. Medidas antropométricas (peso corporal, estatura, circunferências da cintura, abdômen, panturrilha, quadril, e braço, razão cintura-quadril, razão cintura-estatura, índice de conicidade, índice de adiposidade corporal, índice de massa corporal, índice de volume abdominal, índice de forma corporal e índice de arredondamento corporal) foram avaliados utilizando uma balança digital, um estadiômetro e uma fita métrica, ou foram calculados. As variáveis de composição corporal (gordura corporal, percentual de gordura corporal, massa magra, total de água corporal e hidratação da massa magra) foram avaliadas por meio de um equipamento de bioimpedância tetrapolar. Os sinais (alterações de pulso, aumento da pressão sistólica (PAS) >200mmHg e/ou diastólica (PAD) >120mmHg durante o exercício, taquipneia e palidez) e sintomas (angina, cãibra, dor muscular, fadiga, tontura e náusea) foram avaliados em 24 sessões de PRC. Os participantes foram divididos em grupos por sexo, e pela mediana da amostra para consumo máximo de oxigênio (VO2 máx.) e idade, para avaliar a relação entre medidas antropométricas e composição corporal com a ocorrência de sinais e sintomas considerando sexo, idade e aptidão cardiorrespiratória. As relações foram testadas por meio da a correlação de Pearson ou Spearman, dependendo da normalidade dos dados (Shapiro-Wilk). O nível de significância estatística foi definido em <0,05. Resultados: Foram observadas correlações positivas fracas entre dor muscular com índice de massa corporal (r=0,274) e percentual de gordura corporal (r= 0.249), aumento da PAD no exercício com circunferência de braço (r=0,242) e percentual de gordura corporal (r=0,264), alteração de pulso com hidratação da massa magra (r= 0,261), e entre o total de sinais e sintomas com hidratação da massa magra (r= 0.252). Foram observadas correlações negativas fracas entre o aumento da PAD no exercício com índice de forma corporal (r=-0,261) e entre cãibras com circunferência da cintura (r=-0,259) e índice de volume abdominal (r=- 0,247). Observou-se maior número de correlações significativas no grupo masculino, no grupo com participantes mais jovens e no grupo menor VO2 máx. Conclusão: a ocorrência de dor muscular parece estar relacionada a um maior índice de massa corporal e maior percentual de gordura corporal, o aumento da PAD no exercício parece estar relacionado à maior circunferência do braço e maior percentual de gordura, e alteração de pulso e o total de sinais e sintomas parecem estar relacionados à maior hidratação da massa magra. A ocorrência de aumento da PAD no exercício parece estar relacionada a menor índice de forma corporal, e cãibras parecem estar relacionadas a menor circunferência da cintura e índice de volume abdominal. As relações entre as medidas antropométricas e a composição corporal com sinais e sintomas parecem ser influenciadas pelo sexo, idade e aptidão cardiorrespiratória.
Background: Signs and symptoms are frequent in cardiac rehabilitation programs (CRP). Anthropometric measurements and body composition have been related to the occurrence of major adverse events. Identification of whether anthropometric measurements and body composition are related to the occurrence of signs and symptoms may guide therapeutic approaches and risk stratification strategies used in CRP and contribute to increased patient safety. Aim: To investigate the relationship between anthropometric measurements and body composition with the occurrence of signs and symptoms in CRP, considering sex, age, and cardiorespiratory fitness. Methods: An observational longitudinal study that included participants diagnosed with cardiovascular disease (CVD) or CVD risk factors, from an exercise-based CRP. Demographic (age and sex) and medical data (diagnosis, time of participation in the CRP, CVD risk factors, comorbidities, and medicines in use) were obtained from the CRP records of each participant. Anthropometric measurements (body weight, height, abdominal, calf, hip, mid-upper arm, and waist circumferences, waist-hip ratio, waist-height ratio, conicity index, body adiposity index, body mass index, abdominal volume index, body shape index, and body roundness index) were assessed using a scale, a stadiometer, and a tape measure or were calculated. Body composition variables (body fat, body fat percentage, fat-free mass, total body water, and hydration of fat-free mass) were assessed using tetrapolar bioimpedance equipment. Signs (arrhythmias, increased systolic (SBP) >200mmHg and/or diastolic (DBP) >120mmHg blood pressure during the exercise, tachypnea, and pallor) and symptoms (angina, cramp, muscle pain, fatigue, dizziness, and nausea) were assessed in 24 CRP sessions. Participants were divided into groups by sex, and by the median of the sample for maximal oxygen uptake (VO2 max) and age, to evaluate the relationships between anthropometric measurements and body composition with the occurrence of signs and symptoms considering sex, age, and cardiorespiratory fitness. The relationships were tested using Pearson's or Spearman's correlations, depending on the normality of the data (Shapiro-Wilk). The statistical significance level was set at <0.05. Results: Small positive correlations of muscle pain with body mass index (r=0.274) and body fat percentage (r= 0.249), increased DBP in exercise with midupper arm circumference (r=0.242) and body fat percentage (r=0,264), arrhythmias with hydration of fat-free mass (r= 0.261), and total signs and symptoms with hydration of fatfree mass (r= 0.252) were observed. Small negative correlations were found between increased DBP in exercise with body shape index (r=-0.261), and between cramps with waist circumference (r=-0.259) and abdominal volume index (r=-0.247). A higher number of significant correlations were observed in the male group, younger group, and lower VO2 max group. Conclusion: The occurrence of muscle pain seems to be related to a higher body mass index and higher fat mass percentage, increased DBP in exercise seems to be related to a higher mid-upper arm circumference and higher fat mass percentage, and arrhythmias and total signs and symptoms seem to be related to higher hydration of fat-free mass. The occurrence of increased DBP in exercise seems to be related to a lower body shape index, and cramps seem to be related to a lower waist circumference and abdominal volume index. The relationships between anthropometric measurements and body composition with signs and symptoms seem to be influenced by sex, age, and cardiorespiratory fitness.
