Quality of life and cardiopulmonary variables in patients with pulmonary arterial hypertension in the city of Uruguaiana (RS)

Authors

DOI:

https://doi.org/10.33448/rsd-v9i10.8423

Keywords:

Hypertension pulmonary; Quality of life; 6-minute walk test; Respiratory muscle strength.

Abstract

Pulmonary Hypertension (HP) is defined as an increase in mean pulmonary artery pressure (PAPm) ≥ 25mmHg at rest, pulmonary vascular resistance (PVR) greater than 4 Wood Units, or when the transpulmonary gradient is greater than 10-12 mm Hg. Causing dyspnea, fatigue, physical deconditioning and muscle weakness leading to worsening quality of life. Therefore, the aim of this study is evaluate quality of life and cardiopulmonary variables in patients with PH. Case series of patients evaluated at the Santa Casa de Caridade de Uruguaiana (RS) from April to June 2018. After the medical assessment, the Short Form 36 (SF-36) quality of life questionnaire was applied. Then, respiratory muscle strength (FMR) was conducted. After a 30-minute rest, patients underwent the 6-minute walk test (6MWT).Two patients were included in the study, mean age 39.5 ± 2.12 years, functional class I according to NYHA modified for PH, which presented values within normal standards in physical and emotional aspects according to the SF-36 questionnaire and in relation to the cardiopulmonary variables (represented by FMR and the 6MWT). Thus, the domains physical and emotional aspects and the cardiopulmonary variables were within the normal values, since the cases of these patients were in the initial stage of the disease.

Author Biography

Maurício Tatsch Ximenes Carvalho, Centro Universitário da Região da Campanha

Fisioterapeuta pela Universidade Federal de Santa Maria (UFSM) e Mestre em Reabilitação Funcional (UFSM). Docente no curso de Fisioterapia do Centro Universitário da Região da Campanha (Campus Bagé). Foi professor temporário na Universidade Federal do Pampa (Campus Uruguaiana). Tem experiência na área de fisioterapia e em docência no ensino superior, atuando principalmente nos seguintes temas: mobilização precoce do paciente em ventilação mecânica, avaliação muscular através da ultrassonografia e recursos eletrotermofototerapêuticos.

References

American Toracic Society (2002). ATS statement: guidelines for six minute walk test. American Journal of Respiratory and Critical Care Medicine., 166 (111), 117.

Azeredo, C. (1993). Fisioterapia respiratória moderna in: Métodos de avaliação em fisioterapia respiratória (3ª ed). São Paulo: Manole.

Cenedese, E., Speich, R., Dorschner, L., Ulrich, S., Maggiorini, M., Jenni, R. et al (2006). Measurement of quality of life in pulmonary hypertension and its significance. European Respiratory Journal., 28 (4), 808-815.

Channick, R.N., Sitbon, O., Barst, R.J., Manes, A.M.D., & Rubin, L.J. (2004). Endothelin receptorantagonists in pulmonary arterial hypertension. Journal of the American College of Cardiology, 43 (12), 62–67.

Chinello, P., Cicalini, S., Cortese, A., Cicini, M.P., & Petrosillo, N. (2011). Bosentan and sildenafil in the treatment of HIV-associated pulmonary hypertension. Infectious Disease Reports., 3 (2), 14.

Chin, K.M., & Rubin, L.J. (2008). Pulmonary arterial hypertension. Journal of the American College of Cardiology, 51 (16),1527-1538.

Condliffe, R. (2011). Living with pulmonary hypertension: quality not just quantity. European Respiratory Journal, 38, 512–513.

Dodson, M.W., Lynette, M.B., Elliot, C.G. (2018). Pulmonary Arterial Hypertension. Heart Failure Clinics, 14 (3), 255-269.

Fischer, M.R., Forfia, P.R., Chamera, E., Housten-Harris, T., Champion, H.C., Girgis, R.E. et al (2009). Accuracy of doppler echocardiography in the hemodynamic assessment of pulmonary hypertension. American Journal of Respiratory and Critical Care Medicine, 179 (7), 615-621.

Forgiarini-Junior, L.A., Rubleski, A., Garcia, D., Tieppo, J., Vercelino, R., Bosco, A.D. et al (2007). Evaluation of respiratory muscle strength and pulmonary function in heartfailure patients. Arquivos Brasileiros de Cardiologia, 89 (1), 36-41.

Franchi, S.M., Barreto, A.C., Cícero, C., Castro, C.R.P., Ribeiro, Z.V.S., & Lopes, A.A. (2010). Seguimento de dois anos em pacientes com hipertensão arterial pulmonar sobtratamento com sildenafila. Arquivos Brasileiros de Cardiologia, 21 (?), 1-7.

Galie, N., Hinderliter, A.L., Torbicki, A., Fourme, T., Simonneau, G., Pulido, T. et al (2003). Effects of the oral endothelin-receptor antagonist bosentan on echocardiographic and doppler measures in patients with pulmonary arterial hypertension. Journal of the American College of Cardiology, 41 (8), 1380-1386.

