Respostas hemodinâmicas não invasivas de pacientes com hipertensão arterial pulmonar avaliadas durante teste submáximo de capacidade funcional

Abstract

BACKGROUND: Pulmonary arterial hypertension (PAH) is a progressive pulmonary vasculopathy that causes right ventricular dysfunction, severe exercise intolerance and death. In the functional evaluation, the distance covered in 6 minutes (6MWD) correlates with the severity, prognosis and treatment of the pathology and it is suggested that the addition of new parameters such as hemodynamic responses can improve the relevance of the test. OBJECTIVES: To analyze hemodynamic responses, heart rate (HR) and systemic systolic and diastolic blood pressure (SBP and PaD) in the 6-minute walk test (6MWT) and their correlations with the 6MWT. METHODS: Cross-sectional analytical observational study with a convenience sample diagnosed with PAH, aged between 18 and 60 years, where clinical evaluation was performed followed by the evaluation of functional capacity through the 6MWT. The variables of interest were the 6MWD, HR, SBP and DBP at the moments: initial, at the third minute, at the end of the test and after 2 minutes of recovery. RESULTS: Participants were 24 individuals with a median age of 41 [32.7-55.5] years, predominantly female (95.83%). It was observed that the HR and SBP presented a physiological behavior in face of the demands of the 6MWT with a positive correlation of the 6MWT with the moderate SBP (p=0.01; r=0.43) and with the HR in the third minute (p=0, 02; r=0.39), at the end (p=0.001;r=0.60) and after the 2-minute recovery (0.009; r=0.47) being respectively weak and moderate, and the HR delta correlated strongly with the same primary outcome (p=<0.001; r=0.70). Of the 24 participants, only 11 were able to do the re-test after a 30-minute break. CONCLUSION: The participants showed physiological hemodynamic behavior in both tests performed and there was a correlation between the hemodynamic variables and the 6MWD.