Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II

Antecedentes: La estratificación pronóstica en Falla cardiaca (FC) es crucial para guiar el manejo clínico y tomar decisiones referentes al tratamiento, brindar educación a pacientes, familias y monitorear la calidad del cuidado de salud Métodos: Estudio observacional prospectivo, de una serie de cl...

Full description

Autores:: Amaris Vergara, Amaury Alexis

Tipo de recurso:

Fecha de publicación:: 2017

Institución:: Universidad Autónoma de Bucaramanga - UNAB

Repositorio:: Repositorio UNAB

Idioma:: spa

id	UNAB2_e8f8c7143e1605b65f4afd48d4ac4de7
oai_identifier_str	oai:repository.unab.edu.co:20.500.12749/1744
network_acronym_str	UNAB2
network_name_str	Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II
dc.title.translated.eng.fl_str_mv	Evaluation of the grip strength of the fist and its prognostic relationship in patients with Foscal heart failure: estudio Force II
title	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II
spellingShingle	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II Heart disease Ischemic heart disease Chagasic cardiomyopathy Medicine Internal medicine Investigations Complications Patients Prevention and control Heart failure New York Heart Association (NYHA) functional class Grip strength Enfermedades cardíacas Cardiopatía isquémica Cardiomiopatía chagásica Medicina Medicina interna Investigaciones Complicaciones Pacientes Prevención y control Falla cardíaca Clase funcional de New York Heart Association (NYHA) Fuerza prensil Chagas
title_short	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II
title_full	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II
title_fullStr	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II
title_full_unstemmed	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II
title_sort	Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II
dc.creator.fl_str_mv	Amaris Vergara, Amaury Alexis
dc.contributor.advisor.spa.fl_str_mv	Cadena Sanabria, Miguel Oswaldo Ochoa Vera, Miguel Enrique
dc.contributor.author.spa.fl_str_mv	Amaris Vergara, Amaury Alexis
dc.contributor.cvlac.*.fl_str_mv	https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001339250;https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000898465
dc.contributor.googlescholar.*.fl_str_mv	https://scholar.google.es/citations?hl=es#user=jQUx5WcAAAAJ
dc.contributor.orcid.*.fl_str_mv	https://orcid.org/0000-0001-9807-3029;https://orcid.org/0000-0002-4552-3388 https://orcid.org/0000-0002-5984-8386
dc.contributor.scopus.*.fl_str_mv	https://www.scopus.com/authid/detail.uri?authorId=56437735000;https://www.scopus.com/authid/detail.uri?authorId=36987156500
dc.contributor.researchgate.*.fl_str_mv	https://www.researchgate.net/profile/Miguel_Cadena-Sanabria;https://www.researchgate.net/profile/Miguel_Ochoa7
dc.subject.keywords.eng.fl_str_mv	Heart disease Ischemic heart disease Chagasic cardiomyopathy Medicine Internal medicine Investigations Complications Patients Prevention and control Heart failure New York Heart Association (NYHA) functional class Grip strength
topic	Heart disease Ischemic heart disease Chagasic cardiomyopathy Medicine Internal medicine Investigations Complications Patients Prevention and control Heart failure New York Heart Association (NYHA) functional class Grip strength Enfermedades cardíacas Cardiopatía isquémica Cardiomiopatía chagásica Medicina Medicina interna Investigaciones Complicaciones Pacientes Prevención y control Falla cardíaca Clase funcional de New York Heart Association (NYHA) Fuerza prensil Chagas
dc.subject.lemb.spa.fl_str_mv	Enfermedades cardíacas Cardiopatía isquémica Cardiomiopatía chagásica Medicina Medicina interna Investigaciones Complicaciones Pacientes Prevención y control
dc.subject.proposal.none.fl_str_mv	Falla cardíaca Clase funcional de New York Heart Association (NYHA) Fuerza prensil Chagas
