Strain X Cardiopulmonary Test

Study Overview
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Brief Summary
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Introduction : Patients with heart failure (HF ) with systolic dysfunction of moderate to severe exhibit significant reduction in the ability to exercise compared to those with mild dysfunction , and have worse prognosis. However, some clinical markers of severity and diagnosis widely used in this population such as ejection fraction (EF) , are not always able to translate the actual degree of cardiac damage as well as their relationship with the cardiorespiratory fitness of these individuals and prognosis . Objective: To evaluate the ability of the global longitudinal strain ( GLS ) in predicting exercise tolerance in heart failure patients with moderate and significant systolic dysfunction.

Official Title
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Analysis Of Strain Myocardial Associated With The Exercise Tolerance In Patients With Heart Failure Systolic

Conditions
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Heart Failure

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: moderate and significant systolic dysfunction (LVEF < 45%) assessed by transthoracic echocardiography recent ( last month before evaluation ) Teichholz method , or when in the presence of contractile deficit target , by the Simpson method. Exclusion Criteria: deformity in the face to prevent the coupling of the mask to perform the CPET , orthopedic and neurological diseases that could make it impossible to perform the tests , patients with psychiatric disorders that restricted them to respond to the questionnaire , HF FC IV or hospitalization in the last three months , angina unstable; myocardial infarction or heart surgery up to three months before the survey ; FEV1 / FVC <70 % predicted characterizing obstructive respiratory disorder .

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Echocardiography for obtaining the strain  | To strain of technical analysis will be used echocardiography analysis software ( EchoPAC , GE Medical Systems, Horten , Norway, version 10.0 ) . The images will be analyzed in the longitudinal sections ( 4 bedrooms , 3 bedrooms and 2 cameras) . The endocardium is drawn manually from the septum to the lateral mitral annulus. A region of interest will be applied automatically by the software. | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiopulmonary Test | Cardiopulmonary exercise testing will be carried out by the treadmill ramp method ( Centurium 300 , Micromed , Brazil ) through ErgoPC Elite® software associated with the electrocardiogram ( Micromed , Brazil ) with 12 channels. Respiratory variables will be evaluated by a gas analyzer ( Cortex - Metalyzer II , Germany) being obtained in standard conditions of temperature , pressure and humidity ( STPD ) , breath - by - breath , with the patient breathing in a face mask without leaks during exercise. Will be assessed during the test , functional capacity , measured in METs , VO2 , VE / VCO 2 , VE / VCO 2 slope , T1 / 2VO2 and RFC1 . | 1 day |