Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ceilândia, Programa de Pós-graduação em Ciências e Tecnologias em Saúde, 2016. / Submitted by Camila Duarte (camiladias@bce.unb.br) on 2016-10-13T18:40:42Z
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2016_FranciscoValdezSantosdeOliveiraLima.pdf: 3135756 bytes, checksum: ac67e6c48c64695ddbf0b1d557a8f4fe (MD5) / Introdução: O Exercício Resistido (ER) melhora o Consumo de Oxigênio (VO2pico) de forma semelhante ao Exercício Aeróbico (EA). Por outro lado, os efeitos no Remodelamento Cardíaco (RC) não têm sido adequadamente avaliados. Objetivo: Comparar os efeitos do exercício no VO2pico, Fração de Ejeção de Ventrículo Esquerdo (FEVE) e Volume Diastólico Final de Ventrículo Esquerdo (VDFVE) em pacientes com Insuficiência Cardíaca (IC). Fonte de dados e Seleção de Estudos: MEDLINE, EMBASE, Cochrane Library e CINAHL, AMEDEO e base de dados PEDro foram pesquisadas de 1990 à Março de 2016. Extração de dados: Dois revisores extraíram de forma independente as características e dados dos desfechos e tipos de exercício. Principais desfechos: VO2pico (ml kg-1 min-1), LVEF (%) e LVEDV (mL). Resultados: Dos 4919 artigos adquiridos, 59 estudos (n=5046 pacientes) foram incluídos. O ER (5 estudos) resultou em maior incremente do VO2pico (3.57 ml kg-1 min-1; 95% Intervalo de Confiança [IC], 2.45 a 4.68; P<0,00001, I2, 0%). Da mesma forma, tanto o EA (2.63 ml kg-1 min-1; 95% IC, 1,96 a 3.29; P<0,0001, I2, 58%) quanto o Exercício Combinado (EC) (2.48 ml kg-1 min-1; IC, 0.88 a 4.09; P<0,002, I2, 69%) foram também associados com aumento do VO2pico comparado com participantes do grupo controle. As comparações de Exercício Combinado (EC) e ER isolado com EA mostraram efeitos similares (P = 0.84; I2, 0%). O EA foi associado com maior ganho na FEVE (P<0.008; I2, 79.4%), com um aumento de (3.15 %; IC, 1.87 a 4.44; I2, 17%), enquanto o ER isolado ou EC foram similares comparados com participantes do grupo controle. De forma interessante, os efeitos do EC foram similares com os efeitos do EA na FEVE. A análise de subgrupo para VDFVE mostrou que o EA reduz significativamente o VDFVE (-10.21; 95% IC, -17.64 a -2.77; P<0,007, I2, 0%), no entanto o EC ou ER não mostraram efeitos quando comparados aos participantes do grupo controle. Conclusões e relevância: O ER resulta em maior ganho de pico de VO2, sem causar efeitos deletérios na função cardíaca em pacientes com IC. / Introduction: Recent literature suggests that resistance training (RT) improves peak oxygen uptake (O2 peak), similarly to aerobic exercise (AE), but its effect on cardiac remodeling is controversial. Thus, we examined the effects of RT and AE on O2 peak and cardiac remodeling in patients with heart failure (HF) via a systematic review and meta-analysis. Objective: To compare the effect of exercise training on VO2 peak, left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) in heart failure patients. Data sources and study selection MEDLINE, EMBASE, Cochrane Library and CINAHL, AMEDEO and PEDro databases were searched from January 1990 and March 2016. Data extraction and synthesis: Two reviewers independently extracted study characteristics and exercise type and vascular outcome data. Main outcomes and measures: VO2 peak (mlkg-1min-1), LVEF (%) and LVEDV (mL). Results: From 4919 articles retrieved, 59 RCTs (n=5046 patients) were included. RT (5 studies) produced a greater increase in O2 peak (3.57 mlkg-1min-1 ,95% confidence interval [CI] 2.45 to 4.68; P<0.00001, I2 = 0%) compared to AE (28 studies) (2.63 mlkg-1min-1 (95% CI, 1.96 to 3.29; P<0,0001, I2 = 58%) while combined RT and AE (13 studies) produced a 2.48 mlkg-1min-1 increase (95% CI, 0.88 to 4.09; I2 = 69%) in O2 compared to control group. Comparison among the three forms of exercise