IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFMS |
Texto Completo: | https://repositorio.ufms.br/handle/123456789/4889 |
Resumo: | BARBOSA, GWS. EFFECTS OF SMOKING ON CARDIOPULMONARY MORPHOPHYSIOLOGY AND VENTILATORY EFFICIENCY IN INDIVIDUALS WITH HEART FAILURE. Campo Grande - MS, 2022. [Doctoral Thesis - Federal University of Mato Grosso do Sul]. Smoking and heart failure (HF) alone affect the thoracic circulation, which can lead to micro- macrovascular disease. In addition, the presence of pulmonary emphysema (low attenuation area, LAA %) has been poorly studied in smoking associated with HF and without chronic obstructive pulmonary disease. Thus, microvascular disease and emphysema are important factors in ventilatory inefficiency, as both contribute for ventilation-perfusion inequality. Therefore, as a primary objective, we verified the original hypothesis that the ventilatory inefficiency, the degree of emphysema and vascular changes in the chest would be lower in a group of patients with HF never exposed to active smoking (Group 1), compared to a group of individuals with the same clinical-demographic characteristics, exposed to active smoking during their lifetime (Group 2). Additionally, the ventilatory efficiency was analyzed by a new method (ηV´E). As a secondary objective, we explored the correlations between vascular diameters for cross-sectional area of vessels less than 5mm (CSA<5mm) and the ratio between pulmonary artery and aorta diameter (PA/Ao) with Power(W) and peak oxygen consumption (V´O2), for the total group (n=34). Among other tests, both Group 1 (n=17) and Group 2 (n=17) performed complete spirometry, carbon monoxide diffusion test (DCO), high resolution chest computed tomography (HRCT) and cardiopulmonary exercise testing (CPET). As results, the groups were properly matched for clinical-demographic variables. Groups 1 and 2, respectively, did not show significant differences for ventilatory efficiency parameters (mean±SD), including the new method (ηV´E=10.1±2.9% and 10.3±2.7%, p=0.878). There was also no significant difference for microvascular diameter (CSA<5mm 0.5±0.1% and 0.7±0.3%, p=0.244), PA/Ao ratio (0.81±0.1 and 0.83±0.1, p=0.333) and LAA (1.3±06% and 2.6±5.6%, p=0.884). For the total group, the strongest correlations were between W%predicted (rho=0.760, p<0.001), V´O2%predicted (rho=0.745, p<0.001) and PA/Ao ratio (rho= - 0.470, p =0.008) with ηV'E. We conclude that smoking was not an additional adverse factor to deteriorate ventilatory efficiency, as the vascular structure studied and the quantification of emphysema by HRCT were not different between the groups. On the other hand, the new ventilatory efficiency index studied seems to be mechanistically more linked to aerobic performance and PA/Ao ratio, a promising indicator of pulmonary hypertension. Descriptors: Smoking, Heart failure, exercise. |
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2022-07-06T14:07:21Z2022-07-06T14:07:21Z2022https://repositorio.ufms.br/handle/123456789/4889BARBOSA, GWS. EFFECTS OF SMOKING ON CARDIOPULMONARY MORPHOPHYSIOLOGY AND VENTILATORY EFFICIENCY IN INDIVIDUALS WITH HEART FAILURE. Campo Grande - MS, 2022. [Doctoral Thesis - Federal University of Mato Grosso do Sul]. Smoking and heart failure (HF) alone affect the thoracic circulation, which can lead to micro- macrovascular disease. In addition, the presence of pulmonary emphysema (low attenuation area, LAA %) has been poorly studied in smoking associated with HF and without chronic obstructive pulmonary disease. Thus, microvascular disease and emphysema are important factors in ventilatory inefficiency, as both contribute for ventilation-perfusion inequality. Therefore, as a primary objective, we verified the original hypothesis that the ventilatory inefficiency, the degree of emphysema and vascular changes in the chest would be lower in a group of patients with HF never exposed to active smoking (Group 1), compared to a group of individuals with the same clinical-demographic characteristics, exposed to active smoking during their lifetime (Group 2). Additionally, the ventilatory efficiency was analyzed by a new method (ηV´E). As a secondary objective, we explored the correlations between vascular diameters for cross-sectional area of vessels less than 5mm (CSA<5mm) and the ratio between pulmonary artery and aorta diameter (PA/Ao) with Power(W) and peak oxygen consumption (V´O2), for the total group (n=34). Among other tests, both Group 1 (n=17) and Group 2 (n=17) performed complete spirometry, carbon monoxide diffusion test (DCO), high resolution chest