Reabilitação cardíaca no doente coronário isquémico: determinação da capacidade para o exercício

Introduction: Ischemic heart disease presents a high rate of mortality and associated disability. Determining exercise capacity is a fundamental step in planning exercise training throughout the cardiac rehabilitation program, thus allowing the reduction of the negative impact of this disease. The aim of this study is to determine the capacity for exercise after an acute ischemic event and to understand if it is significantly altered compared to the reference values. Methodology: Retrospective cross-sectional study, with non-probabilistic convenience sampling, evaluating the 6-minute walk test after acute coronary syndrome with and without ST-segment elevation, to characterize exercise capacity in patients after an acute event. The distance walked was compared with the theoretically predicted distance based on the Enright equation, and it was verified whether the resulting difference between these two parameters was different for patients with and without ST-segment elevation. Results: A total of 315 patients were included in the study, 76.2% male (n=240), with a mean age of 62 years (SD=11.6). A decrease in the distance walked compared to the predicted distance was observed in both groups (with and without ST-elevation), being more pronounced in the group with ST-elevation (p=0.039). Discussion: The difference resulting from the assessments suggests a functional loss, probably due to hospitalization for the acute event. Thus, a real determination of the functional level will allow a more adjusted planning of the exercise training plan, considering the event that led to hospitalization. The use of reference values based on existing equations does not seem to be adjusted to the reality and needs of patients. Conclusion: Existing predictive equations overestimate exercise capacity in patients after an acute ischemic coronary event. It is suggested to determine a new equation that allows estimating the real exercise capacity for this type of patient.