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Capacidade inspiratória e sua relação com diferentes medidas de capacidade de exercício em indivíduos com DPOC*

Inspiratory capacity and its relationship with different measures of exercise capacity in COPD subjects

Camila Monteiro Mazzarin, Rafael Mesquita, Leila Donária, Isabel Cristina Hilgert Genz, Larissa Moreno Martinez Faria, Nidia Aparecida Hernandes, Fabio Pitta, Vanessa Suziane Probst

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Resumo

Introdução: Em indivíduos com Doença Pulmonar Obstrutiva Crônica (DPOC), a Capacidade Inspiratória (CI) já mostrou-se associada a diferentes medidas de capacidade de exercício. Contudo, desconhece-se estudo que tenha investigado essa relação numa mesma amostra de indivíduos. Objetivo: Verificar a relação entre a CI e medidas de testes funcional, máximo e submáximo de capacidade de exercício numa mesma amostra de indivíduos com DPOC. Métodos: Trinta indivíduos com DPOC (15H; 66[8] anos; Volume Expiratório Forçado no primeiro segundo [VEF1 ] 40[14]% previsto) foram avaliados quanto à sua CI, por meio de espirometria, e capacidade de exercício, por meio dos seguintes testes: Teste de Caminhada de seis minutos (TC6min), como teste funcional; Teste Cardiopulmonar de Esforço (TCPE), como teste máximo e Teste de Endurance (TE), como teste submáximo. Variáveis fisiológicas foram avaliadas antes e após os testes, que foram realizados em dias distintos. O TCPE e o TE foram realizados em cicloergômetro. Resultados: Em relação ao TC6min, a CI (em litros) correlacionou-se apenas com a distância percorrida no teste (r=0,41; P=0,02). No teste cardiopulmonar de esforço, a CI correlacionou-se com o trabalho máximo (rho de Spearman=0,59, P=0,0006) e com a frequência cardíaca máxima em valor absoluto (r=0,46, P=0,01) e % previsto (r=0,36, P=0,05). No TE, não houve correlação da CI com a duração do teste (rho de Spearman=0,03, P=0,86). Na comparação dos indivíduos com diferentes valores de CI (< ou ≥ 80% previsto), observou-se diferença somente na distância percorrida no TC6min (372 [96] vs. 452 [77] metros, respectivamente; P=0,04). Conclusão: A capacidade inspiratória correlaciona-se com os principais desfechos dos testes funcional e máximo de capacidade de exercício. O teste funcional, contudo, parece ser o que melhor se associa com a capacidade inspiratória.

Palavras-chave

Doença Pulmonar Obstrutiva Crônica; Capacidade Inspiratória; Tolerância ao Exercício.

Abstract

Introduction: In Chronic Obstructive Pulmonary Disease (COPD) patients, the Inspiratory Capacity (CI) has already shown to be associated with different measures of exercise capacity. However, this relationship has not been investigated in a same sample of individuals. Objective: To investigate the relationship between IC and measures of functional, maximal and submaximal exercise capacity tests in the same sample of individuals with COPD. Methods: Thirty subjects with COPD (15 men; 66[8] years; Forced Expiratory Volume in the first second [FEV1 ] 40[14]% predicted) were evaluated for their IC, by spirometry, and exercise capacity, by the following tests: 6-Minute Walk Test (6MWT), as functional test; Cardiopulmonary Exercise Test (CPET), as maximal test and; Endurance Test (ET), as submaximal test. Physiological variables were assessed before and after the tests, which were all performed in distinct days. The CPET and ET were performed using a cycloergometer. Results: In the 6MWT, the IC (in liters) correlated sign-ificantly only with the distance walked in the test (r=0.41, P=0.02). In the CPET, the IC correlated with the maximum workload (Spearman’s rho=0.59, P=0.0006) and the maximum heart rate, both in absolute value (r=0.46, P=0.01) and % predicted (r=0.36, P=0.05). In the ET, there was no correlation with the duration of the test (Spearman’s rho=0.03, P=0.86). When comparing individuals with different values of IC (< or ≥ 80% predicted), there was statistical difference only in the distance walked in the 6MWT (372 [96] vs. 452 [77] meters, respectively; P=0.04). Conclusion: The inspiratory capacity correlates with the main measures of functional and maximal exercise capacity tests. The functional test, however, seems to be better associated with the inspiratory capacity.

Keywords

Chronic Obstructive Pulmonary Disease; Inspiratory Capacity; Exercise Tolerance.

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