description	Antecedentes: La estratificación pronóstica en Falla cardiaca (FC) es crucial para guiar el manejo clínico y tomar decisiones referentes al tratamiento, brindar educación a pacientes, familias y monitorear la calidad del cuidado de salud Métodos: Estudio observacional prospectivo, de una serie de clínica de pacientes con diagnóstico de FC del estudio FORCE, a quienes se le realizó seguimiento y visita a los 18 meses. Resultados: de los 120 pacientes incluidos en el estudio FORCE en 2015, se lograron contactar 95 pacientes en 2017. 17 pacientes fallecieron para una mortalidad del 17.8%. A los 78 pacientes restantes, se les realizó un seguimiento a 18 meses. La frecuencia de hospitalización fue del 78% en el periodo evaluado. En el análisis bivariado se encontró un aumento significativo del riesgo de mortalidad en pacientes con fuerza de empuñadura bajo con RR 2.9 IC 95% (1.11 – 7.59). Este comportamiento también se observó en pacientes pertenecientes al grupo III y IV de NYHA que a menor fuerza prensil hay mayor riesgo significativo RR 2.42 IC 95% (1.07 – 5.45). En el modelo multivariado solo se encontró asociación significativa para la clase funcional de manera global con respecto a mortalidad, con un OR 3.52 IC 95% (1.47 – 8.39). Sin embargo, en el análisis de subgrupo por sexo, resalta que sólo se mantienen estos resultados en el grupo de hombres con un OR 3.21 IC 95% (1.11– 9.26) P < 0.031. En cuanto al desenlace de hospitalización el promedio de fuerza de agarre fue menor en las mujeres hospitalizadas vs las que no presentaron el desenlace (18kg/f vs 22kg/f p0.0261). Conclusiones: el principal hallazgo de este estudio es que en pacientes con FC, hay una correlación entre la clase funcional NYHA y fuerza de agarre con el desenlace de mortalidad y hospitalización.. El presente estudio aporta evidencia estadística que justifica futuros estudios prospectivos que incluyan un mayor numero de pacientes y tiempo de seguimiento para confirmar esta relación. La fuerza prensil, por lo tanto, representa una medida aislada de función del músculo esquelético y fragilidad y podría aumentar la caracterización de pacientes con FC avanzada, y podría jugar un papel importante en predecir tasa de hospitalización.
publishDate	2017
dc.date.issued.none.fl_str_mv	2017
dc.date.accessioned.none.fl_str_mv	2020-06-26T19:59:56Z
dc.date.available.none.fl_str_mv	2020-06-26T19:59:56Z
dc.type.driver.none.fl_str_mv	info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv	Tesis
dc.type.redcol.none.fl_str_mv	http://purl.org/redcol/resource_type/TM
dc.identifier.uri.none.fl_str_mv	http://hdl.handle.net/20.500.12749/1744
dc.identifier.instname.spa.fl_str_mv	instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv	reponame:Repositorio Institucional UNAB
url	http://hdl.handle.net/20.500.12749/1744
identifier_str_mv	instname:Universidad Autónoma de Bucaramanga - UNAB reponame:Repositorio Institucional UNAB
dc.language.iso.spa.fl_str_mv	spa
language	spa
dc.relation.references.spa.fl_str_mv	Amaris Vergara, Amaury Alexis (2017). Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio force II. Bucaramanga (Santander, Colombia) : Universidad Autónoma de Bucaramanga UNAB 1. Cadena M, Velandia C. Relationship between handgrip strength and functional class in elderly patients with heart failure. Innovation in aging. 2017;1: 245-246 2. Swedberg K CJ, Dargie H, et al: . Eur Heart J 26:1115, 2005. Guidelines for the diagnosis and treatment of chronic heart failure: Executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005;26:1115. 3. Investigators TS. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327(10):685-91 4. Investigators TS. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325(5):293-302. 5. Group TCTS. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316(23):1429. 6. Gradman A DP, Cody R, Massie B, Packer M, Pitt B, Goldstein S, Captopril-Digoxin Study Group. Predictors of total mortality and sudden death in mild to moderate heart failure. J Am Coll Cardiol. 1989;14(3):564. 7. Levy WC MD, Linker DT, Sutradhar SC, Anker SD, Cropp AB, Anand I, Maggioni A, Burton P, Sullivan MD, Pitt B, Poole-Wilson PA, Mann DL, Packer M. The Seattle Heart Failure Model: prediction of survival in heart failure. Circulation. 2006;113:1424–33. 8. Aaronson KD SJ, Chen TM, Wong KL, Goin JE, Mancini DM. Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. Circulation. 1997;95:2660–7. 9. O’Connor CM WD, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ, Leifer ES, Kraus WE, Kitzman DW, Blumenthal JA, Rendall DS, Miller NH, Fleg JL, Schulman KA, McKelvie RS, Zannad F, Pin˜a IL. HF-ACTION Investigators. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301:1439 –50. 10. Chyu J FG, Tseng CH, Horwich TB. Four-variable risk model in men and women with heart failure. Circ Heart Fail. 2014 7(1):88-95. 