Avaliação de fragilidade em insuficiência cardíaca com fração de ejeção reduzida de etiologia chagásica

• Ano de defesa: 2019
• Autor(a) principal: Araújo, Fabrício Alves
• Orientador(a): Rassi, Salvador
• Banca de defesa: Rassi, Salvador, Sá, Luiz Antônio Batista de, Silva, Nílzio Antonio da, Silva, Daniela Graner Schuwartz Tannus, Souza, Weimar Kunz Sebba Barroso de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/38995/0013000009rw1
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Programa de Pós-graduação em Ciências da Saúde (FM)
• Departamento: Faculdade de Medicina - FM (RG)
• País: Brasil
• Palavras-chave em Português: Fragilidade; Fenótipo de fragilidade; Insuficiência cardíaca; Insuficiência cardíaca com fração de ejeção reduzida; Doença de Chagas
• Palavras-chave em Inglês: Frailty; Frailty phenotype; Heart failure; Chagas disease; Heart failure with reduced ejection fraction
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/10245

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.