Are anthropometric measurements and body composition related to the occurrence of signs and symptoms in cardiac rehabilitation programs?

Author(s)

Heloisa Balotari Valente

• Document type: Master's Dissertation
• Press: Presidente Prudente. 2022-03-31.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente
• Defense date: 2022-03-17
• Advisor: Luiz Carlos Marques Vanderlei

Abstract

Background: Signs and symptoms are frequent in cardiac rehabilitation programs (CRP). Anthropometric measurements and body composition have been related to the occurrence of major adverse events. Identification of whether anthropometric measurements and body composition are related to the occurrence of signs and symptoms may guide therapeutic approaches and risk stratification strategies used in CRP and contribute to increased patient safety. Aim: To investigate the relationship between anthropometric measurements and body composition with the occurrence of signs and symptoms in CRP, considering sex, age, and cardiorespiratory fitness. Methods: An observational longitudinal study that included participants diagnosed with cardiovascular disease (CVD) or CVD risk factors, from an exercise-based CRP. Demographic (age and sex) and medical data (diagnosis, time of participation in the CRP, CVD risk factors, comorbidities, and medicines in use) were obtained from the CRP records of each participant. Anthropometric measurements (body weight, height, abdominal, calf, hip, mid-upper arm, and waist circumferences, waist-hip ratio, waist-height ratio, conicity index, body adiposity index, body mass index, abdominal volume index, body shape index, and body roundness index) were assessed using a scale, a stadiometer, and a tape measure or were calculated. Body composition variables (body fat, body fat percentage, fat-free mass, total body water, and hydration of fat-free mass) were assessed using tetrapolar bioimpedance equipment. Signs (arrhythmias, increased systolic (SBP) >200mmHg and/or diastolic (DBP) >120mmHg blood pressure during the exercise, tachypnea, and pallor) and symptoms (angina, cramp, muscle pain, fatigue, dizziness, and nausea) were assessed in 24 CRP sessions. Participants were divided into groups by sex, and by the median of the sample for maximal oxygen uptake (VO2 max) and age, to evaluate the relationships between anthropometric measurements and body composition with the occurrence of signs and symptoms considering sex, age, and cardiorespiratory fitness. The relationships were tested using Pearson's or Spearman's correlations, depending on the normality of the data (Shapiro-Wilk). The statistical significance level was set at <0.05. Results: Small positive correlations of muscle pain with body mass index (r=0.274) and body fat percentage (r= 0.249), increased DBP in exercise with midupper arm circumference (r=0.242) and body fat percentage (r=0,264), arrhythmias with hydration of fat-free mass (r= 0.261), and total signs and symptoms with hydration of fatfree mass (r= 0.252) were observed. Small negative correlations were found between increased DBP in exercise with body shape index (r=-0.261), and between cramps with waist circumference (r=-0.259) and abdominal volume index (r=-0.247). A higher number of significant correlations were observed in the male group, younger group, and lower VO2 max group. Conclusion: The occurrence of muscle pain seems to be related to a higher body mass index and higher fat mass percentage, increased DBP in exercise seems to be related to a higher mid-upper arm circumference and higher fat mass percentage, and arrhythmias and total signs and symptoms seem to be related to higher hydration of fat-free mass. The occurrence of increased DBP in exercise seems to be related to a lower body shape index, and cramps seem to be related to a lower waist circumference and abdominal volume index. The relationships between anthropometric measurements and body composition with signs and symptoms seem to be influenced by sex, age, and cardiorespiratory fitness. (AU)

• FAPESP's process: 20/10366-6 - Are anthropometric measures and body composition are related to the occurrence of signs and symptoms in cardiovascular rehabilitation programs?
• Grantee: Heloisa Balotari Valente
• Support Opportunities: Scholarships in Brazil - Master