Benefits of Physical exercise in pulmonary arterial hypertension associated with uncorrected congenital heart disease
DOI:
https://doi.org/10.15448/1980-6108.2021.1.38061Keywords:
exercise, heart defects, congenital, pulmonary hypertension, cardiac rehabilitation, physiotherapyAbstract
Introduction: congenital heart disease is classified as one of the main groups to develop pulmonary arterial hypertension. The exercise program can help to improve daily living, capacity, clinical and functional improvement, minimizing the deleterious consequences of the disease.
Case report: we report a case of a 31-year-old male patient with a clinical diagnosis of severe pulmonary arterial hypertension due to the right ventricular double outflow tract with interventricular communication without surgical intervention. After being referred to the Cardiopulmonary and Metabolic Rehabilitation program at a cardiology reference center in Rio Grande do Sul, clinical evaluation was performed, as well as functional capacity by the 6-minute walk test, muscle strength and peripheral resistance by the sitting-rising test, and respiratory muscle strength by the manovacuometry exam. The values were below the predicted value. The proposed exercise program was performed during 30 sessions consisting of aerobic exercises lasting 33 minutes, added strength training of large muscle groups.
Conclusion: after the program there was an increase of 83 meters in the 6-minute walk test and an increase in respiratory muscle strength, as well as a reduction in Borg scale parameters.
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Brasil. Ministério da Saúde. Portaria n.º 1.727, de 11 de julho de 2017. Aprova o Plano Nacional de Assistência à Criança com Cardiopatia Congênita. Diário Oficial da República Federativa do Brasil [Online] 2017 maio [acesso 15 mar. 2020]. Disponível em: https://portalarquivos2.saude.gov.br/images/pdf/2017/julho/31/Portaria-1727.pdf
Barbero-Marcial M, Tanamati C, Jatene MB, Aiello VD, Baucia JA, Atik E, et al. Dupla via de saída do ventrículo direito com comunicação interventricular não relacionada: resultados da correção cirúrgica com técnica de múltiplos retalhos. Rev Bras Cir Cardiovasc. 1997;12(2):160-65. http://dx.doi.org/10.1590/S0102-76381997000200009
Hoeper MM, Bogaard HJ, Condliffe R, Frantz R, Khanna D, Kurzyna M, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol. 2013;62(25):D42-50. https://doi.org/10.1016/j.jacc.2013.10.032
Kabitz HJ, Bremer HC, Schwoerer A, Sonntag F, Walterspacher S, Walker DJ, et al. The Combination of Exercise and Respiratory Training Improves Respiratory Muscle Function in Pulmonary Hypertension. Lung. 2014;192(2):321-28. https://doi:10.1007/s00408-013-9542-9
Costa CH, Rufino R. Hipertensão arterial pulmonar associada às cardiopatias congênitas. Pulmão RJ. 2015;24(2):43-6.
Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998; 158(5 Pt 1):1384-7. http://doi:10.1164/ajrccm.158.5.9710086
Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 1999;32(6):719-27. http://doi.org/10.1590/S0100-879X1999000600007
Chia KSM, Faux SG, Wong PKK, Holloway C, Assareh H, McLachlan CS, et al. Randomised controlled trial examining the effect of an outpatient exercise training programme on haemodynamics and cardiac MR parameters of right ventricular function in patients with pulmonary arterial hypertension: the ExPAH study protocol. BMJ Open. 2017;7(2):e014037. https://doi:10.1136/bmjopen-2016-014037
Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. ESC Scientific Document Group. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016;37(1):67-119. https://doi:10.1093/eurheartj/ehv317
Richter MJ, Grimminger J, Krüger B, Ghofrani HA, Mooren FC, Gall H, et al. Effects of exercise training on pulmonary hemodynamics, functional capacity and inflammation in pulmonary hypertension. Pulm Circ. 2017;7(1): 20-37. https://doi:10.1086/690553
Saglam M, Vardar-Yagli N, Calik-Kutukcu E, Arikan H, Savci S, Inal-Ince D, et al. Functional exercise capacity, physical activity, and respiratory and peripheral muscle strength in pulmonary hypertension according severity. J Phys Ther Sci. 2015;27(5):1309-12. https://doi:10.1589/jpts.27.1309
Pandey A, Garg S, Khunger M, Garg S, Kumbhani DJ, Chin KM, et al. Efficacy and safety of exercise training in chronic pulmonar hyoertencion: systematic review and meta-analysis. Circ heart fail. 2015;8(6):1032-43. https://doi.org/10.1161/circheartfailure.115.002130
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