Effects of a combined exercise program on cardiac function and biochemical and genetic cardiovascular markers in patients with heart failure.

Abstract

Introduction: The World Health Organization (WHO) has defined heart failure (HF) as one of the priorities among the chronic diseases that require special strategy of primary prevention and treatment worldwide. Currently, the HF is defined as a pathophysiological state where the heart is unable to ensure adequate cardiac output to tissue demands, or to do so by the high filling pressures of the heart chambers. The current armamentarium of IC consists of a triad composed of several classes of drugs, use of implantable devices (pacemakers, implantable cardioverter) and nutritional education. However, the basic treatment of the disease, still falls short when it comes to improvement in exercise tolerance. And in that sense, is increasingly recognized the impact of physical exercise (PE) on survival, quality of life (QL), functional capacity (FC), inflammation, autonomic function in reverse cardiac remodeling and endothelial function . According to the literature data and the clinical relevance of the question, the hypothesis to be tested in this project is that a PE combined program (aerobic PE complemented by PE force - CPE) is able of promoting improvement in cardiac function overall, the profile of biochemical and genetic markers and that these effects are associated with the decrease in symptoms, increased FC and QL of these patients. Objectives: To evaluate the effect of an CPE program on the morphological and functional echocardiographic variables; Analyze the plasma concentrations of circulating miRNAs; Check plasma concentrations of BNP; Analyze the plasma concentrations of nitrite / nitrate; Secondary: To evaluate the inflammatory response; Assess the FC and QL of patients. Methodology: It will be held longitudinal clinical trial, randomized controlled trial, composed of patients with HF. The calculation of sample size was set at 120 volunteers divided into two groups: control group (CG n = 60): composed of volunteers who receive only medical recommendation of routine physical activities; Intervention group (IG n = 60): IG volunteers held for a period of 16 weeks and frequency of three times a week, a CPE program, consisting of aerobic exercise of continuous walking type, plus strength PE. Volunteers (both the CG and IG) will be initially submitted and after 16 weeks of research, the following: clinical and physical assessment, the completion of QL questionnaire - SF36, transthoracic echocardiography, Holter and blood collection for analysis of miRNAs, BNP and nitrite / nitrate. Expected results: It is expected to find improvement in overall cardiac function assessed by echocardiography parameters, molecular biological and biochemical of IG patients, and that these parameters after the CPE program have correlation with the improvement in quality of life and functional capacity of patients with HF. (AU)