Unidade Clínica de Insuficiencia Cardíaca e Transplante do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da USP (InCor HC-FMUSP), Brazil.
Cardiol J. 2010;17(2):143-5.
Physical activity (PA) has proven benefits in the primary prevention of heart diseases such as heart failure (HF). Although it is well known, HF PA habits and physicians' advice have been poorly described. The aim of this study was to investigate if physicians were advising HF patients to exercise and to quantify patients' exercise profiles in a complex cardiology hospital.
All 131 HF patients (80 male, average age 53 +/- 10 years, NYHA class I-V, left ventricular ejection fraction 35 +/- 11%, 35 ischemic, 35 idiopatic, 32 hypertensive and 29 with Chagas disease) went to the hospital for a HF routine check-up. On this occasion, after seeing the physician , we asked the patients if the physician had advised them about PA. Then, we asked them to fill in the international physical activity questionnaire (IPQA) Short Form to classify their PA level.
Our data showed a significant difference between patients who had received any kind of PA advice from physicians (36%) and those who had not (64%, p<0.0001). Using the IPAQ criteria, of the 36% of patients who had received advice, 12.4% were classified as low and 23.6% as moderate. Of the 64% of patients who did not receive advice, 26.8% were classified as low and 37.2% as moderate. Etiology (except Chagas), functional class, ejection fraction, sex and age did not influence the PA profile.
Physicians at a tertiary cardiology hospital were not giving patients satisfactory advice as to PA. Our data supports the need to strengthen exercise encouragement by physicians and for complementary studies on this area.
身体活动（PA）已被证明对预防心力衰竭（HF）等心脏病有好处。尽管这是众所周知的，但 HF 患者的 PA 习惯和医生的建议却描述得很差。本研究旨在调查医生是否建议 HF 患者进行运动，并在一家复杂的心脏病医院量化患者的运动情况。
所有 131 名 HF 患者（80 名男性，平均年龄 53±10 岁，NYHA 分级 I-V，左心室射血分数 35±11%，35 例缺血性，35 例特发性，32 例高血压，29 例恰加斯病）到医院进行 HF 常规检查。在这个时候，在看了医生之后，我们询问了患者医生是否建议他们进行 PA。然后，我们让他们填写国际体力活动问卷（IPQA）短表来分类他们的 PA 水平。
我们的数据显示，患者是否从医生那里获得任何类型的 PA 建议存在显著差异（36% vs. 64%，p<0.0001）。根据 IPAQ 标准，在接受过建议的 36%的患者中，12.4%被归类为低水平，23.6%为中水平。在未接受过建议的 64%的患者中，26.8%被归类为低水平，37.2%为中水平。病因（除恰加斯病外）、功能分级、射血分数、性别和年龄均未影响 PA 状况。
三级心脏病医院的医生没有给患者提供满意的 PA 建议。我们的数据支持加强医生对运动的鼓励，并需要对此领域进行补充研究。
