Associação entre o nível de atividade física com marcadores de aterosclerose subclínica em pacientes com doença de chagas crônica
Associação entre o nível de atividade física com marcadores de aterosclerose subclínica em pacientes com doença de chagas crônica
Data
2025
Autores
Diferenz, Erica Maria
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Introdução: A doença de Chagas (DC) é uma infecção parasitária causada pelo protozoário Trypanosoma cruzi (T.cruzi). O perfil clínico-epidemiológico da DC tem se modificado ao longo dos últimos anos, com migração de grande parte dos indivíduos de zonas rurais para centros urbanos, facilitando a mudanças no estilo de vida, como baixos níveis de atividade física (AF), o que pode estar associado a alterações na saúde cardiovascular. Objetivos: O presente estudo teve como objetivo investigar a associação entre níveis de AF com marcadores de aterosclerose subclínica (espessura da camada médio-intimal da artéria carótida comum [ECMI], presença de placa aterosclerótica carotídea [PAC] e quantidade de tecido adiposo epicárdico [TAE]) em pacientes com DC. Método: Trata-se de um estudo transversal incluindo pacientes com sorologia positiva para DC por meio de dois métodos distintos. O nível de AF foi determinado através do questionário IPAQ (International Physical Activity Questionnaire) versão curta. A ECMI e PAC foram verificadas por exame de ecodoppler das artérias carótidas. A quantidade de TAE foi avaliada pelo ecocardiograma transtorácico ao final da sístole. Variáveis sociodemográficas, clínicas e de estilo de vida foram consideradas como covariáveis. Modelos de regressão linear não ajustados e ajustados foram calculados para determinar a associação entre os níveis de AF com ECMI, a presença de PAC e a quantidade de TAE. Resultados: A mediana de idade foi de 62 anos, com maioria de mulheres (56,5%) e predominância de escolaridade inferior a nove anos de estudo (67,6%). A mediana do nível de atividade física total foi de 1.548,0 METs x min/semana, enquanto a de atividade física moderada a vigorosa foi de 720,0 METs x min/semana. A mediana da ECMI foi de 0,65 mm à esquerda e 0,66 mm à direita. Observou-se que 46,4% dos participantes apresentavam PAC. A mediana da TAE foi de 5,0 mm. Não foi observada associação estatisticamente significativa entre aumento dos níveis de AF com menor ECMI, menor quantidade de PAC e menor TAE após ajustes por potenciais variáveis de confundimento. Conclusões: O nível de AF não se associou com os marcadores de aterosclerose subclínica em indivíduos com DC crônica.
Introduction: Chagas disease (CD) is a parasitic infection caused by the protozoan Trypanosoma cruzi (T. cruzi). The clinical and epidemiological profile of CD has changed over the last decades, with a large proportion of individuals migrating from rural areas to urban centers, contributing to lifestyle changes such as lower levels of physical activity (PA), which may be associated with cardiovascular health changes. Objectives: This study aimed to investigate the association between PA levels with markers of subclinical atherosclerosis (carotid intima-media thickness [CIMT], presence of carotid atherosclerotic plaque [CAP], and the amount of epicardial adipose tissue [EAT]) in patients with CD. Methods: This was a cross-sectional study including patients with a positive serological diagnosis for CD confirmed by two distinct methods. PA levels were assessed using the IPAQ short version (International Physical Activity Questionnaire) questionnaire. CIMT and CAP were evaluated via carotid artery Doppler ultrasound. EAT was measured by transthoracic echocardiography at end-systole. Sociodemographic, clinical, and lifestyle variables were considered as covariates. Both unadjusted and adjusted linear regression models were used to determine the association between PA levels and CIMT, CAP presence, and EAT. Results: The median age was 62 years, with a predominance of women (56.5%) and a high percentage of participants with less than nine years of schooling (67.6%). The median total PA level was 1,548.0 MET-min/week, while moderate-to-vigorous PA had a median of 720.0 MET-min/week. Median CIMT was 0.65 mm on the left and 0.66 mm on the right. CAP was present in 46,4% of participants. The median EAT was 5.0 mm. No statistically significant associations were found between higher PA levels and lower CIMT, lower CAP, or lower EAT after adjustment for potential confounding variables. Conclusions: The level of PA physical activity was not associated with subclinical markers of atherosclerosis in individuals with chronic CD.
Introduction: Chagas disease (CD) is a parasitic infection caused by the protozoan Trypanosoma cruzi (T. cruzi). The clinical and epidemiological profile of CD has changed over the last decades, with a large proportion of individuals migrating from rural areas to urban centers, contributing to lifestyle changes such as lower levels of physical activity (PA), which may be associated with cardiovascular health changes. Objectives: This study aimed to investigate the association between PA levels with markers of subclinical atherosclerosis (carotid intima-media thickness [CIMT], presence of carotid atherosclerotic plaque [CAP], and the amount of epicardial adipose tissue [EAT]) in patients with CD. Methods: This was a cross-sectional study including patients with a positive serological diagnosis for CD confirmed by two distinct methods. PA levels were assessed using the IPAQ short version (International Physical Activity Questionnaire) questionnaire. CIMT and CAP were evaluated via carotid artery Doppler ultrasound. EAT was measured by transthoracic echocardiography at end-systole. Sociodemographic, clinical, and lifestyle variables were considered as covariates. Both unadjusted and adjusted linear regression models were used to determine the association between PA levels and CIMT, CAP presence, and EAT. Results: The median age was 62 years, with a predominance of women (56.5%) and a high percentage of participants with less than nine years of schooling (67.6%). The median total PA level was 1,548.0 MET-min/week, while moderate-to-vigorous PA had a median of 720.0 MET-min/week. Median CIMT was 0.65 mm on the left and 0.66 mm on the right. CAP was present in 46,4% of participants. The median EAT was 5.0 mm. No statistically significant associations were found between higher PA levels and lower CIMT, lower CAP, or lower EAT after adjustment for potential confounding variables. Conclusions: The level of PA physical activity was not associated with subclinical markers of atherosclerosis in individuals with chronic CD.
Description
Palavras-chave
Doença de chagas, Espessura íntima-média carotídea, Placa aterosclerótica carotídea, Tecido adiposo epicárdico, Chagas disease, Carotid intima-media thickness, Carotid atherosclerotic plaque, Epicardial adipose tissue.
Citação
Diferenz EM. Associação entre o nível de atividade física com marcadores de aterosclerose subclínica em pacientes com doença de chagas crônica. Rio de Janeiro. Dissertação [Mestrado Profissional em Ciências Cardiovasculares] - Instituto Nacional de Cardiologia - INC; 2025.