Mady et al. (1986)2222. Mady C, Junior PY, Barreto ACP, Saraiva JF, Vianna CdB, Azul LGdS, et al. Estudo da capacidade funcional máxima pela ergoespirometria em pacientes portadores da doença de Chagas. Arq Bras Cardiol. 1986;47(3):201-5.
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13 patients with ChC and preserved LVEF (30±5.76 years) and 15 patients with dilated ChC (30±6.82 years, NYHA II-III) |
CPET (Naughton protocol, treadmill) |
The VO2peak, O2 pulse, HR, VE, and VCO2 in patients with dilated ChC were significantly lower compared to those in patients with ChC and preserved LVEF (p<0.05). |
Pedrosa; Campos (2004)3333. Pedrosa RC, Campos MCd. Teste ergométrico e o Holter de 24 horas na detecção de arritmias ventriculares complexas em diferentes estádios da cardiopatia chagásica crônica. Rev Soc Bras Med Trop . 2004;37(5):376-83.
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20 patients with ChC and preserved LVEF (30% male, 51.2±11 years, LVEF: 59.3±14%) and 20 patients with dilated ChC (20% male, 55.8±10 years, LVEF: 37.6±9.3%) |
CPET (Bruce protocol, treadmill) |
No differences (p>0.05) were observed in the prevalence of ventricular extrasystoles, pairs of extrasystoles, nonsustained ventricular tachycardia, and sustained monomorphic ventricular tachycardia, detected by 24-h Holter monitoring and those induced by exercise both in dilated ChC and with preserved LVEF. |
Rocha et al. (2005)2121. Rocha ALL, Rocha MOdC, Teixeira BOS, Lombardi F, Abreu CDG, Bittencourt RJ, et al. Índice cronotrópico-metabólico na doença de Chagas. Rev Soc Bras Med Trop . 2005;38(5):373-6.
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154 patients with ChC and preserved LVEF [57% male, 41.7±9.3 years, LVEF: 62 (58-65)%] and 17 patients with dilated ChC [59% male, 42.8±9.2 years, LVEF: 35 (31-39)%] |
Maximal Exercise Testing (Bruce protocol, treadmill) |
No differences were observed between groups with preserved LVEF and dilated ChC in VO2peak, maximum HR, delta HR, and effort time (p>0.05). |
Lima et al. (2010)2525. Lima MM, Nunes MC, Rocha MO, Beloti FR, Alencar MC, Ribeiro AL. Left ventricular diastolic function and exercise capacity in patients with Chagas cardiomyopathy. Echocardiography. 2010;27(5):519-24.
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40 patients with dilated ChC; 49±8 years; 58% male; NYHA I-II; LVEF: 36.3±7.8% |
Maximal Exercise Testing (Bruce protocol, treadmill) |
The VO2peak was correlated with E/E’ ratio (r= -0.516; p=0.001) but not with LVEF, LVDd, and BNP. The predictors of VO2peak in the final multivariate model were age, female sex, E/E’ ratio, and left atrial volume (LAV) (r2=0.521). |
Nunes et al. (2010)2727. Nunes Mdo C, Beloti FR, Lima MM, Barbosa MM, Pinto Filho MM, de Barros MV, et al. Functional capacity and right ventricular function in patients with Chagas heart disease. Eur J Echocardiogr. 2010;11(7):590-5.
