Impacto da intensidade do treino nas respostas cardiovasculares em doentes com doença arterial coronária: revisão sistemática alargada e meta-análise
DOI:
https://doi.org/10.47197/retos.v67.111325Palavras-chave:
capacidade de exercício, treino intervalado de alta intensidade, PCR-us, perfis lipídicos, treino contínuo de intensidade moderadaResumo
Introdução: A intensidade desempenha um papel importante na obtenção do máximo benefício do exercício em doentes com doença coronária (DAC). O efeito superior entre o treino intervalado de alta intensidade (HIIT) e o treino contínuo de intensidade moderada (MICT) é ainda incerto.
Objectivo: investigar o efeito de diferentes intensidades de exercício aeróbio na capacidade de exercício, PCR-as e perfil lipídico em doentes com DAC.
Metodologia: Foi realizada uma pesquisa abrangente em bases de dados como a Pebmed, Scopus, ClinicalKey e ScienceDirect (a partir dos dados mais antigos disponíveis até maio de 2024) para ensaios clínicos randomizados comparando HIIT e MICT entre doentes com DAC. As diferenças médias e o intervalo de confiança (IC) de 95% foram calculados utilizando o modelo de efeitos aleatórios na versão 5.4 do Revman, foi utilizado um gráfico de funil para o viés de publicação e a heterogeneidade foi reportada utilizando as estatísticas I2.
Resultados: Foram identificados 35 estudos, que incluíram 1.879 doentes com DAC. O HIIT resultou numa melhoria significativa da diferença média ponderada no VO2pico (1,39 ml/kg/min, p <0,00001, IC 95%: 0,87 – 1,90, n = 1461, I2=0%) em comparação com o MICT. Além disso, o HIIT resultou numa melhoria significativa do colesterol total (CT) com uma diferença média ponderada (-0,08, p = 0,03, IC 95%: -0,15 – -0,01, n = 738, I2=26%) em comparação com o MICT. Ambas as intensidades melhoraram no PCR-as, LDL-C, HDL-C e TG, mas não houve diferenças estatisticamente significativas.
Conclusões: Este estudo confirmou que o HIIT proporciona uma maior melhoria do VO2 pico e pode ser uma parte importante de um programa de exercício eficaz para doentes com DAC. São necessários ensaios clínicos randomizados melhor desenhados para estabelecer a segurança do HIIT através de marcadores inflamatórios.
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