11. Anker SD, Coats AJS. Metabolic, functional, and haemodynamic staging for CHF? Lancet 1996; 348: 1530–31. 12. Anker SD, Ponikiwski P, Varney S, Chua TP, Clark AL. Wasting as indepedent risk factor for mortalitu in chronic heart failiure. Lancet 1997;349:1050-53. 13. Mancini DM, Eisen H, Kussmaul W, Mull R, Edmunds LH, Wilson JR. Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure. Circulation 1991;83:778 –86. 14. Huelsmann M, Stanek B, Sturm B, Berger R, Pacher R. Workload is superior to pVO2 predicting outcome in congestive heart failure. Am Heart J 2002;143(2):308 –12. 15. Bittner V. Determining prognosis in congestive heart failure: role of the 6-minute walk test. Am Heart J 1999;138(4):593 –6. 16. Mancini D, Walter G, Reichek N, et al. Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure. Circulation 1992;85:1364 –73. 17. Anker S, Swan J, Volterrani M, Chua T, Clark A, Poole- Wilson P, Coats A. The influence of muscle mass, strength, fatigability and blood flow on exercise capacity in cachectic and non-cachectic patients with chronic heart failure. Eur Heart J 1997;18:259 –69. 18. Drexler H, Riede U, Mu¨nzel T, Ko¨nig H, Funke E, Just H. Alterations of skeletal muscle in chronic heart failure. Circulation. 1992;85:1751 –9. 19. Mancini DM, Coyle E, Coggan A, et al. Contribution of intrinsic skeletal muscle changes to 31P NMR skeletal muscle metabolic abnormalities in patients with chronic heart failure. Circulation 1989;80: 1338-46. 20. Duscha BD, Kraus WE, Keteyian SJ, et al. Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations. J Am Coll Cardiol 1999;33:1956-63. 21. Vescovo G, Volterrani M, Zennaro R, et al. Apoptosis in the skeletal muscle of patients with heart failure: investigation of clinical and biochemical changes. Heart 2000;84:431-7. 22. Anker SD, Chua TP, Ponikowski P, et al. Hormonal changes and catabolic/ anabolic imbalance in chronic heart failure and their importance for cardiac cachexia. Circulation 1997;96:526-34. 23. Cesari M, Leeuwenburgh C, Lauretani F, et al. Frailty syndrome and skeletal muscle: results from the Invecchiare in Chianti study. Am J Clin Nutr 2006;83:1142-8. 24. Afilalo J, Eisenberg MJ, Morin JF, et al. Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. J Am Coll Cardiol 2010;56:1668-76. 25. Lee DH, Buth KJ, Martin BJ, Yip AM, Hirsch GM. Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation 2010;121:973-8. 26. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56: M146-56. 27. Rantanen T, Volpato S, Ferrucci L, Heikkinen E, Fried LP, Guralnik JM. Handgrip strength and cause-specific and total mortality in older disabled women: exploring the mechanism. J Am Geriat Soc 2003;51:636-41. 28. Purser JL, Kuchibhatla MN, Fillenbaum GG, Harding T, Peterson ED, Alexander KP. Identifying frailty in hospitalized older adults with significant coronary artery disease. J Am Geriat Soc 2006;54:1674-81. 29. Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol 2009;103:1616-21. 30. Chung C, Wu C, Jones M, Kato T, Dam T, et al. Reduced Handgrip Strength as a Marker of Frailty Predicts Clinical Outcomes in Patients With Heart Failure Undergoing Ventricular Assist Device Placement.J Cardiac Fail. 2014;20:310-5. 31. Massy-Westropp NM, Gill TK, Taylor AW, Bohannon RW, Hill CL. Hand grip strength: age and gender stratified normative data in a population-based study. BMC Res Notes 2011;4:127. 32. Trampisch US, Franke J, Jedamzik N, Hinrichs T, Platen P. Optimal Jamar dynamometer handle position to assess maximal isometric hand grip strength in epidemiological studies. J Hand Surg 2012;37: 2368-73. 33. Sasaki H, Kasagi F, Yamada M, Fujita S. Grip strength predicts causespecific mortality in middle-aged and elderly persons. Am J Med 2007;120:337-42. 34. Izawa KP, Watanabe S, Osada N, et al. Handgrip strength as a predictor of prognosis in Japanese patients with congestive heart failure. Eur J Cardiovasc Prev Rehab 2009;16:21-7. 35. Chang YT, Wu HL, Guo HR, et al. Handgrip strength is an independent predictor of renal outcomes in patients with chronic kidney diseases. Nephrology 2011;26:3588-95. 36. Rantanen T EP, Heikkinen E. Maximal isometric strength and mobility among 75-year-old men and women. Age Ageing. 1994;23:132-7. 37. Jansen CW NB, Coussirat DJ, et al. Hand force of men and women over 65 years of age as measured by maximum pinch and grip force. J Aging Phys Act 2008;16:24-41. 