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FACTORS RELATED TO THE DISCONTINUATION AND MORTALITY RATES OF A CARDIAC REHABILITATION PROGRAM IN PATIENTS WITH CHAGAS DISEASE A 6‐YEAR EXPERIENCE IN A BRAZILIAN TERTIARY CENTER
Chagas cardiomyopathy
Cardiac rehabilitation
Exercise
Heart failure
Survival analysis
Author
Vieira, Marcelo Carvalho
Mendes, Fernanda de Souza Nogueira Sardinha
Mazzoli-Rocha, Flavia
Silva, Rudson Silva
Viana, Aline Maria Nunes
Frota, Aline Xavier
Silva, Gilberto Marcelo Sperandio da
Silva, Paula Simplicio da
Hasslocher-Moreno, Alejandro Marcel
Saraiva, Roberto Magalhaes
Mediano, Mauro Felippe Felix
Mendes, Fernanda de Souza Nogueira Sardinha
Mazzoli-Rocha, Flavia
Silva, Rudson Silva
Viana, Aline Maria Nunes
Frota, Aline Xavier
Silva, Gilberto Marcelo Sperandio da
Silva, Paula Simplicio da
Hasslocher-Moreno, Alejandro Marcel
Saraiva, Roberto Magalhaes
Mediano, Mauro Felippe Felix
Affilliation
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Aloysio de Castro State Institute of Cardiology. Center for Cardiology and Exercise. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / National Institute of Cardiology. Department of Research and Education. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / National Institute of Cardiology. Department of Research and Education. Rio de Janeiro, RJ, Brazil.
Abstract
objectives To describe the clinical and sociodemographic characteristics of participants as well as
discontinuation and mortality rates in a cardiac rehabilitation programme (CRP) tailored to Chagas
disease (CD).
methods Participants underwent functional capacity, anthropometry and cardiac function
evaluations before beginning a CRP. Univariate and multivariate Cox proportional hazards models
were performed to investigate the associations between clinical and sociodemographic characteristics
at baseline with discontinuation rates and deaths.
results Forty-two patients were enrolled in the CRP (61.9% men, mean age of 58.1 11.8 years).
During a median follow-up period of 10.8 months, 74% discontinued and 14% died while enrolled
in CRP. 34% of the patients who discontinued CRP died during follow-up. White race (HR = 0.09;
95% CI 0.01–1.00), right ventricular systolic dysfunction (HR = 10.54; 95% CI 1.24–89.50) and
oxygen pulse (HR = 0.69; 95% CI 0.48–0.99) were independently associated with death while
enrolled in CRP. Married status (HR = 0.44; 95% CI 0.21–0.95) was independently associated with
discontinuation rates from CRP. VO2 peak (HR = 0.85; 95% CI 0.74–0.98) and CRP
discontinuation due to CD-related reasons (HR = 8.33; 95% CI 1.91–36.27) were the variables
independently associated with death after discontinuation of CRP.
conclusion In this population, sociodemographic aspects and severity of CD were important
determinants of CRP discontinuation and mortality.
Keywords
Chagas diseaseChagas cardiomyopathy
Cardiac rehabilitation
Exercise
Heart failure
Survival analysis
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