Galie, N., Hoeper, M.M., Humbert-Torbicki, M.A., Vachiery, J.L., Barbera, J.A., Behetti, M., Corris, P.et al (2009). Guidelines for the diagnosis and treatment of pulmonary hypertension. European Respiratory Journal, 34 (6), 1219-1263.

Ganderton, L., Jenkins, S., Gain, K., Fowler, R., Winship, P., Lunt, D. et al (2011). Short term effects of exercise training on exercise capacity and quality of life in patients with pulmonary arterial hypertension: protocol for a randomised controlled trial. BMC Pulmonary Medicine,11 (25),1-7.

Gazzana, M.B. (2015). Investigação da hiperinsuflação pulmonar dinâmica durante o exercício e sua relação com a força dos músculos inspiratórios em pacientes com hipertensão arterial pulmonar. Dissertação de doutorado, Programa de Pós graduação em Ciências Pneumologias, Universidade Federal do Rio Grande do Sul. Porto Alegre, Brasil.

Genta, P.R., Jatene, F.B., & Terra-Filho, M. (2005). Qualidade de vida antes e após tromboendarterectomia pulmonar: resultados preliminares. Jornal Brasileiro de Pneumologia, 31(1), 48-51.

Ghofrani, H.A., Wiedemann, R., Rose, F., Olschewski, H., Schermuly, R.T., Weissmann, N. et al (2002). Combination therapy with oral sildenafil and inhaled iloprost for severe pulmonary hypertension. Annals of Internal Medicine, 136 (7), 515–522.

Gomberg-Maitland, M., Thenappan, T., Rizvi, K., Chandra, S., Meads, D.M., & McKenna, S.P. (2008). United States validation of the Cambridge pulmonary hypertension outcome review (CAMPHOR). The Journal of Heart and Lung Transplantation, 27(1), 124-130.

Hoeper, M.H., Humbert, M., Souza, R., Idrees, M., Kawut, S.M., Sliwa-Hahnle, K. et al (2016). A global view of pulmonary hypertension. The Lancet Respiratory Medicine, 4 (4), 306-22.

Junior, L.A.F., Rubleski, A., Garcia, D., Tieppo, J., Vercelino, R., Bosco, A.D. et al (2007). Avaliação da força muscular respiratória e da função pulmonar em pacientes com insuficiência cardíaca. Arquivos Brasileiros de Cardiologia, 89 (1), 36-41.

Kim, D., & George, M.P. (2019). Pulmonary Hypertension. Medical Clinics of North America, 103 (3), 413-423.

Kwapiszewska, G., Hoffmann, J., Kovacs, G., Stacher, E., Olschewski, A., & Olschewski, H. (2016). [Pulmonary (Arterial) Hypertension]. Pneumologie, 70 (10), 630-637.

Lapa, M.S., Ferreira, E.V.M., Jardim, C., Martins, B.C.S., Arakaki, J.S.O., & Souza, R. (2006). Características clínicas dos pacientes com hipertensão pulmonar em dois centros de referência em São Paulo. Revista da Associação Médica Brasileira, 52 (3), 139-143.

Levine, D.J. (2006). Diagnosis and management of pulmonary arterial hypertension: implication for respiratory care. Respiratory Care, 51 (4), 368-381.

Malachias, M.V.B., Souza, W.K.S.B., Plavnik, F.L., Rodrigues, C.I.S., Brandão, A.A., Neves, M.F.T. et al (2016). 7ª Diretriz brasileira de hipertensão arterial. Arquivos Brasileiros de Cardiologia, 107 (3), 1-103.

Macchia, A., Marchioli, R., Marfisi, R., Scarano, M., Levantesi, G., Tavazzi, L. et al (2007). A meta-analysis of trials of pulmonary hypertension: a clinical condition looking for drugs and research methodology. American Heart Journal,153 (6), 1037-1047.

Martins, B.C.S., & Souza, R. (2008). Avaliação da qualidade de vida na hipertensão arterial pulmonar. Dissertação de doutorado em Ciências, Programa dos Pós Graduação em Ciências, Faculdade de Medicina, Universidade de São Paulo. São Paulo, Brasil.

Mancini, D.M., Henson, D., La-Manca, J., Donchez, L., & Levine, S. (1995). Benefit of selective respiratory muscle training on exercise capacity in patients with chronic congestive heart failure. Circulation., 91 (2), 320–329.

Mathai, S.C., Girgis, R.E., Fisher, M.R., Champion, H.C., Housten-Harris, T., Zaiman, A. et al (2007). Addition of sildenafil to bosentan monotherapy in pulmonary arterial hypertension. European Respiratory Journal, 29, 469-475.

McKenna, S.P., Doughty, N., Meads, D.M., Doward, L.C., & Pepke-Zaba, J. (2006). The Cambridge pulmonary hypertension outcome review (CAMPHOR): a measure of health-related quality of life and quality of life for patients with pulmonary hypertension. Quality of Life Research,15 (1), 103-115.

McLaughlin, V.V., Archer, S.L., Badesch, D.B., Barst, R.J., Farber, H.W., Lindner, J.R. et al (2009). ACCF/AHA Expert consensus document on pulmonary hypertension: a report of the american college of cardiology foundation task force on expert consensus documents and the american heart association. Journal of the American College of Cardiology, 53 (17), 1573-1619.

