Testes submáximos na avaliação do paciente com hipertensão pulmonar: Uma revisão narrativa da literatura

Abstract

Introduction: Pulmonary hypertension (PH) is characterized as a circulatory abnormality that causes increased pressure in the pulmonary arteries. Pulmonary hypertension is defined as pressure greater than 25 mmHg at rest. This increase is due to a constriction or obstruction of pulmonary blood vessels that will cause some symptoms in the individual such as: fatigue, dyspnea on exertion, syncope and chest discomfort. The increased resistance of the vessels of the lungs is caused by destruction of the vascular bed and/or pathological vasoconstriction or thrombosis. The assessment of functional capacity is extremely important to determine tolerance to physical effort, generate prognosis and outline the therapeutic plan. Due to the clinical value that the assessment of the functional capacity of the patient with PH has, many health professionals make use of stress tests to measure the functional status of each individual. Objective: The study sought to understand and study the best strategy for assessing functional capacity in patients with PH. Methodology: this study is a narrative review where a survey of articles published in online databases (Pubmed, Physiotherapy evidence database (PEDro), Academic Google, Scientific Electronic Library Online (SciELO), International Journal of Cardiovascular Science, Revista Ciência & Saúde and Capes Journal Portal) with the main maximum and submaximal tests performed in patients with PH, in which 8 articles were selected that met the inclusion criteria. Results: It was observed that the 6-minute walk test (6MWT) is still the main test used in the assessment of functional capacity because it combines its practicality, low cost and still has its result linked to the prognosis of the disease. However, more recent studies have brought the shuttle walking test (SWT) as an alternative to the 6MWT because it combines the advantages that a maximal test has with the simplicity of performance similar to the 6MWT. The study observed that there is still a deficit of works that correlate HP with some tests, such as the up and go test (TUG) and the 30-second sit-and-stand test (STS30). Conclusion: Studies show the 6MWT as the most used test in clinical practice. However, the literature has been seeking and signaling other tests to assess functional capacity that present similar or superior characteristics to the 6MWT.