38. RW. B. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31:3-10. 39. Cantarero-Villanueva I F-LC, Díaz-Rodríguez L, et al. . The handgrip strength test as a measure of function in breast cancer survivors: relationship to cancer-related symptoms and physical and physiologic parameters. Am J Phys Med Rehabil. 2012;91:774-82. 40. Newman AB KV, Visser M, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci. 2006;61:72-7. 41. Marrodán M RCJ, Moreno Romero S. Mesa Santurino, M, et all. Handgrip strength in children and teenagers aged from 6 to 18 years: Reference values and relationship with size and body composition. An Pediatr (Barc). 2009;70:340-8. 42. Boissy P, Bourbonnais, D., Carlotti, M.M., Gravel, D., Arsenault, B.A. Maximal grip force in chronic stroke subjects and its relationship to global upper extremity function. Clinical Rehabilitation 1999;14(4):354e62. 43. Helfant RH DVM, Meister SG. Effect of sustained isometric handgrip exercise on left ventricular performance. Circulation 1971 44(6):982-93. 44. Budziareck MB PDR, Barbosa-Silva MC. Reference values and determinants for handgrip strength in healthy subjects. Clin Nutr. 2008;27:357-62. 45. Gallagher D, Visser M, De Meersman RE, Sepulveda D, Baumgartner RN, Pierson RN, et al. Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol (1985). 1997;83(1):229-39. Epub 1997/07/01. 46. Mette Aadahl NB, Allan Linneberg, Betina Heinsbæk Thuesen, Torben Jørgensen. Grip strength and lower limb extension power in 19-72 year-old Danish men and women: the Health2006 study. BMJ Open. 2011;2:e000192. 47. ChristianM. Günther M, Alexander Bürger, MD, Markus Rickert, MD, Alexander Crispin, MPH, Christoph U. Schulz, MD. Grip Strength in Healthy Caucasian Adults: Reference Values. J Hand Surg Am. 2008;33(4):558-65. 48. Jeune B, Skytthe A, Cournil A, Greco V, Gampe J, Berardelli M, et al. Handgrip strength among nonagenarians and centenarians in three European regions- J Gerontol A Biol Sci Med Sci 2006;61:707-12 49. Mroszczyk-McDonald A, Savage PD, Ades P. Handgrip strength in cardiac rehabilitation: normative values, interaction with physical function, and response to training- J CArdiopulm Rehabil 2007;27:298-302 50. Balducci S ZS, Cardelli P, Salvi L, Bazuro A, Pugliese L, et al. Italian Diabetes Exercise Study (IDES) Investigators. Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES). PLoS One. 2012;7(11):e49297. 51. Davies EJ1 MT, Rees K, Singh S, Coats AJ, Ebrahim S, Lough F, Taylor RS. Exercise based rehabilitation for heart failure. Cochrane Database Syst Rev. 2010;4:CD003331. 52. Onoue Y, Izumiya Y, Hanatani S, Tanaka T, Yamamura S, et al. A simple sarcopenia screening test predicts future adverse events in patients with heart failure. International Journal of Cardiology. 2016; 215:301–6
dc.rights.uri.*.fl_str_mv	http://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.rights.local.spa.fl_str_mv	Abierto (Texto Completo)
dc.rights.accessrights.spa.fl_str_mv	info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2
dc.rights.creativecommons.*.fl_str_mv	Atribución-NoComercial-SinDerivadas 2.5 Colombia
rights_invalid_str_mv	http://creativecommons.org/licenses/by-nc-nd/2.5/co/ Abierto (Texto Completo) http://purl.org/coar/access_right/c_abf2 Atribución-NoComercial-SinDerivadas 2.5 Colombia
eu_rights_str_mv	openAccess
dc.format.mimetype.spa.fl_str_mv	application/pdf
dc.coverage.spa.fl_str_mv	Bucaramanga (Santander, Colombia)
dc.publisher.grantor.spa.fl_str_mv	Universidad Autónoma de Bucaramanga UNAB
dc.publisher.faculty.spa.fl_str_mv	Facultad Ciencias de la Salud
dc.publisher.program.spa.fl_str_mv	Especialización en Medicina Interna
institution	Universidad Autónoma de Bucaramanga - UNAB
bitstream.url.fl_str_mv	https://repository.unab.edu.co/bitstream/20.500.12749/1744/1/2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdf https://repository.unab.edu.co/bitstream/20.500.12749/1744/2/2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdf https://repository.unab.edu.co/bitstream/20.500.12749/1744/3/2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdf.jpg https://repository.unab.edu.co/bitstream/20.500.12749/1744/4/2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdf.jpg