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65 patients with ChC (comprising dilated ChC and with preserved LVEF); 48.6±9.1 years; 60% male; NYHA I-II); LVEF: 43.1±11.4% |
Maximal Exercise Test (treadmill, Bruce protocol) |
The VO2peak was correlated with LVDd/BSA (r= -0.38; p=0.002), e’ (r= 0.40; p=0.001), E/e’ ratio (r= -0.37; p=0.003), RV e’ (r= 0.29; p=0.025), RV e’/A’ ratio (r= 0.41; p=0.001), RV systolic velocity (r= 0.45; p<0.001), RV Tei index (r= -0.28; p=0.029), and PASP (r= -0.36; p=0.009). The VO2peak did not correlate with LVEF, E/A ratio, DT, LA volume index, E/Vp. The independent predictors of VO2peak were age, female sex and RV systolic velocity (r2=0.71). |
Alvarenga et al. (2014)2424. Alvarenga JCd, Jansen PD, Marques VEG, Costa HS, Sousa GRd, Souza ACd, et al. Relação entre a fração de ejeção do ventrículo esquerdo e razão e/e' com a capacidade funcional na cardiopatia chagásica. Rev Assoc Med Minas Gerais. 2014;24(Supl 9):S20-S5.
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35 patients with ChC (dilated and with preserved LVEF); 47.11±8.15 years, 65% male; NYHA I-III; LVEF: 59.0 [41.0-64.0] |
CPET (ramp protocol, treadmill) |
In the overall study population, a significant correlation was observed between VO2peak and LVEF (r=0.536, p=0.001) and E/e' ratio (r=-0.399; p=0.022). In patients with dilated ChC (n=16), the VO2peak was also correlated with LVEF (r=0.611, p=0.016) and with the ratio E/e' (r=-0.601, p=0.018). In the multivariate analysis, LVEF and E/e’ ratio were strong predictors of VO2peak (r2 = 0.723) only in patients with dilated ChC. |
Costa et al. (2014)2323. Costa HS, Lima MM, de Sousa GR, de Souza AC, Alencar MC, Nunes MC, et al. Functional capacity and risk stratification by the Six-minute Walk Test in Chagas heart disease: comparison with Cardiopulmonary Exercise Testing. Int J Cardiol . 2014;177(2):661-3.
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41 patients with ChC (dilated and with preserved LVEF); 47.8±8.3 years; 68% male; NYHA I-III |
CPET (ramp protocol, treadmill) |
Patients with dilated ChC had lower VO2peak (p=0.001) and 6MWT distance (p=0.045) values and higher VE/VCO2 slope (p=0.029) value compared to those in patients with ChC and preserved LVEF. |
Costa et al. (2017)2626. Costa HS, Lima MM, Alencar MC, Sousa GR, Figueiredo PH, Nunes MC, et al. Prediction of peak oxygen uptake in patients with Chagas heart disease: Value of the Six-minute Walk Test. Int J Cardiol . 2017;228:385-7.
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81 patients with ChC (dilated and with preserved LVEF); 48.6±8.1 years; 63% male; NYHA I-III); LVEF: 43.7±13.7% |
Maximal Exercise Test (treadmill) |
The VO2peak was correlated with age (r= -0.490; p<0.001), sex (r = 0.283; p=0.010), body mass index (r= -0.333; p=0.002), NYHA functional class (r= -0.667; p<0.001), and 6MWT distance (r=0.527; p<0.001). The VO2peak was predicted by sex, NYHA functional class, 6MWT distance, age, and body mass index |
Costa et al. (2017)2828. Costa HS, Lima MMO, Nunes MCP, Sousa GR, Almeida FRd, Figueiredo PHS, et al. Inspiratory muscle weakness in patients with Chagas heart disease: Echocardiographic and functional predictors. IJC Metab Endocr. 2017;14:21-5.
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48 patients with ChC (dilated and with preserved LVEF); 56.4 (53.3-59.5) years; 29% male; NYHA I-III; LVEF: 54.3 (48.6-59.9)% |
CPET (ramp protocol, treadmill) |
VE/VCO2 slope was correlated with the percentage of maximal inspiratory pressure (r= -0.446; p=0.004). The VO2peak was not correlated with maximal inspiratory pressure. In the final multivariate model, patients with impaired VE/VCO2 slope had a 1.2-fold increased risk for inspiratory muscle weakness (prevalence ratio 1.2, 95% CI 1.1 to 1.5, p = 0.001). |