Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical p...Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.展开更多
Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This st...Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.展开更多
Hyperhidrosis is a condition resulting from a systemic sympathetic hyperactivity. The gold standard treatment is the resection or surgical ablation of the paravertebral sympathetic chain: the endoscopic thoracoscopic ...Hyperhidrosis is a condition resulting from a systemic sympathetic hyperactivity. The gold standard treatment is the resection or surgical ablation of the paravertebral sympathetic chain: the endoscopic thoracoscopic sympathectomy (ETS). Non-cardiac thoracic surgeries carry a considerable incidence of pathological postoperative cardiac events, raising attention to possible worsen cardiac functional capacity after the resection of a pair of thoracic sympathetic ganglia. The aim of this study is to investigate literature evidences of postoperative cardiovascular functional changes on patients submitted to ETS as treatment for hyperidrosis. This is a systematic review of the literature. Clinical studies published between January 1999 and April 2019 were analyzed. The PICO strategy was used to construct the question of systematic reviews research. The process of selecting articles was organized according to PRISMA Diagram. The search in electronic databases resulted in seven articles, of which one was excluded for being out of scope of the research, leaving six articles. All studies showed a pattern of heart rate (HR) reduction after endoscopic thoracic sympathectomy. It was suggested a relation between the extension of the procedure and the presence of cardiac functional alterations. There was an improvement in myocardial physical conditioning and maintenance of functional capacity. To elucidate the real mechanisms involved in the maintenance of myocardial function, and even its improvement, it is necessary to develop further studies that directly evaluate them.展开更多
Left ventricular contractility was measured using Doppler echocardiography in 37 pa-tients with rheumatic mitral valve disease.Myocardial pathological lesions were studied quanti-tatively by means of the image analysi...Left ventricular contractility was measured using Doppler echocardiography in 37 pa-tients with rheumatic mitral valve disease.Myocardial pathological lesions were studied quanti-tatively by means of the image analysis system and light microscopic examination.The resultsshowed that attenuated cardiac function is due to pathological change of the mitral valve andpathological lesions of the left ventrieular myocardium including increased interstitial fibrosis,thickened intramyocardial arterial wall leading to concentric narrowing of the lumen,hyper-trophic myocardial fiber and endocardial proliferation.Since mitral valve replacement can notcorrect the irreversible myocardial pathological lesions,perioperative protection of the my-ocardium should be emphasized,and intraoperative injury to the myocardium should be mini-mized as far as possible.展开更多
Fifty-six patients with chest pain underwent selective coronaryangiography,radionuclide ventriculography (RNV) and frequency domaincardiography (FCG) to evaluate left ventricular function in coronary artery dis-ease (...Fifty-six patients with chest pain underwent selective coronaryangiography,radionuclide ventriculography (RNV) and frequency domaincardiography (FCG) to evaluate left ventricular function in coronary artery dis-ease (CAD).The sensitivity,specificity and accuracy of FCG were 87.5%,77.8%and 82.9%,respectively,which were slightly less than those of RNV (92.5%,88.9% and 90.8%,respectively).The changes of FCG scores were negatively corre-lated with changes of LVEF (r=-0.586,P【0.01),and TS (r=-0.679,P【0.01).These results indicate that FCG may be useful for the evaluation of leftventricular function in patients with CAD.展开更多
文摘Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.
文摘Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.
文摘Hyperhidrosis is a condition resulting from a systemic sympathetic hyperactivity. The gold standard treatment is the resection or surgical ablation of the paravertebral sympathetic chain: the endoscopic thoracoscopic sympathectomy (ETS). Non-cardiac thoracic surgeries carry a considerable incidence of pathological postoperative cardiac events, raising attention to possible worsen cardiac functional capacity after the resection of a pair of thoracic sympathetic ganglia. The aim of this study is to investigate literature evidences of postoperative cardiovascular functional changes on patients submitted to ETS as treatment for hyperidrosis. This is a systematic review of the literature. Clinical studies published between January 1999 and April 2019 were analyzed. The PICO strategy was used to construct the question of systematic reviews research. The process of selecting articles was organized according to PRISMA Diagram. The search in electronic databases resulted in seven articles, of which one was excluded for being out of scope of the research, leaving six articles. All studies showed a pattern of heart rate (HR) reduction after endoscopic thoracic sympathectomy. It was suggested a relation between the extension of the procedure and the presence of cardiac functional alterations. There was an improvement in myocardial physical conditioning and maintenance of functional capacity. To elucidate the real mechanisms involved in the maintenance of myocardial function, and even its improvement, it is necessary to develop further studies that directly evaluate them.
基金Supported by the Youth Foundation of the General Logistics Department of PLA
文摘Left ventricular contractility was measured using Doppler echocardiography in 37 pa-tients with rheumatic mitral valve disease.Myocardial pathological lesions were studied quanti-tatively by means of the image analysis system and light microscopic examination.The resultsshowed that attenuated cardiac function is due to pathological change of the mitral valve andpathological lesions of the left ventrieular myocardium including increased interstitial fibrosis,thickened intramyocardial arterial wall leading to concentric narrowing of the lumen,hyper-trophic myocardial fiber and endocardial proliferation.Since mitral valve replacement can notcorrect the irreversible myocardial pathological lesions,perioperative protection of the my-ocardium should be emphasized,and intraoperative injury to the myocardium should be mini-mized as far as possible.
文摘Fifty-six patients with chest pain underwent selective coronaryangiography,radionuclide ventriculography (RNV) and frequency domaincardiography (FCG) to evaluate left ventricular function in coronary artery dis-ease (CAD).The sensitivity,specificity and accuracy of FCG were 87.5%,77.8%and 82.9%,respectively,which were slightly less than those of RNV (92.5%,88.9% and 90.8%,respectively).The changes of FCG scores were negatively corre-lated with changes of LVEF (r=-0.586,P【0.01),and TS (r=-0.679,P【0.01).These results indicate that FCG may be useful for the evaluation of leftventricular function in patients with CAD.