bitstream.checksum.fl_str_mv	64ca2779b2c44d3c68f4d99e938790b2 b6e0dcc694e10fdd7339837c2e55a77b d2524a54cdf1b5e749d98a8fdd2e803c 2521bef96fa2d752299b314a6301b2f0
bitstream.checksumAlgorithm.fl_str_mv	MD5 MD5 MD5 MD5
repository.name.fl_str_mv	Repositorio Institucional \| Universidad Autónoma de Bucaramanga - UNAB
repository.mail.fl_str_mv	repositorio@unab.edu.co
_version_	1814278417354326016
spelling	Cadena Sanabria, Miguel OswaldoOchoa Vera, Miguel EnriqueAmaris Vergara, Amaury Alexishttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001339250;https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000898465https://scholar.google.es/citations?hl=es#user=jQUx5WcAAAAJhttps://orcid.org/0000-0001-9807-3029;https://orcid.org/0000-0002-4552-3388https://orcid.org/0000-0002-5984-8386https://www.scopus.com/authid/detail.uri?authorId=56437735000;https://www.scopus.com/authid/detail.uri?authorId=36987156500https://www.researchgate.net/profile/Miguel_Cadena-Sanabria;https://www.researchgate.net/profile/Miguel_Ochoa72020-06-26T19:59:56Z2020-06-26T19:59:56Z2017http://hdl.handle.net/20.500.12749/1744instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABAntecedentes: La estratificación pronóstica en Falla cardiaca (FC) es crucial para guiar el manejo clínico y tomar decisiones referentes al tratamiento, brindar educación a pacientes, familias y monitorear la calidad del cuidado de salud Métodos: Estudio observacional prospectivo, de una serie de clínica de pacientes con diagnóstico de FC del estudio FORCE, a quienes se le realizó seguimiento y visita a los 18 meses. Resultados: de los 120 pacientes incluidos en el estudio FORCE en 2015, se lograron contactar 95 pacientes en 2017. 17 pacientes fallecieron para una mortalidad del 17.8%. A los 78 pacientes restantes, se les realizó un seguimiento a 18 meses. La frecuencia de hospitalización fue del 78% en el periodo evaluado. En el análisis bivariado se encontró un aumento significativo del riesgo de mortalidad en pacientes con fuerza de empuñadura bajo con RR 2.9 IC 95% (1.11 – 7.59). Este comportamiento también se observó en pacientes pertenecientes al grupo III y IV de NYHA que a menor fuerza prensil hay mayor riesgo significativo RR 2.42 IC 95% (1.07 – 5.45). En el modelo multivariado solo se encontró asociación significativa para la clase funcional de manera global con respecto a mortalidad, con un OR 3.52 IC 95% (1.47 – 8.39). Sin embargo, en el análisis de subgrupo por sexo, resalta que sólo se mantienen estos resultados en el grupo de hombres con un OR 3.21 IC 95% (1.11– 9.26) P < 0.031. En cuanto al desenlace de hospitalización el promedio de fuerza de agarre fue menor en las mujeres hospitalizadas vs las que no presentaron el desenlace (18kg/f vs 22kg/f p0.0261). Conclusiones: el principal hallazgo de este estudio es que en pacientes con FC, hay una correlación entre la clase funcional NYHA y fuerza de agarre con el desenlace de mortalidad y hospitalización.. El presente estudio aporta evidencia estadística que justifica futuros estudios prospectivos que incluyan un mayor numero de pacientes y tiempo de seguimiento para confirmar esta relación. La fuerza prensil, por lo tanto, representa una medida aislada de función del músculo esquelético y fragilidad y podría aumentar la caracterización de pacientes con FC avanzada, y podría jugar un papel importante en predecir tasa de hospitalización.NTRODUCCIÓN 1. OBJETIVO GENERAL 14 1.1 Objetivo Específicos 14 2. PLANTEAMIENTO DEL PROBLEMA 15 3. MARCO TEORICO Y ESTADO DEL ARTE 16 4. METODOLOGIA 24 4.1 Diseño 4.2 Universo 4.3 Población objeto 4.4 Muestra 4.5 Criterios de inclusión y exclusión 4.6 Muestreo 4.7 Variables 4.8 Recolección de la información 28 4.8.1 Evaluación inicial 4.8.2 Recolección de datos 4.8.3 Procesamiento y control de calidad de los datos 4.9 Procesamiento y análisis estadístico 29 8 5. CONSIDERACIONES ETICAS 30 6. RESULTADOS 31 7. DISCUSION 38 8. CONCLUSIONES 42 9. BIBLIOGRAFIA 89EspecializaciónBackground: Prognostic stratification in heart failure (HF) is crucial to guide clinical management and make decisions regarding treatment, provide education to patients, families, and monitor the quality of health care Methods: A prospective observational study of a clinical series of patients with a diagnosis of CF from the FORCE study, who were followed up and visited at 18 months. Results: of the 120 patients included in the FORCE study in 2015, 95 patients were contacted in 2017. 