reveal similar effects on O2 peak (P = 0.84 and 1.00 respectively; I2 = 0%). In regard to cardiac remodeling, AE (16 studies) was associated with a greater gain in LVEF (3.15 %. CI, 1.87 to 4.44; P<0.00001, I2=17%) compared to RT alone or combined RT and AE which produced similar gains compared to control groups (provide these gains as above for AE). Subgroup analysis revealed that AE reduces LVEDV (-10.21 ml. CI, -17.64 to -2.77; P=???, I2= 0%), while RT and combined RT and AE had no effect on LVEDV compared with control participants.. Conclusions and relevance: RT results in a higher gain in O2 peak, and induces no deleterious effects on cardiac function in heart failure patients. / Introduction: Recent literature suggests that resistance training (RT) improves peak oxygen uptake (O2 peak), similarly to aerobic exercise (AE), but its effect on cardiac remodeling is controversial. Thus, we examined the effects of RT and AE on O2 peak and cardiac remodeling in patients with heart failure (HF) via a systematic review and meta-analysis. Objective: To compare the effect of exercise training on VO2 peak, left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) in heart failure patients. Data sources and study selection MEDLINE, EMBASE, Cochrane Library and CINAHL, AMEDEO and PEDro databases were searched from January 1990 and March 2016. Data extraction and synthesis: Two reviewers independently extracted study characteristics and exercise type and vascular outcome data. Main outcomes and measures: VO2 peak (ml kg-1 min-1), LVEF (%) and LVEDV (mL). Results: From 4919 articles retrieved, 59 RCTs (n=5046 patients) were included. RT (5 studies) produced a greater increase in O2 peak (3.57 ml•kg-1 min-1 ,95% confidence interval [CI] 2.45 to 4.68; P<0.00001, I2 = 0%) compared to AE (28 studies) (2.63 ml kg-1•min-1 (95% CI, 1.96 to 3.29; P<0,0001, I2 = 58%) while combined RT and AE (13 studies) produced a 2.48 ml•kg-1•min-1 increase (95% CI, 0.88 to 4.09; I2 = 69%) in O2 compared to control group. Comparison among the three forms of exercise reveal similar effects on O2 peak (P = 0.84 and 1.00 respectively; I2 = 0%). In regard to cardiac remodeling, AE (16 studies) was associated with a greater gain in LVEF (3.15 %. CI, 1.87 to 4.44; P<0.00001, I2=17%) compared to RT alone or combined RT and AE which produced similar gains compared to control groups (provide these gains as above for AE). Subgroup analysis revealed that AE reduces LVEDV (-10.21 ml. CI, -17.64 to -2.77; P=???, I2= 0%), while RT and combined RT and AE had no effect on LVEDV compared with control participants.. Conclusions and relevance: RT results in a higher gain in O2 peak, and induces no deleterious effects on cardiac function in heart failure patients
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unb.br:10482/22234 |
| Date | 05 August 2016 |
| Creators | Lima, Francisco Valdez Santos de Oliveira |
| Contributors | Cipriano Júnior, Gérson |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UnB, instname:Universidade de Brasília, instacron:UNB |
| Rights | A concessão da licença deste item refere-se ao termo de autorização impresso assinado pelo autor com as seguintes condições: Na qualidade de titular dos direitos de autor da publicação, autorizo a Universidade de Brasília e o IBICT a disponibilizar por meio dos sites www.bce.unb.br, www.ibict.br, http://hercules.vtls.com/cgi-bin/ndltd/chameleon?lng=pt&skin=ndltd sem ressarcimento dos direitos autorais, de acordo com a Lei nº 9610/98, o texto integral da obra disponibilizada, conforme permissões assinaladas, para fins de leitura, impressão e/ou download, a título de divulgação da produção científica brasileira, a partir desta data., info:eu-repo/semantics/openAccess |
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