Follow-up of cardiorrespiratory changes and its impact on capacity of physical exercise in patients with heart failure and COPD overlap

Abstract

Cardiopulmonary diseases are the leading causes of death in Brazil, accounting for an average of 20% of deaths in the age group above 30 years of age. Chronic Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD) share similar signs and symptoms, and they often coexist, leading to poorer prognosis as well as a greater challenge in diagnosis and therapeutic processes. One of the most relevant symptoms in patients with CHF and COPD overlap is impairment of ability or even intolerance to exercise. The behavior of cardiorespiratory and metabolic variables derived from ECPD in patients with CHF and in patients with COPD are already well established in the literature, however, it is not yet known enough of these variables in patients who have had an overlap syndrome. Hypothesis: We hypothesized that the coexistence of CHF in COPD results in worse prognosis for these patients, impacting both their health condition and functional capacity, negatively affecting quality of life. We also believe that the worst prognosis will lead to greater use of health services and hospitalizations, which may increase mortality and morbidity rates. It is also expected that the functional decline of these patients within a year will be greater than in patients with COPD or isolated CHF. Objectives: To evaluate the impact of COPD coexistence on patients with CHF and vice versa, on maximal exercise capacity, tolerance to exercise, quality of life and health conditions of these individuals, as well as to verify the functional decline in 1 year follow-up. Study design: This is a prospective, observational, one-year follow-up study. Subjects and methods: individuals previously diagnosed with CHF, COPD or the coexistence of these two diseases in a stable state, which, after diagnostic confirmation, will undergo a clinical evaluation. To assess quality of life, disease status and comorbidities, these patients will be asked to complete validated questionnaires for the CHF and COPD population. For investigation of ventilatory and cardiocirculatory changes, these will undergo a test of maximum cardiopulmonary exercise or limited symptom. They will then be followed up for 1 year, and at the end of this period, they will be submitted to the same experimental procedures. Relevance of the study: The intention of this study is to raise the attention to a population of poorly diagnosed individuals that present a very fast functional decline, however, the mechanisms that cause these declines are still poorly understood. In addition, through this study we intend to understand how the coexistence of these diseases contributes to such functional decline. (AU)