computed tomography (HRCT) and cardiopulmonary exercise testing (CPET). As results, the groups were properly matched for clinical-demographic variables. Groups 1 and 2, respectively, did not show significant differences for ventilatory efficiency parameters (mean±SD), including the new method (ηV´E=10.1±2.9% and 10.3±2.7%, p=0.878). There was also no significant difference for microvascular diameter (CSA<5mm 0.5±0.1% and 0.7±0.3%, p=0.244), PA/Ao ratio (0.81±0.1 and 0.83±0.1, p=0.333) and LAA (1.3±06% and 2.6±5.6%, p=0.884). For the total group, the strongest correlations were between W%predicted (rho=0.760, p<0.001), V´O2%predicted (rho=0.745, p<0.001) and PA/Ao ratio (rho= - 0.470, p =0.008) with ηV'E. We conclude that smoking was not an additional adverse factor to deteriorate ventilatory efficiency, as the vascular structure studied and the quantification of emphysema by HRCT were not different between the groups. On the other hand, the new ventilatory efficiency index studied seems to be mechanistically more linked to aerobic performance and PA/Ao ratio, a promising indicator of pulmonary hypertension. Descriptors: Smoking, Heart failure, exercise.BARBOSA, GWS. EFEITOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA. Campo Grande – MS, 2022. [Tese de Doutorado – Universidade Federal de Mato Grosso do Sul] O tabagismo e a insuficiência cardíaca (IC), isoladamente, afetam a circulação do tórax, podendo levar a alterações micro- e macrovasculares. Além disso, a presença de enfisema pulmonar (low attenuation area, LAA %) foi pouco estudada na IC associada ao tabagismo, sem doença pulmonar obstrutiva crônica. Assim, doença microvascular e enfisema pulmonar são fatores importantes na ineficiência ventilatória, pois contribuem para o distúrbio na relação ventilação-perfusão. Portanto, como objetivo primário, verificamos a hipótese original de que a ineficiência ventilatória no exercício, o grau de enfisema e as alterações vasculares do tórax seriam menores em um grupo de pacientes com IC nunca expostos ao tabagismo ativo (Grupo 1), comparado a um grupo de indivíduos com as mesmas características clínico-demográficas expostos ao tabagismo ativo durante a vida (Grupo 2). Adicionalmente, a eficiência ventilatória foi analisada por um novo método (ηV´E). Como objetivo secundário, exploramos as correlações entre diâmetros vasculares para área seccional cruzada de vasos com menos de 5mm (CSA<5mm) e a relação entre diâmetro de artéria pulmonar e aorta (AP/Ao) com variáveis de potência (W) e consumo pico de oxigênio (V´O2), além de eficiência ventilatória, para o grupo total (n=34). Entre outros testes, tanto o Grupo 1 (n=17) como o Grupo 2 (n=17) realizaram espirometria completa, teste de difusão pelo monóxido de carbono (DCO), tomografia computadorizada de tórax de alta resolução (TCAR) e teste de exercício cardiopulmonar (TECP). Como resultado, os grupos foram pareados adequadamente para variáveis clínico-demográficas. Os Grupos 1 e 2, respectivamente, não apresentaram diferenças significativas (média±DP) para parâmetros de eficiência ventilatória, incluindo o novo método (ηV´E=10,1±2,9% e 10,3±2,7%, p=0,878). Também não houve diferença significativa para diâmetro microvascular (CSA<5mm 0,5±0,1% e 0,7±0,3%, p=0.244), relação AP/Ao (0,81±0,1 e 0,83±0,1, p=0,333) e LAA (1,3±06% e 2,6±5,6%, p=0,884). Para o grupo total, as correlações mais fortes foram entre W%previsto (rho=0,760, p<0,001), V´O2%previsto (rho=0,745, p<0,001) e relação AP/Ao (rho= - 0,470, p=0,008) com ηV´E. Concluímos que, no grupo estudado, o tabagismo não foi um fator adverso adicional para deteriorar a eficiência ventilatória, observamos também, que a estrutura vascular estudada e a quantificação de enfisema por TCAR não foram diferentes entre os grupos. Por outro lado, o novo índice de eficiência ventilatória estudado parece ser mecanisticamente mais interligado à performance aeróbia e relação AP/Ao, um indicador promissor de hipertensão pulmonar. Descritores: Hábito de fumar, Insuficiência cardíaca, exercício.Fundação Universidade Federal de Mato Grosso do SulUFMSBrasilHábito de fumar, Insuficiência Cardíaca, ExercícioIMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACAinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisPaulo de Tarso Guerrero MullerGisele Walter da Silva Barbosainfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da UFMSinstname:Universidade Federal de Mato Grosso do Sul (UFMS)instacron:UFMSORIGINALTese de Doutorado Gisele Walter da Silva Barbosa.pdfTese de Doutorado Gisele Walter da Silva Barbosa.pdfapplication/pdf10060887https://repositorio.ufms.br/bitstream/123456789/4889/-1/Tese%20de%20Doutorado%20Gisele%20Walter%20da%20Silva%20Barbosa.pdfd88ea47500c2b8d29a30e4b216afdf71MD5-1123456789/48892022-07-06 10:07:22.499oai:repositorio.ufms.br:123456789/4889Repositório InstitucionalPUBhttps://repositorio.ufms.br/oai/requestri.prograd@ufms.bropendoar:21242022-07-06T14:07:22Repositório Institucional da UFMS - Universidade Federal de Mato Grosso do Sul (UFMS)false |
