Comparação de três testes de campo na avaliação da tolerância ao exercício em indivíduos com hipertensão arterial pulmonar

Abstract

Background: Pulmonary arterial hypertension (PAH) is an increase in pulmonary vascular resistance and consequently overload of the right ventricle. It is a serious, progressive and fatal disease, which leads to reduced functional capacity, and dyspnea. Functional capacity evaluation field tests are alternatives to cardiopulmonary test (CPET) to be simpler and less costly. The most common among them is the Six Minute Walk Test (6MWT), but there is evidence that 6MWT does not reflect the real tolerance to the efforts of individuals with PAH. Study design: Cross over. Objectives: To compare the performance of three field tests with the cardiopulmonary exercise test in the assessing the functional capacity of patients with PAH. Methods and Results: 20 volunteers (49.8 ± 14,6 years old), WHO functional class II and III and a mean pulmonary artery pressure: 45 mmHg, were subjected to field tests: 6MWT, Incremental Shuttle Walk Test (SWTi) and Endurance Shuttle Walk Test (SWTe) and also to CPET in different, non-consecutive days. The SWTi reached maximum levels of effort and no significant differences in any variable evaluated with CPET. But the 6MWT and SWTe proved submaximal tests. Conclusion: The SWTi is an effective and safe alternative to CPET with the advantage of being simple and inexpensive, capable of reproducing the functional status of patients with PAH.