Effect of Physical Exercise Training in Patients With Chagas Heart Disease (from the PEACH STUDY)

Area of Science:

• Cardiology
• Exercise Physiology
• Tropical Medicine

Background:

• Chagas heart disease (HD) is a chronic, fibrosing myocarditis associated with high mortality.
• Left ventricular dysfunction and heart failure are common complications in Chagas HD.
• Limited evidence exists on the efficacy of exercise interventions for improving functional capacity in this patient population.

Purpose of the Study:

• To evaluate the impact of supervised exercise training on functional capacity in patients with Chagas HD and left ventricular dysfunction or heart failure.
• To assess changes in cardiopulmonary exercise test variables, cardiac function, body composition, and metabolic biomarkers.

Main Methods:

• A single-center, parallel-group clinical trial involving 30 clinically stable Chagas HD patients.
• Patients were randomized to either supervised exercise training (3 times/week for 6 months) or a control group.
• Both groups received standard pharmaceutical and nutritional counseling; the primary endpoint was peak exercise oxygen consumption (peak VO2).

Main Results:

• The exercise group showed an increase in peak VO2 from 17.60 to 19.40 mlO2 kg-1 min-1, while the control group experienced a decrease from 15.40 to 12.96 mlO2 kg-1 min-1.
• Significant differences in the change of peak VO2 were observed between groups (β = +4.6, p = 0.004).
• Improvements were also noted in anaerobic threshold (p = 0.05), peak oxygen pulse (p = 0.032), and maximum minute ventilation (p < 0.0001) in the exercise group compared to controls.

Conclusions:

• Supervised exercise training is effective in improving functional capacity in chronic Chagas HD patients with left ventricular dysfunction and/or heart failure.
• Exercise interventions can positively impact key cardiopulmonary parameters in this population.
• Further research may explore long-term benefits and optimal exercise protocols for Chagas HD management.