dc.title.pt_BR.fl_str_mv |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA |
title |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA |
spellingShingle |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA Gisele Walter da Silva Barbosa Hábito de fumar, Insuficiência Cardíaca, Exercício |
title_short |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA |
title_full |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA |
title_fullStr |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA |
title_full_unstemmed |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA |
title_sort |
IMPACTOS DO TABAGISMO NA MORFOFISIOLOGIA CARDIOPULMONAR E EFICIÊNCIA VENTILATÓRIA EM INDIVÍDUOS COM INSUFICIÊNCIA CARDÍACA |
author |
Gisele Walter da Silva Barbosa |
author_facet |
Gisele Walter da Silva Barbosa |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Paulo de Tarso Guerrero Muller |
dc.contributor.author.fl_str_mv |
Gisele Walter da Silva Barbosa |
contributor_str_mv |
Paulo de Tarso Guerrero Muller |
dc.subject.por.fl_str_mv |
Hábito de fumar, Insuficiência Cardíaca, Exercício |
topic |
Hábito de fumar, Insuficiência Cardíaca, Exercício |
description |
BARBOSA, GWS. EFFECTS OF SMOKING ON CARDIOPULMONARY MORPHOPHYSIOLOGY AND VENTILATORY EFFICIENCY IN INDIVIDUALS WITH HEART FAILURE. Campo Grande - MS, 2022. [Doctoral Thesis - Federal University of Mato Grosso do Sul]. Smoking and heart failure (HF) alone affect the thoracic circulation, which can lead to micro- macrovascular disease. In addition, the presence of pulmonary emphysema (low attenuation area, LAA %) has been poorly studied in smoking associated with HF and without chronic obstructive pulmonary disease. Thus, microvascular disease and emphysema are important factors in ventilatory inefficiency, as both contribute for ventilation-perfusion inequality. Therefore, as a primary objective, we verified the original hypothesis that the ventilatory inefficiency, the degree of emphysema and vascular changes in the chest would be lower in a group of patients with HF never exposed to active smoking (Group 1), compared to a group of individuals with the same clinical-demographic characteristics, exposed to active smoking during their lifetime (Group 2). Additionally, the ventilatory efficiency was analyzed by a new method (ηV´E). As a secondary objective, we explored the correlations between vascular diameters for cross-sectional area of vessels less than 5mm (CSA<5mm) and the ratio between pulmonary artery and aorta diameter (PA/Ao) with Power(W) and peak oxygen consumption (V´O2), for the total group (n=34). Among other tests, both Group 1 (n=17) and Group 2 (n=17) performed complete spirometry, carbon monoxide diffusion test (DCO), high resolution chest computed tomography (HRCT) and cardiopulmonary exercise testing (CPET). As results, the groups were properly matched for clinical-demographic variables. Groups 1 and 2, respectively, did not show significant differences for ventilatory efficiency parameters (mean±SD), including the new method (ηV´E=10.1±2.9% and 10.3±2.7%, p=0.878). There was also no significant difference for microvascular diameter (CSA<5mm 0.5±0.1% and 0.7±0.3%, p=0.244), PA/Ao ratio (0.81±0.1 and 0.83±0.1, p=0.333) and LAA (1.3±06% and 2.6±5.6%, p=0.884). For the total group, the strongest correlations were between W%predicted (rho=0.760, p<0.001), V´O2%predicted (rho=0.745, p<0.001) and PA/Ao ratio (rho= - 0.470, p =0.008) with ηV'E. We conclude that smoking was not an additional adverse factor to deteriorate ventilatory efficiency, as the vascular structure studied and the quantification of emphysema by HRCT were not different between the groups. On the other hand, the new ventilatory efficiency index studied seems to be mechanistically more linked to aerobic performance and PA/Ao ratio, a promising indicator of pulmonary hypertension. Descriptors: Smoking, Heart failure, exercise. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-07-06T14:07:21Z |
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2022-07-06T14:07:21Z |
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2022 |
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