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THE PROGNOSTIC VALUE OF THE INCREMENTAL SHUTTLE WALK TEST IN CHAGAS CARDIOMYOPATHY
Author
Ávila, Matheus Ribeiro
Figueiredo, Pedro Henrique Scheidt
Lima, Vanessa Pereira
Oliveira, Luciano Fonseca Lemos de
Oliveira, Lucas Frois Fernandes de
Silva, Whesley Tanor
Trede Filho, Renato Guilherme
Bastone, Alessandra de Carvalho
Lacerda, Ana Cristina Rodrigues
Mendonça, Vanessa Amaral
Mediano, Mauro Felippe Felix
Costa, Henrique Silveira
Figueiredo, Pedro Henrique Scheidt
Lima, Vanessa Pereira
Oliveira, Luciano Fonseca Lemos de
Oliveira, Lucas Frois Fernandes de
Silva, Whesley Tanor
Trede Filho, Renato Guilherme
Bastone, Alessandra de Carvalho
Lacerda, Ana Cristina Rodrigues
Mendonça, Vanessa Amaral
Mediano, Mauro Felippe Felix
Costa, Henrique Silveira
Affilliation
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal de Minas Gerais. School of Physical Education, Physiotherapy and Occupational Therapy. Department of Physiotherapy. Belo Horizonte, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal de Minas Gerais. School of Physical Education, Physiotherapy and Occupational Therapy. Department of Physiotherapy. Belo Horizonte, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri. Physical Therapy School, Healthy and Biological Sciences Faculty. Diamantina, MG, Brazil / Universidade Federal dos Vales do Jequitinhonha e Mucuri. Postgraduate Course of Reabilitação e Desempenho Funcional. Diamantina, MG, Brazil.
Abstract
Purpose: To verify the value of the Incremental Shuttle Walk Test (ISWT) distance to identify patients
with Chagas cardiomyopathy (ChC) at risk of adverse cardiovascular events.
Methods: Fifty-two patients with ChC (51 ± 6 years) were evaluated by ISWT, echocardiography,
Cardiopulmonary Exercise Testing, and Human Activity Profile (HAP) Questionnaire. Patients were prospectively followed for 44 ± 10 months. The combined endpoint was cardiac death/heart transplant/stroke.
The prognostic value of ISWT was verified by the Cox regression, and the ISWT was adjusted for age, sex,
left ventricular ejection fraction (LVEF), and minute ventilation/carbon dioxide production relationship
(VE/VCO2 slope).
Results: At the final follow-up, 11 patients (21%) had experienced the endpoint event. When adjusted for
age, sex, LVEF, and VE/VCO2 slope, only ISWT distance (HR 0.99, 95% confidence interval (CI): 0.98–0.99;
p ¼ 0.026) and VE/VCO2 slope (HR 0.93, 95% CI: 0.87–0.99; p ¼ 0.044) remained as independent predictors
of adverse cardiovascular events in patients with ChC. The optimal cutoff point for identifying poor prognosis was the ISWT distance less than 440 m (AUC ¼ 0.72). There was a significant difference (p ¼ 0.032)
in the number of events between the groups with low ISWT distance (440 m) and high (>440 m)
ISWT distance.
Conclusions: The ISWT is a valuable tool with potential value in the prognostic evaluation of patients
with ChC.
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