17 patients died for a mortality of 17.8%. The remaining 78 patients were followed up for 18 months. The frequency of hospitalization was 78% in the evaluated period. In the bivariate analysis, a significant increase in the risk of mortality was found in patients with low grip strength with RR 2.9 95% CI (1.11 - 7.59). This behavior was also observed in patients belonging to NYHA group III and IV, where the lower the grip strength, the greater the significant risk RR 2.42 95% CI (1.07 - 5.45). In the multivariate model, only a significant association was found for the functional class globally with respect to mortality, with an OR 3.52 95% CI (1.47 - 8.39). However, in the subgroup analysis by sex, it stands out that only these results in the group of men with an OR 3.21 95% CI (1.11– 9.26) P <0.031. Regarding the hospitalization outcome, the average grip strength was lower in hospitalized women vs those who did not present the outcome (18kg / f vs 22kg / f p0.0261). Conclusions: the main finding of this study is that in patients with CF, there is a correlation between NYHA functional class and grip strength with the outcome of mortality and hospitalization. The present study provides statistical evidence that justifies future prospective studies that include a greater number of patients and follow-up time to confirm this relationship. Grip strength, therefore, represents an isolated measure of skeletal muscle function and frailty and could enhance the characterization of patients with advanced HR, and could play an important role in predicting hospitalization rates.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-SinDerivadas 2.5 ColombiaEvaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force IIEvaluation of the grip strength of the fist and its prognostic relationship in patients with Foscal heart failure: estudio Force IIEspecialista en Medicina InternaBucaramanga (Santander, Colombia)Universidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Medicina Internainfo:eu-repo/semantics/masterThesisTesishttp://purl.org/redcol/resource_type/TMHeart diseaseIschemic heart diseaseChagasic cardiomyopathyMedicineInternal medicineInvestigationsComplicationsPatientsPrevention and controlHeart failureNew York Heart Association (NYHA) functional classGrip strengthEnfermedades cardíacasCardiopatía isquémicaCardiomiopatía chagásicaMedicinaMedicina internaInvestigacionesComplicacionesPacientesPrevención y controlFalla cardíacaClase funcional de New York Heart Association (NYHA)Fuerza prensilChagasAmaris Vergara, Amaury Alexis (2017). Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio force II. Bucaramanga (Santander, Colombia) : Universidad Autónoma de Bucaramanga UNAB1. Cadena M, Velandia C. Relationship between handgrip strength and functional class in elderly patients with heart failure. Innovation in aging. 2017;1: 245-2462. Swedberg K CJ, Dargie H, et al: . Eur Heart J 26:1115, 2005. Guidelines for the diagnosis and treatment of chronic heart failure: Executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005;26:1115.3. Investigators TS. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327(10):685-914. Investigators TS. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325(5):293-302.5. Group TCTS. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316(23):1429.6. Gradman A DP, Cody R, Massie B, Packer M, Pitt B, Goldstein S, Captopril-Digoxin Study Group. Predictors of total mortality and sudden death in mild to moderate heart failure. J Am Coll Cardiol. 1989;14(3):564.7. Levy WC MD, Linker DT, Sutradhar SC, Anker SD, Cropp AB, Anand I, Maggioni A, Burton P, Sullivan MD, Pitt B, Poole-Wilson PA, Mann DL, Packer M. The Seattle Heart Failure Model: prediction of survival in heart failure. Circulation. 2006;113:1424–33.8. Aaronson KD SJ, Chen TM, Wong KL, Goin JE, Mancini DM. Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. Circulation. 1997;95:2660–7.9. O’Connor CM WD, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ, Leifer ES, Kraus WE, Kitzman DW, Blumenthal JA, Rendall DS, Miller NH, Fleg JL, Schulman KA, McKelvie RS, Zannad F, Pin˜a IL. HF-ACTION Investigators. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301:1439 –50.10. Chyu J FG, Tseng CH, Horwich TB. Four-variable risk model in men and women with heart failure. Circ Heart Fail. 2014 7(1):88-95.11. Anker SD, Coats AJS. Metabolic, functional, and haemodynamic staging for CHF? Lancet 1996; 348: 1530–31.12. Anker SD, Ponikiwski P, Varney S, Chua TP, Clark AL. Wasting as indepedent risk factor for mortalitu in chronic heart failiure. Lancet 1997;349:1050-53.13. Mancini DM, Eisen H, Kussmaul W, Mull R, Edmunds LH, Wilson JR. Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure. Circulation 1991;83:778 –86.14. Huelsmann M, Stanek B, Sturm B, Berger R, Pacher R. Workload is superior to pVO2 predicting outcome in congestive heart failure. Am Heart J 2002;143(2):308 –12.15. Bittner V. Determining prognosis in congestive heart failure: role of the 6-minute walk test. Am Heart J 1999;138(4):593 –6.16. Mancini D, Walter G, Reichek N, et al. Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure. Circulation 1992;85:1364 –73.17. Anker S, Swan J, Volterrani M, Chua T, Clark A, Poole- Wilson P, Coats A. The influence of muscle mass, strength, fatigability and blood flow on exercise capacity in cachectic and non-cachectic patients with chronic heart failure. Eur Heart J 1997;18:259 –69.18. Drexler H, Riede U, Mu¨nzel T, Ko¨nig H, Funke E, Just H. Alterations of skeletal muscle in chronic heart failure. Circulation. 1992;85:1751 –9.19. Mancini DM, Coyle E, Coggan A, et al. Contribution of intrinsic skeletal muscle changes to 31P NMR skeletal muscle metabolic abnormalities in patients with chronic heart failure. Circulation 1989;80: 1338-46.20. Duscha BD, Kraus WE, Keteyian SJ, et al. Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations. J Am Coll Cardiol 1999;33:1956-63.21. Vescovo G, Volterrani M, Zennaro R, et al. Apoptosis in the skeletal muscle of patients with heart failure: investigation of clinical and biochemical changes. Heart 2000;84:431-7.22. Anker SD, Chua TP, Ponikowski P, et al. Hormonal changes and catabolic/ anabolic imbalance in chronic heart failure and their importance for cardiac cachexia. Circulation 1997;96:526-34.23. Cesari M, Leeuwenburgh C, Lauretani F, et al. Frailty syndrome and skeletal muscle: results from the Invecchiare in Chianti study. Am J Clin Nutr 2006;83:1142-8.24. Afilalo J, Eisenberg MJ, Morin JF, et al. Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. J Am Coll Cardiol 2010;56:1668-76.25. Lee DH, Buth KJ, Martin BJ, Yip AM, Hirsch GM. Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation 2010;121:973-8.26. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56: M146-56.27. Rantanen T, Volpato S, Ferrucci L, Heikkinen E, Fried LP, Guralnik JM. Handgrip strength and cause-specific and total mortality in older disabled women: exploring the mechanism. J Am Geriat Soc 2003;51:636-41.28. Purser JL, Kuchibhatla MN, Fillenbaum GG, Harding T, Peterson ED, Alexander KP. Identifying frailty in hospitalized older adults with significant coronary artery disease. J Am Geriat Soc 2006;54:1674-81.29. Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol 2009;103:1616-21.30. Chung C, Wu C, Jones M, Kato T, Dam T, et al. Reduced Handgrip Strength as a Marker of Frailty Predicts Clinical Outcomes in Patients With Heart Failure Undergoing Ventricular Assist Device Placement.J Cardiac Fail. 2014;20:310-5.31. Massy-Westropp NM, Gill TK, Taylor AW, Bohannon RW, Hill CL. Hand grip strength: age and gender stratified normative data in a population-based study. BMC Res Notes 2011;4:127.32. Trampisch US, Franke J, Jedamzik N, Hinrichs T, Platen P. Optimal Jamar dynamometer handle position to assess maximal isometric hand grip strength in epidemiological studies. J Hand Surg 2012;37: 2368-73.33. Sasaki H, Kasagi F, Yamada M, Fujita S. Grip strength predicts causespecific mortality in middle-aged and elderly persons. Am J Med 2007;120:337-42.34. Izawa KP, Watanabe S, Osada N, et al. Handgrip strength as a predictor of prognosis in Japanese patients with congestive heart failure. Eur J Cardiovasc Prev Rehab 2009;16:21-7.35. Chang YT, Wu HL, Guo HR, et al. Handgrip strength is an independent predictor of renal outcomes in patients with chronic kidney diseases. Nephrology 2011;26:3588-95.36. Rantanen T EP, Heikkinen E. Maximal isometric strength and mobility among 75-year-old men and women. Age Ageing. 1994;23:132-7.37. Jansen CW NB, Coussirat DJ, et al. Hand force of men and women over 65 years of age as measured by maximum pinch and grip force. J Aging Phys Act 2008;16:24-41.38. RW. B. