Assessment of functional performance in Chagas heart disease by Human Activity Profile questionnaire

Abstract

Purpose

To verify the association between Human Activity Profile and functional capacity, functional class and systolic function of the patients with Chagas heart disease (CHD).

Methods

Sixty-two patients with CHD were evaluated by echocardiography, maximal exercise testing and Human Activity Profile questionnaire. The sample was stratified, according to the values of peak oxygen uptake (low or normal), functional class (symptomatic or asymptomatic), and left ventricular ejection fraction (preserved or systolic dysfunction). Linear regression and two-group comparisons analyses were used. Receiver-operating characteristic analysis was used to determine different cutoff values of the Human Activity Profile for low peak oxygen uptake prediction.

Results

Peak oxygen uptake was an independent predictor of Human Activity Profile (R²-adjusted = 0.27). Patients with low peak oxygen uptake had lower scores in Human Activity Profile [difference of 6.9 (95%CI 2.5–11.4)] than those with normal peak oxygen uptake. Symptomatic patients also showed lower scores when compared to the asymptomatic [difference of 6.2 (95%CI 1.7–10.8)]. There was no difference between left ventricular ejection fraction classes. The Human Activity Profile score of 76.5 was the optimal cut point value in predicting low peak oxygen uptake (sensitivity = 66.0% and specificity = 71.8%).

Conclusion

The Human Activity Profile questionnaire is associated with functional capacity of patients with CHD and is able to identify individuals with low peak oxygen uptake.

Implications for rehabilitation

• Functional impairment is one of the most common clinical findings in all stages and is an important predictor of poor prognosis of the Chagas heart disease;

• A patient-derived measure of functional capacity is potentially useful in the setting of the Chagas heart disease;

• The Human Activity Profile questionnaire is effective in the identification of patients with Chagas heart disease with functional impairment and may be a valid method for functional evaluation.

Keywords:

• Chagas disease
• evaluation
• patient-reported outcomes
• oxygen uptake
• daily activities
• ROC curve

Acknowledgments

The Laboratory of Cardiovascular Rehabilitation, Laboratory of Inflammation and Metabolism, and Laboratory of Exercise Physiology of Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The present work was financially supported by Fundação de Amparo à Pesquisa do Estado de Minas Gerais.