Perfil epidemiológico, aptidão cardiopulmonar e qualidade de vida relacionada à saúde de pacientes com insuficiência cardíaca

Abstract

Introduction: Heart Failure (HF) is a serious and self-limiting condition. It believes that its signs and symptoms are predictors of poorer health-related quality of life (HRQOL), mainly influenced by depletion of physical capability. Objective: To analyze the epidemiological profile of patients with HF and the influence of clinical and socioeconomic variables on cardiopulmonary fitness and HRQOL in four different moments of clinical follow - up. Materials and methods: This is a longitudinal, quantitative, descriptive and analytical study, composed of semiannual evaluations for one and a half year (T0, T1, T2 and T3). Participants were followed through face-to-face visits (T0 and T2) and telephone monitoring (T1 and T3), at each contact the following assessment instruments were applied: Clinical and Socioeconomic Characterization Questionnaire; Minnesota Living With Heart Failure Questionnaire (MLHFQ) and Veterans Specific Activity Questionnaire (VSAQ). Statistical analysis was performed using the Statistical Package for Social Science (SPSS), version 20.0, where frequency and descriptive analyzes were performed, with normality tests, central tendency measures, confidence interval, comparisons by the test Student's t test or the Wilcoxon-Mann Whitney test and Spearman correlations. Adopting 5% significance for all analyzes. The project was submitted and approved by the Ethics Committee, Report No. 1,864,889. Results: In T0 the sample consisted of 108 participants, in T1 total of 75 individuals, 72 in T2 and in the last contact T3 had a sample of 68 participants, mostly elderly (66.62 ± 11.33 years) and of females (50.90%). The chagasic etiology was prevalent (57.40%) and functional class III (48.10%), with frequent comorbidity in the sample (84.30%). The aerobic capacity scores showed high cardiopulmonary deterioration and high cardiopathy severity, reaching METs = 3 throughout the time of clinical follow - up. The MLHFQ showed a negative impact of the disease in all domains, with significant worsening over the time of clinical follow-up. In the Spearman correlation model, the physical domain of the MLHFQ established a significant relationship (p <0.05) with the clinical variables: diagnosis time (r = -0.21) and NYHA functional class (r = 0.29). The VSAQ established significant relationships (p <0.05) with clinical variables: NYHA functional class (r = -0.20), right bundle branch block (r = -0.26), and atrioventricular block (r = -0. 20), use of Antithrombotics (r = 0.20) and Anxiolytics (r = -0.21). Conclusion: The individuals in this study portray a severe cardiomyopathy of great functional impact and a predictor for the deterioration of HRQoL over time. The results support the need for the development of new studies, with proposals for new therapeutics and interventions able to hold back the cardiac remodeling process and improving the cardiopulmonary fitness and quality of life scores.