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31:3-10.39. Cantarero-Villanueva I F-LC, Díaz-Rodríguez L, et al. . The handgrip strength test as a measure of function in breast cancer survivors: relationship to cancer-related symptoms and physical and physiologic parameters. Am J Phys Med Rehabil. 2012;91:774-82.40. Newman AB KV, Visser M, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci. 2006;61:72-7.41. Marrodán M RCJ, Moreno Romero S. Mesa Santurino, M, et all. Handgrip strength in children and teenagers aged from 6 to 18 years: Reference values and relationship with size and body composition. An Pediatr (Barc). 2009;70:340-8.42. Boissy P, Bourbonnais, D., Carlotti, M.M., Gravel, D., Arsenault, B.A. Maximal grip force in chronic stroke subjects and its relationship to global upper extremity function. Clinical Rehabilitation 1999;14(4):354e62.43. Helfant RH DVM, Meister SG. Effect of sustained isometric handgrip exercise on left ventricular performance. Circulation 1971 44(6):982-93.44. Budziareck MB PDR, Barbosa-Silva MC. Reference values and determinants for handgrip strength in healthy subjects. Clin Nutr. 2008;27:357-62.45. Gallagher D, Visser M, De Meersman RE, Sepulveda D, Baumgartner RN, Pierson RN, et al. Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol (1985). 1997;83(1):229-39. Epub 1997/07/01.46. Mette Aadahl NB, Allan Linneberg, Betina Heinsbæk Thuesen, Torben Jørgensen. Grip strength and lower limb extension power in 19-72 year-old Danish men and women: the Health2006 study. BMJ Open. 2011;2:e000192.47. ChristianM. Günther M, Alexander Bürger, MD, Markus Rickert, MD, Alexander Crispin, MPH, Christoph U. Schulz, MD. Grip Strength in Healthy Caucasian Adults: Reference Values. J Hand Surg Am. 2008;33(4):558-65.48. Jeune B, Skytthe A, Cournil A, Greco V, Gampe J, Berardelli M, et al. Handgrip strength among nonagenarians and centenarians in three European regions- J Gerontol A Biol Sci Med Sci 2006;61:707-1249. Mroszczyk-McDonald A, Savage PD, Ades P. Handgrip strength in cardiac rehabilitation: normative values, interaction with physical function, and response to training- J CArdiopulm Rehabil 2007;27:298-30250. Balducci S ZS, Cardelli P, Salvi L, Bazuro A, Pugliese L, et al. Italian Diabetes Exercise Study (IDES) Investigators. Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES). PLoS One. 2012;7(11):e49297.51. Davies EJ1 MT, Rees K, Singh S, Coats AJ, Ebrahim S, Lough F, Taylor RS. Exercise based rehabilitation for heart failure. Cochrane Database Syst Rev. 2010;4:CD003331.52. Onoue Y, Izumiya Y, Hanatani S, Tanaka T, Yamamura S, et al. A simple sarcopenia screening test predicts future adverse events in patients with heart failure. International Journal of Cardiology. 2016; 215:301–6ORIGINAL2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdf2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdfTesisapplication/pdf2507533https://repository.unab.edu.co/bitstream/20.500.12749/1744/1/2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdf64ca2779b2c44d3c68f4d99e938790b2MD51open access2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdf2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdfLicenciaapplication/pdf730841https://repository.unab.edu.co/bitstream/20.500.12749/1744/2/2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdfb6e0dcc694e10fdd7339837c2e55a77bMD52metadata only accessTHUMBNAIL2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdf.jpg2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdf.jpgIM Thumbnailimage/jpeg5940https://repository.unab.edu.co/bitstream/20.500.12749/1744/3/2017_Tesis_Amaury_Alexis_Amaris_Vergara.pdf.jpgd2524a54cdf1b5e749d98a8fdd2e803cMD53open access2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdf.jpg2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdf.jpgIM Thumbnailimage/jpeg11633https://repository.unab.edu.co/bitstream/20.500.12749/1744/4/2017_Licencia_Amaury_Alexis_Amaris_Vergara.pdf.jpg2521bef96fa2d752299b314a6301b2f0MD54metadata only access20.500.12749/1744oai:repository.unab.edu.co:20.500.12749/17442021-11-11 17:44:40.276open accessRepositorio Institucional \| Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.co

Evaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force II

Publicaciones similares