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Human Activity Profile Questionnaire: functional assessment and screening for systolic dysfunction in patients with
Lucas Frois Fernandes Oliveira1, Matheus Ribeiro Ávila1,2, Whesley Tanor Silva1,3
1Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil.
Insights
The Human Activity Profile (HAP) effectively identifies left ventricular (LV) systolic dysfunction in chronic Chagas cardiomyopathy (CCC) patients. Lower HAP scores indicate a higher likelihood of LV systolic dysfunction, aiding in functional assessment.
Area of Science:
- Cardiology
- Medical Diagnostics
- Public Health
Background:
- Chronic Chagas cardiomyopathy (CCC) impairs function, causing fatigue and dyspnea.
- Current methods for assessing functional impairment and left ventricular (LV) systolic dysfunction in CCC are limited.
- The Human Activity Profile (HAP) shows promise for evaluating functional capacity in CCC patients.
Purpose of the Study:
- To analyze the association between HAP, functional parameters, and LV systolic dysfunction in CCC patients.
- To determine the accuracy of HAP in identifying LV systolic dysfunction.
- To explore HAP's utility in assessing functional impairment in CCC.
Main Methods:
- 126 patients with CCC (NYHA I-III) underwent echocardiography, the 60-second sit-to-stand test (STS60), and HAP questionnaire.
- Gait speed and handgrip strength were also measured.
- Binary logistic regression and ROC curve analysis were used to assess HAP's association with LV systolic dysfunction.
Main Results:
- HAP scores correlated with gait speed, STS60, and handgrip strength.
- HAP score was the sole functional variable linked to LV systolic dysfunction.
- Patients with LV systolic dysfunction had significantly lower HAP scores (p <0.01), with an optimal cut-off of <56 points (AUC=0.713).
Conclusions:
- HAP score is significantly associated with LV systolic dysfunction in CCC.
- HAP demonstrates acceptable discriminatory ability for identifying LV systolic dysfunction.
- HAP offers a valuable, simple tool for functional evaluation and identifying systolic dysfunction in CCC.
Background:
Patients with chronic Chagas cardiomyopathy (CCC) may present with fatigue and dyspnea, which contribute to functional impairment. However, simple and inexpensive methods for evaluation of functional impairment and identification of left ventricular (LV) systolic dysfunction in patients with CCC are lacking. The Human Activity Profile (HAP) has potential in functional evaluation of patients with CCC. This study was conducted to analyze the association between HAP, functional parameters, and LV systolic dysfunction in patients with CCC, and to demonstrate the accuracy of HAP in identifying LV systolic dysfunction in patients with CCC.
Methods:
One hundred and twenty-six patients with CCC (NYHA I-III, 18.9% with LV systolic dysfunction) were evaluated using echocardiography, the 60-second sit-to-stand test (STS60, for lower limb strength and endurance), and the HAP questionnaire. In addition, the gait speed and handgrip strength of each patient was measured.
Results:
HAP score was correlated with gait speed (r=-0.206; p=0.023), STS60 score (r=0.199, p=0.030), and handgrip strength (r=0.315, p<0.01). Binary logistic regression showed that HAP score was the only functional variable associated with LV systolic dysfunction. Patients with LV systolic dysfunction (n=24) had lower HAP scores than those without LV systolic dysfunction (n=102) (p <0.01). The area under the ROC curve indicated that HAP score had an acceptable discriminatory ability to identify LV systolic dysfunction in patients with CCC (AUC=0.713). The optimal cut-off HAP score for identifying these patients was <56 points.
Conclusion:
HAP score is associated with LV systolic dysfunction in patients with CCC.
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