Browsing by Author "Ferreira, Rui Cruz"
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- Impact of syncope on quality of life: validation of a measure in patients undergoing tilt testingPublication . Nave‐Leal, Elisabete; Oliveira, Mário; Pais‐Ribeiro, José Luís; Santos, Sofia; Oliveira, Eunice; Alves, Teresa; Ferreira, Rui CruzIntroduction: Recurrent syncope has a significant impact on quality of life. The development of measurement scales to assess this impact that is easy to use in clinical settings is crucial. The objective of the present study is a preliminary validation of the Impact of Syncope on Quality of Life questionnaire for the Portuguese population. Methods: The instrument underwent a process of translation, validation, analysis of cultural appropriateness and cognitive debriefing. A population of 39 patients with a history of recurrent syncope (>1 year) who underwent tilt testing, aged 52.1 ± 16.4 years (21-83), 43.5% male, most in active employment (n=18) or retired (n=13), constituted a convenience sample. The resulting Portuguese version is similar to the original, with 12 items in a single aggregate score, and underwent statistical validation, with the assessment of reliability, validity, and stability over time. Results: With regard to reliability, the internal consistency of the scale is 0.9. Assessment of convergent and discriminant validity showed statistically significant results (p<0.01). Regarding stability over time, a test-retest of this instrument at six months after tilt testing with 22 patients of the sample who had not undergone any clinical intervention found no statistically significant changes in quality of life. Conclusions: The results indicate that this instrument is of value for assessing the quality of life in patients with recurrent syncope in Portugal.
- Impacto da síncope na qualidade de vida: validação duma escala de avaliação em doentes submetidos a teste de inclinação em mesa basculantePublication . Nave-Leal, Elisabete; Oliveira, Mário; Pais-Ribeiro, José Luís; Santos, Sofia; Oliveira, Eunice; Alves, Teresa; Ferreira, Rui CruzIntrodução e objetivos: A síncope recorrente tem um impacto significativo na qualidade de vida. O desenvolvimento de escalas de medida de fácil aplicabilidade clínica para avaliar este impacto é fundamental. O objetivo do presente estudo é a validação preliminar da escala Impact of Syncope on Quality of Life, para a população portuguesa. Métodos: O instrumento foi submetido a um processo de tradução, validação, adequação cultural e cognitive debriefing. Participaram 39 doentes com história de síncopes recorrentes (>1 ano de evolução), submetidos a teste de inclinação em mesa basculante (teste de tilt), que constitui uma amostra de conveniência, com idade de 52,1±16,4 anos (21-83; 43,5% do sexo masculino), a maioria com uma situação profissional ativa (n=18) ou reformados (n=13). A versão portuguesa resultou numa versão semelhante unidimensional à original com 12 itens agregados num único somatório, tendo passado por validação estatística, com avaliação da fidelidade, validade e estabilidade no tempo. Resultados: Em relação à fidelidade, a consistência interna da escala é de 0,9. Avaliámos a validade convergente, tendo obtido resultados estatisticamente significativos (p<0,01). Avaliámos a validade divergente tendo obtido resultados estatisticamente significativos. Relativamente à estabilidade no tempo foi efetuado um teste-reteste do instrumento aos seis meses após o teste de inclinação com 22 doentes desta amostra não submetidos a intervenção clínica, que não mostrou alterações estatisticamente significativas da qualidade de vida. Conclusões: Os resultados obtidos indicam a pertinência da utilização deste instrumento em contexto português na avaliação da qualidade de vida de doentes com síncope recorrente.
- Lockdown measures for COVID-19 outbreak and variation in physical activity in patients with heart failure and cardiac implantable devicesPublication . Silva Cunha, Pedro; Laranjo, Sérgio; Lourenço, André; Rodrigues, Lourenço; Cardoso, Isabel; Portugal, Guilherme; Valente, Bruno; Delgado, Ana Sofia; Ferreira, Rui Cruz; Abreu, Ana; Oliveira, MarioAims: The present study analysed the patterns of physical activity pre-, during and post-lockdown measures for COVID-19 pandemic in patients with chronic heart failure (CHF) and cardiac implantable electronic devices (CIED) under remote monitoring (RM), and assessed the physical activity patterns during these periods. Methods: The raw data from 95 patients with CHF (age 67,7 +/- 15,1 years, 71,5% male) corresponding to 2238 RM transmissions of the Medtronic Carelink (TM) network platform was obtained. The physical exercise profiles and the impact of the lockdown measures on the physical behaviour during and after the measures were analysed. According to the level of activity duration in the pre-lockdown, lockdown and post-lockdown periods, the patterns of behaviour were identified (non-recoverees, incomplete recoverees, recoverees and full-recoverees). Conclusion: RM of CHF patients with CIED using the Carelink (TM) network is useful for close follow-up and identification of heart failure risk status variations. After relieving the confinement measures there were two groups of patients that did not recover the previous physical activity levels. Physical inactivity in patients with CHF can have a significant impact on outcomes.
- Optimizing risk stratification in heart failure and the selection of candidates for heart transplantationPublication . Pereira-da-Silva, Tiago; Soares, Rui M.; Papoila, Ana Luisa; Pinto, Iola; Feliciano, Joana; Morais, Luís Almeida; Abreu, Ana; Ferreira, Rui CruzIntroduction and Aims: Selecting patients for heart transplantation is challenging. We aimed to identify the most important risk predictors in heart failure and an approach to optimize the selection of candidates for heart transplantation. Methods: Ambulatory patients followed in our center with symptomatic heart failure and left ventricular ejection fraction <= 40% prospectively underwent a comprehensive baseline assessment including clinical, laboratory, electrocardiographic, echocardiographic, and cardiopulmonary exercise testing parameters. All patients were followed for 60 months. The combined endpoint was cardiac death, urgent heart transplantation or need for mechanical circulatory support, up to 36 months. Results: In the 263 enrolled patients (75% male, age 54 +/- 12 years), 54 events occurred. The independent predictors of adverse outcome were ventilatory efficiency (VE/VCO2) slope (HR 1.14, 95% CI 1.11-1.18), creatinine level (HR 2.23, 95% CI 1.14-4.36), and left ventricular ejection fraction (HR 0.96, 95% CI 0.93-0.99). VE/VCO2 slope was the most accurate risk predictor at any follow-up time analyzed (up to 60 months). The threshold of 39.0 yielded high specificity (97%), discriminated a worse or better prognosis than that reported for post-heart transplantation, and outperformed peak oxygen consumption thresholds of 10.0 or 12.0 ml/kg/min. For low-risk patients (VE/VCO2 slope <39.0), sodium and creatinine levels and variations in end-tidal carbon dioxide partial pressure on exercise identified those with excellent prognosis. Conclusions: VE/VCO2 slope was the most accurate parameter for risk stratification in patients with heart failure and reduced ejection fraction. Those with VE/VCO2 slope >= 39.0 may benefit from heart transplantation.