Fração de ejeção do ventrículo esquerdo em indivíduos com insuficiência cardíaca e fatores associados
DOI:
https://doi.org/10.17267/2317-3378rec.2024.e5754Palavras-chave:
Insuficiência Cardíaca, Tratamento Farmacológico, Fração de Ejeção Ventricular, Fatores de RiscoResumo
OBJETIVOS: Verificar a relação de fatores de risco modificáveis, complicações clínicas e terapia medicamentosa com a fração de ejeção do ventrículo esquerdo (FEVE) em indivíduos com insuficiência cardíaca (IC). MÉTODOS: Estudo de corte transversal, com dados secundários de um estudo matriz “Infarto cerebral em pacientes com insuficiência cardíaca: características associadas e função atrial esquerda”. A amostra composta por 75 indivíduos adultos atendidos em ambulatório de referência em Salvador, Bahia. Os grupos da FEVE foram classificados: FEVE reduzida (FEVEr) ≤ 40%, FEVE intermediária (FEVEi) 40-49% e FEVE preservada (FEVEp) ≥50%. Foi realizado uma análise através do software SPSS e considerado significância estatística p≤0,05. RESULTADOS: A amostra apresentou média de idade 62±10 anos, sendo a maioria homens n=42(56%), classe funcional II/IV n=41 (54,7%) e etiologia idiopática n=33 (44%). A FEVEr e FEVEp foram semelhantes n=31(41%), seguida de FEVEi n=13 (18%). Os subgrupos de FEVE foram relacionados a Diabetes Melitus (DM) como fator de risco (p=0,049), Acidente Vascular Cerebral (AVC) como complicação (p=0,001) e na terapia medicamentosa betabloqueadores (p=0,004) e Inibidores da Enzima Conversora de Angiotensina (IECA/BRA) (p=0,007). CONCLUSÃO: O DM como fator de risco, o AVC como complicação e os medicamentos betabloqueadores e IECA/BRA possuem relação com a FEVE de indivíduos com IC.
Downloads
Referências
(1) Rohde LEP, Montera MW, Bocchi EA, Clausell NO, Albuquerque DC, Rassi S, et al. Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda. Arq Bras Cardiol. 2018;111(3):436–539. https://doi.org/10.5935/abc.20180190
(2) Fernandes ADF, Fernandes GC, Mazza MR, Knijnik LM, Fernandes GS, Vilela AT, et al. A 10-year trend analysis of heart failure in the less developed Brazil. Arq Bras Cardiol. 2020;114(2):222–31. https://doi.org/10.36660/abc.20180321
(3) Ministério da saúde. DATASUS [Internet]. Brasília, DF: Ministério da Saúde; 2020. Available from: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def
(4) Cestari VRF, Garces TS, Sousa GJB, Maranhão TA, Neto JDS, Pereira MLD, et al. Spatial Distribution of Mortality for Heart Failure in Brazil, 1996 – 2017. Arq Bras Cardiol. 2022;118(1):41–51. https://doi.org/10.36660/abc.20201325
(5) Silva-Cardoso J, Brás D, Canário-Almeida F, Andrade A, Oliveira L, Pádua F, et al. Neurohormonal modulation: The new paradigm of pharmacological treatment of heart failure. Revista Portuguesa de Cardiologia. 2019;38(3):175–85. https://doi.org/10.1016/j.repc.2018.10.011
(6) Cardoso J, Espíndola MD, Cunha M, Netto E, Cardoso C, Novaes M, et al. Is current drug therapy for heart failure sufficient to control the heart rate of patients? Arq Bras Cardiol. 2020;115(6):1063-9. https://doi.org/10.36660/abc.20190090
(7) Francisco PMSB, Assumpção D, Borim FSA, Senicato C, Malta DC. Prevalence and co-occurrence of modifiable risk factors in adults and older people. Rev Saude Publica. 2019;53:1–13. https://doi.org/10.11606/S1518-8787.2019053001142
(8) Van Deursen VM, Damman K, Van Der Meer P, Wijkstra PJ, Luijckx GJ, Van Beek A, et al. Comorbidities in Heart Failure. Heart Fail Rev. 2014;19(2):163–72. https://doi.org/10.1007/s10741-012-9370-7
(9) Conde-Martel A, Hernández-Meneses M. Prevalence and prognostic meaning of comorbidity in heart failure. Rev Clin Esp. 2016;216(4):222–8. https://doi.org/10.1016/j.rce.2015.08.005
(10) Barbosa CC, Perinote LCSC, Gomes RC, Oliveira FT, Costa JS. Cuidados de enfermagem no paciente com insuficiência cardíaca congestiva descompensada. Brazilian Journal of Health Review. 2024;7(2):e69175. https://doi.org/10.34119/bjhrv7n2-442
(11) McDonagh TA, Metra M, Adamo M, Baumbach A, Böhm M, Burri H, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021;42(36):3599–726. https://doi.org/10.1093/eurheartj/ehab368
(12) Khan SS, Beach LB, Yancy CW. Sex-Based Differences in Heart Failure: JACC Focus Seminar 7/7. Journal of the American College of Cardiology. Elsevier Inc. 2022;79(15):1530–41. https://doi.org/10.1016/j.jacc.2022.02.013
(13) Huo X, Pu B, Wang W, Peng Y, Li J, Lei L, et al. New York Heart Association Class and Kansas City Cardiomyopathy Questionnaire in Acute Heart Failure. JAMA Netw Open. 2023;6(10):e2339458. https://doi.org/10.1001/jamanetworkopen.2023.39458