Medeiros, E.K.; & Souza, G.R. (2010). Saturação em hemoglobina pelo oxigênio através da oximetria de pulso: comparação entre prong nasal e cânula nasal locada em nasofaringe e fossa nasal. Revista de Atenção à Saúde, 1 (1),201-208.

Mereles, D., Ehlken, N., Kreuscher, S., Ghofrani, S., Hoeper, M.M., Halank, M. et al (2006). Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation., 114 (14),1482-1489.

Meyer, F.J., Borst, M.M., Zugck, C., Kirschke, A., Schellberg, D., Kubler, W. et al (2001). Respiratory muscle dysfunction in congestive heart failure: clinical correlation and prognostic significance. Circulation.,103 (17), 2153–2158.

Minai, O.A., & Budev, M.M. (2008). Diagnostic strategies for suspected pulmonary arterial hypertension: a primer for the internist. Cleveland Clinic Journal of Medicine, 74 (10), 737-747.

Miyamoto, S., Nagaya, N., Satoh, T., Kyotani, S., Sakamaki, F., Fujita, M. et al (2000). Clinical correlates and prognostic significance of 6-minute walk test in patients with pulmonary hypertension. Comparison with cardiopulmonary exercise testing. American Journal of Respiratory and Critical Care Medicine, 161 (2), 487-492.

Nagendran, J., Archer, S.L., Soliman, D., Gurtu, V., Moudgil, R., Haromy, A. et al (2007). Phosphodiesterase type 5 is highly expressed in the hypertrophied human right ventricle, and acute inhibition of phosphodiesterase type 5 improves contractility. Circulation., 116 (3), 238-248.

Olson, T.P., Joyner, M.J, Dietz, N.M., Eisenach, J.H., Curry, T.B., & Johnson, B.D. (2010). Effects of respiratory muscle work on blood flow distribution during exercise in heart failure. The Journal of physiology, 588 (13),2487-2501.

Paciocco, G., Martinez, F.J., Bossone, E., Pielsticker, E., Gillespie, B., & Rubenfire, M. (2001). Oxygen desaturation on the six-minute walk test and mortality in untreated primary pulmonary hypertension. European Respiratory Journal, 17 (4), 647–652.

Polito, M.D., & Farinatti, P.T.V. (2003). Considerações sobre a medida da pressão arterial em exercícios contra-resistência. Revista Brasileira de Medicina do Esporte, 9 (1), 1-9.

Rich, S., Rubin, L., Walker, A.M., Schneeweiss, S., & Abenhaim, L. (2000). Anorexigens and pulmonary hypertension in the United States: results from the surveillance of North American pulmonary hypertension. Chest, 117 (3), 870-874.

Rochester, D.F., & Braun, N.M. (1985). Determinants of maximal inspiratory pressures in chronic obstructive pulmonary disease. American review of respiratory disease, 132 (1), 42–47.

Rubin, L.J., Badesch, D.B., Barst, R.J., Galie, N., Black, C.M., Keogh, A. et al (2002). Bosentantherapy for pulmonary arterial hypertension. New England Journal of Medicine, 346 (16), 896–903.

Sastry, B.K.S., Narasimhan, C., Reddy, K., & Raju, S. (2004). Clinical efficacy of sildenafil in primary pulmonary hypertension. Journal of the American College of Cardiology, 43, 1149-1153.

Simonneau, G., Robbins, I.M., Beghetti, M., Channick, R.N., Delcroix, M., Denton, C.P. et al (2009). Updated clinical classification of pulmonary hypertension. Journal of the American College of Cardiology, 63(7), 43-54.

Sitbon, O., Badesch, D.B., Channick, R.N., Frost, A., Robbins, I.M., Simonneau, G. et al (2003). Pulmonary arterial hypertension antagonist bosentan in patients with effects of the dual endothelin receptor. Chest.,124 (1), 247-254.

Soares, M.R., & Pereira, C.A.D.C (2011). Teste de caminhada de seis minutos: valores de referência para adultos saudáveis no Brasil. Jornal brasileiro de pneumologia, 37 (5), 576-583.

Souza, R.B. (2002). Pressões respiratórias estáticas máximas. Jornal Brasileiro de Pneumologia, 28 (3), 155-165.

Ware, J.E.J, & Sherbourne, C.D. (1992). The MOS 36-item short-form health survey (SF-36): conceptual framework and item selection. Medical Care, 30 (6), 473-483.

Published

20/09/2020

How to Cite

SERRÃO JÚNIOR, N. F. .; CABREIRA, B. R. .; MENEZES, J. D. .; FERREIRA, P. E. B. .; CASTRO, A. A. M. de .; CARVALHO, M. T. X. . Quality of life and cardiopulmonary variables in patients with pulmonary arterial hypertension in the city of Uruguaiana (RS). Research, Society and Development, [S. l.], v. 9, n. 10, p. e1369108423, 2020. DOI: 10.33448/rsd-v9i10.8423. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/8423. Acesso em: 8 aug. 2022.

Issue

Section

Health Sciences