Aptidão cardiorrespiratória, adesão ao baixo consumo de sódio e qualidade de vida de pacientes com insuficiência cardíaca

Abstract

Heart Failure (HF) negatively impacts health-related quality of life (HRQoL) and may be related to constructs such as sodium consumption and cardiorespiratory fitness (ACR). This study aimed to evaluate the impact of ACR and adherence to low sodium consumption on the specific HRQOL of patients with HF, as well as to characterize the clinical, electrocardiographic, echocardiographic and socioeconomic profile of the patients. Longitudinal, quantitative and analytical survey. Patients were evaluated semiannually at three different times in the outpatient setting (T0, T2) and by telephone monitoring (T1), with application of the instruments: Clinical and Socioeconomic Characterization Questionnaire; Minnesota Living With Heart Failure Questionnaire (MLHFQ), Dietary Sodium Restriction Questionnaire (DSRQ) and Veterans Specific Activity Questionnaire (VSAQ). Statistical analysis was performed in the R environment: The Language and Environment for Statistical Computing, performing measures of central tendency, proportion, normality test, confidence intervals, Spearman correlations and multiple regression analysis. Project approved by the Ethics Committee, nº 1.864.889. A total of 81 patients were included in T0, 74 in T1 and 72 in T2, predominantly female (51.85%) and mean age of 66.75 (± 10.84) years. The NYHA III Functional Class was the most prevalent (50.63%) of Chagasic etiology (53.10%), and the main comorbidity was (82.72%). The adhesion scores to low sodium consumption were found to be below the proposed cut-off point for good adhesion, as well as ACR values, which indicated VSAQ = 3 METs at all times. Death rates increased from 8.64% in T1 to 11.11% in T2, as well as the hospitalization of 4.94% in T1 to 7.4% in T2. The MLHFQ showed negative impact in all domains, besides worsening over time in the non-specific domain and total score. The active working condition indicated 16.5 times more chances of going to death. In the regression model, the physical domain of the MLHFQ established a significant relationship (p <0.01) with the variables: sex (r = 0.25), obesity (r = -0.22), NYHA Function Class , 23), Cardiopathy Severity Rating (r = -0.44) and age-corrected VSAQ (r = -0.37). The age-adjusted VSAQ established significant relationships (p <0.01) with the independent variables: age (r = -0.49), marital status (r = -0.26), schooling (r = 0.29), (R = 0.23), quantitative echocardiographic measurement of the aorta (r = -0.23), anatomical and functional alteration of the aortic valve (r = 0.24), classification of the severity of the cardiopathy (r = 0, 65) and physical domain of MLHFQ (r = -0.37). These results contribute to the development of multiprofessional interventions aimed at the needs of patients with HF12 in relation to the evaluated constructs, aiming at the prevention or staging of worsening conditions of ACR, low adhesion to sodium consumption and HRQoL.