Background: Signs and symptoms are frequent in cardiac rehabilitation programs (CRP). Anthropometric measurements and body composition have been related to the occurrence of major adverse events. Identification of whether anthropometric measurements and body composition are related to the occurrence of signs and symptoms may guide therapeutic approaches and risk stratification strategies used in CRP and contribute to increased patient safety. Aim: To investigate the relationship between anthropometric measurements and body composition with the occurrence of signs and symptoms in CRP, considering sex, age, and cardiorespiratory fitness. Methods: An observational longitudinal study that included participants diagnosed with cardiovascular disease (CVD) or CVD risk factors, from an exercise-based CRP. Demographic (age and sex) and medical data (diagnosis, time of participation in the CRP, CVD risk factors, comorbidities, and medicines in use) were obtained from the CRP records of each participant. Anthropometric measurements (body weight, height, abdominal, calf, hip, mid-upper arm, and waist circumferences, waist-hip ratio, waist-height ratio, conicity index, body adiposity index, body mass index, abdominal volume index, body shape index, and body roundness index) were assessed using a scale, a stadiometer, and a tape measure or were calculated. Body composition variables (body fat, body fat percentage, fat-free mass, total body water, and hydration of fat-free mass) were assessed using tetrapolar bioimpedance equipment. Signs (arrhythmias, increased systolic (SBP) >200mmHg and/or diastolic (DBP) >120mmHg blood pressure during the exercise, tachypnea, and pallor) and symptoms (angina, cramp, muscle pain, fatigue, dizziness, and nausea) were assessed in 24 CRP sessions. Participants were divided into groups by sex, and by the median of the sample for maximal oxygen uptake (VO2 max) and age, to evaluate the relationships between anthropometric measurements and body composition with the occurrence of signs and symptoms considering sex, age, and cardiorespiratory fitness. The relationships were tested using Pearson's or Spearman's correlations, depending on the normality of the data (Shapiro-Wilk). The statistical significance level was set at <0.05. Results: Small positive correlations of muscle pain with body mass index (r=0.274) and body fat percentage (r= 0.249), increased DBP in exercise with midupper arm circumference (r=0.242) and body fat percentage (r=0,264), arrhythmias with hydration of fat-free mass (r= 0.261), and total signs and symptoms with hydration of fatfree mass (r= 0.252) were observed. Small negative correlations were found between increased DBP in exercise with body shape index (r=-0.261), and between cramps with waist circumference (r=-0.259) and abdominal volume index (r=-0.247). A higher number of significant correlations were observed in the male group, younger group, and lower VO2 max group. Conclusion: The occurrence of muscle pain seems to be related to a higher body mass index and higher fat mass percentage, increased DBP in exercise seems to be related to a higher mid-upper arm circumference and higher fat mass percentage, and arrhythmias and total signs and symptoms seem to be related to higher hydration of fat-free mass. The occurrence of increased DBP in exercise seems to be related to a lower body shape index, and cramps seem to be related to a lower waist circumference and abdominal volume index. The relationships between anthropometric measurements and body composition with signs and symptoms seem to be influenced by sex, age, and cardiorespiratory fitness.
Descrição
Palavras-chave
Antropometria, Composição corporal, Doenças cardiovasculares, Reabilitação cardíaca, Sinais e sintomas, Anthropometry, Body composition, Cardiovascular diseases, Cardiac rehabilitation, Signs and symptoms