(14) Nunes MCP, Beaton A, Acquatella H, Bern C, Bolger AF, Echeverría LE, et al. Chagas Cardiomyopathy: An Update of Current Clinical Knowledge and Management: A Scientific Statement From the American Heart Association. Circulation. 2018;138(12):e169–209. https://doi.org/10.1161/CIR.0000000000000599
(15) Braga JCV, Reis F, Aras R, Dantas Costa N, Bastos C, Silva R, et al. Clinical and therapeutics aspects of heart failure due to Chagas disease. Arq Bras Cardiol. 2006;86(4):296-301. https://doi.org/10.1590/S0066-782X2006000400010
(16) Mentz RJ, Kelly JP, von Lueder TG, Voors AA, Lam CSP, Cowie MR, et al. Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction. J Am Coll Cardiol. 2014;64(21):2281–93. https://doi.org/10.1016/j.jacc.2014.08.036
(17) Pereira AWS, Miranda BCB, Pereira BWS, Coutinho RET. Arterial hypertension and heart failure: critical analysis of new drugs. Revista Brasileira de Hipertensão. 2021;28(1):27–34. https://doi.org/10.47870/1519-7522/2021280127-34
(18) Barkhudaryan A, Doehner W, Scherbakov N. Ischemic stroke and heart failure: Facts and numbers. An update. Journal of Clinical Medicine. 2021;10(5);1–14. https://doi.org/10.3390/jcm10051146
(19) Di Tullio MR, Qian M, Thompson JLP, Labovitz AJ, Mann DL, Sacco RL, et al. Left Ventricular Ejection Fraction and Risk of Stroke and Cardiac Events in Heart Failure: Data from the Warfarin Versus Aspirin in Reduced Ejection Fraction Trial. Stroke. 2016;47(8):2031–7. https://doi.org/10.1161/STROKEAHA.116.013679
(20) Adelborg K, Szépligeti S, Sundbøll J, Horváth-Puhó E, Henderson VW, Ording A, et al. Risk of Stroke in Patients with Heart Failure: A Population-Based 30-Year Cohort Study. Stroke. 2017;48(5):1161–8. https://doi.org/10.1161/STROKEAHA.116.016022
(21) Kim W, Kim EJ. Heart failure as a risk factor for stroke. Journal of Stroke. 2018;20(1):33–45. https://doi.org/10.5853/jos.2017.02810
(22) Malgie J, Clephas PRD, Brunner-La Rocca HP, de Boer RA, Brugts JJ. Guideline-directed medical therapy for HFrEF: sequencing strategies and barriers for life-saving drug therapy. Heart Failure Reviews. Springer. 2023;28:1221–34. https://doi.org/10.1007/s10741-023-10325-2
(23) Liu B, Zhang R, Zhang A, Wang G, Xu J, Zhang Y, et al. Effectiveness and safety of four different beta-blockers in patients with chronic heart failure. MedComm. 2023;4(1):e199. https://doi.org/10.1002/mco2.199
(24) Patel AH, Natarajan B, Pai RG. Current Management of Heart Failure with Preserved Ejection Fraction. International Journal of Angiology. 2022;31(3):166–78. https://doi.org/10.1055/s-0042-1756173
(25) Hikoso S, Kida H, Sunaga A, Nakatani D, Okada K, Dohi T, et al. β-blockers may be detrimental in frail patients with heart failure with preserved ejection fraction. Clinical Research in Cardiology. 2023;113:842–855. https://doi.org/10.1007/s00392-023-02301-5
(26) Meyer M, Du Fay Lavallaz J, Benson L, Savarese G, Dahlström U, Lund LH. Association Between β-Blockers and Outcomes in Heart Failure With Preserved Ejection Fraction: Current Insights From the SwedeHF Registry. J Card Fail. 2021;27(11):1165–74. https://doi.org/10.1016/j.cardfail.2021.04.015
(27) Beggs SAS, Rørth R, Gardner RS, Mcmurray JJV. Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis. Heart. 2019;105:1325–34. https://doi.org/10.1136/heartjnl-2018-314381
(28) Shpak M, Ramakrishnan A, Nadasdy Z, Cowperthwaite M, Fanale C. Higher incidence of ischemic stroke in patients taking novel oral anticoagulants. Stroke. 2018;49(12):2851–6. https://doi.org/10.1161/STROKEAHA.118.022636
(29) Kumana CR, Cheung BMY, Siu DCW, Tse HF, Lauder IJ. Non-vitamin K Oral Anticoagulants Versus Warfarin for Patients with Atrial Fibrillation: Absolute Benefit and Harm Assessments Yield Novel Insights. Cardiovascular Therapeutics. 2016;34:100–6. https://doi.org/10.1111/1755-5922.12173
(30) Boyne JJJ, Van Asselt ADI, Gorgels APM, Steuten LMG, De Weerd G, Kragten J, et al. Cost-effectiveness analysis of telemonitoring versus usual care in patients with heart failure: The TEHAF-study. J Telemed Telecare. 2013;19(5):242–8. https://doi.org/10.1177/1357633X13495478
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2024 Clarice Oliveira Santos , Glicia Gleide Gonçalves Gama, Maria Márcia Carneiro Oliveira de Carvalho
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Esta obra está licenciada com uma Licença Creative Commons Atribuição 4.0 Internacional.
