Avaliação de fragilidade em insuficiência cardíaca com fração de ejeção reduzida de etiologia chagásica
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2019-12-06
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Universidade Federal de Goiás
Resumo
BACKGROUND: Frailty is a syndrome characterized by weakness, fatigue and increased
vulnerability to physical stressors. Assessing and understanding frailty in patients with heart
failure (HF) is essential, as it brings new perspectives to the management and treatment of
patients. The frailty phenotype is the most accepted measurement instrument because it can
differentiate frailty from disability and comorbidity. There are no frailty studies in patients
with heart failure due to Chagas disease. OBJECTIVES: To evaluate frailty and its prevalence
in patients with heart failure with reduced EF and Chagas disease who attend heart failure
ambulatory in a tertiary hospital. METHODS: Evaluation of adult patients with heart failure
with EF <40% and chagas disease according to frailty phenotype criteria: weakness,
slowness, exhaustion, low physical activity and unintentional weight loss. RESULTS: The
sample consisted of 45 patients, with mean age of 61.6 years, male predominantly (71.1%)
and in New york Heart Association class II (93.3%), clinically optimized, with 88.9% in use of
beta-blockers, 88.9% using spironolactone and 77.8% using Angiotensin Converting Enzyme
Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin
Inhibitors (ARNI). Non-frail individuals used more ACEI / ARB / ARNI (p = 0.03) and frail
individuals used more loop diuretics (p = 0.04). There was a prevalence of 20% of frailty and
60% of pre-frailty in the study population. The number of positive criteria for frailty increased
with advanced age (p = 0.006) and the presence of comorbidities (p = 0.03). CONCLUSION:
In a population of Chagas disease and heart failure, frailty and pre-frailty are frequent,
together accounting for 80% of the studied population. Understanding this process favors
actions that aim to avoid limitations, reduce disability and improve life quality of the patient.
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ARAÚJO, F. A. Avaliação de fragilidade em insuficiência cardíaca com fração de ejeção reduzida de etiologia chagásica. 2019. 66 f. Dissertação (Mestrado Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2019.