O teste ergométrico em indivíduos com obesidade mórbida

• Ano de defesa: 2008
• Autor(a) principal: Fornitano, Luis Domingos
• Orientador(a): Godoy, Moacir Fernandes de
• Banca de defesa: Bestetti, Reinaldo Bulgarelli , Cipullo, José Paulo , Vanderlei, Luiz Carlos Marques , Chalela, William Azem
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Faculdade de Medicina de São José do Rio Preto
• Programa de Pós-Graduação: Programa de Pós-Graduação em Ciências da Saúde::123123123123::600
• Departamento: Medicina Interna; Medicina e Ciências Correlatas::123123123123::600
• País: BR
• Palavras-chave em Português: Teste ergométrico; Obesidade mórbida; Cirurgia bariátrica; Avaliação de risco; Índice de massa corporal; Teste de Esforço; Obesidade Mórbida; Medição de Risco
• Palavras-chave em Inglês: Treadmill test; Morbid obesity; Bariatric surgery; Risk assessment; Body mass index; Cardiology; Exercise Test; Obesity, Morbid
• Palavras-chave em Espanhol: Prueba de Esfuerzo; Obesidad Mórbida; Medición de Riesgo; Índice de Masa Corporal
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CARDIOLOGIA::3831979423518044663::600
• Link de acesso: http://bdtd.famerp.br/handle/tede/80

Obesity is an independent risk factor for cardiovascular disease, especially in its morbid form. Bariatric surgery is an effective therapeutic option for sustained weight loss. However, there is no consensus in these cases regarding the performance of functional tests for preoperative evaluations. Objective: The aim of the present study was to analyze clinical, electrocardiographic and hemodynamic response variables using a conventional exercise test on individuals with morbid obesity in comparison to overweight individuals. Materials and Method: Six hundred seventeen cases were included. Group I had 290 patients with morbid obesity and Group II had 327 overweight patients. All were submitted to a conventional treadmill exercise test. Classic positivity criteria were used. Results: Both groups tolerated the test well. There was no statistically significant difference in terms of positivity of the test [ST segment abnormality or angor (p=0.3863) or ST segment abnormality alone (p=0.1000)]. The significantly higher values in the obese individuals were basal heart rate (HR), basal sistolic arterial pressure (SAP), maximum SAP, basal diastolic arterial pressure (DAP), maximum DAP, chronotropic incompetence (p<0.0001) and maximum double product (p<0.0421). The significantly lower values in the obese individuals were exercise time, maximum HR and METs values (p<0.0001). Conclusions: Hemodynamic parameters were significantly different between the two groups. However, there were no differences in terms of ST segment abnormalities or effort-induced angina. The very low functional capacity and complex arrhythmia found in some obese individuals draws attention to the need for complementary investigation with the aim of diminishing the risk of postoperative heart complications.