Objective: To evaluate quality of life in elderly patients with obstructive sleep apnea (OSA) who have a pacemaker. Methods: This was a cross-sectional study involving elderly patients (≥ 60 years of age) with a pacemaker. The dependent variable was quality of life, as evaluated with the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Sociodemographic and clinical parameters, including anxiety and depression (Hospital Anxiety and Depression Scale score), as well as the presence of OSA (defined as an apnea-hypopnea index ≥ 15 events/h), were analyzed as independent variables. Patients with cognitive/neurological deficits or decompensated heart failure were excluded. Results: We evaluated 72 patients, 17 (23.6%) of whom presented OSA. Of those 17 patients, 9 (52.9%) were male. The mean age was 72.3 ± 9.3 years. A diagnosis of OSA was not associated with gender (p = 0.132), age (p = 0.294), or body mass index (p = 0.790). There were no differences between the patients with OSA and those without, in terms of the SF-36 domain scores. Fourteen patients (19.4%) presented moderate or severe anxiety. Of those 14 patients, only 3 (21.4%) had OSA (p = 0.89 vs. no OSA). Twelve patients (16.6%) had moderate or severe depression. Of those 12 patients, only 2 (16.6%) had OSA (p = 0.73 vs. no OSA). Conclusions: In elderly patients with a pacemaker, OSA was not found to be associated with quality of life or with symptoms of anxiety or depression.

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para avaliação de sintomas de depressão. A coleta foi realizada no Ambulatório de Transplante Cardíaco do referido hospital, através de entrevistas individuais. Os dados coletados foram digitados no programa Microsoft Excel versão 2010 e foram utilizados os Softwares Statistical Package for the Social Sciences -SPSS 13.0 para Windows. Todos os testes foram aplicados com 95% de confiança. Esse estudo está baseado na Resolução 466/2012 do Conselho Nacional de Saúde. Esta pesquisa foi aprovada no Comitê de Ética do Instituto de Medicina Integral Professor Fernando Figueira, com CAAE nº66851517.7.0000.5201. Resultados: A amostra foi composta por 76% do sexo masculino, idade média de 47,76 anos e 48% apresentavam baixa escolaridade. Os dados obtidos pela aplicação do BDI-II (n=50) apresentaram média de 13,36, mediana de 13,00, desvio padrão de 7,78. Foram considerados com sintomas de depressão, atingindo escores com mais de 9 pontos, 70%, sendo a diferença de gêneros pouco significativa estatisticamente. Dentre as variáveis relacionadas à sintomas de depressão, somente a necessidade de ansiolítico após o transplante foi estatisticamente relevante. Na comparação do SF-36 com os 35 pacientes sintomáticos para depressão, das suas oito escalas somente limitação por aspectos físicos e aspectos emocionais não foram estatisticamente relevantes. Conclusão: Os sintomas de depressão puderam ser verificados na amostra com impacto significativo na qualidade de vida prioritariamente, quando associados à capacidade funcional, dor, estado geral de saúde, vitalidade, aspectos sociais e saúde mental. Pacientes que se submeteram ao transplante cardíaco devem receber atendimento multidisciplinar a fim de minimizar suas vulnerabilidades.

Introduction: Cardiac transplantation represents a treatment opportunity for cardiovascular diseases that are refractory to traditional methods. For the procedure’s success, the individual needs to be collaborative and remain surrounded by restrictions and intensive care even after its performance. Thus, the emotional burden that surrounds the process contributes to depression after the surgery. The impact of depression on one’s quality of life has been subject of research all over the world, but its value is not completely clarified after a heart transplantation. Objective: To estimate the occurrence of symptoms of depression in 50 patients who underwent cardiac transplantation at the Institute of Integral Medicine Professor Fernando Figueira between 2012 and 2018. Hypothesis: Depression was a frenquent event after cardiac transplatation in the sample of this study. Methods: A cross-sectional observational study using questionnaires adapted, translated and validated in Brazil, the Medical Outcomes Study 36- Item Short-Form Health Survey (SF-36) for quality of life assessment and the Beck II Depression Inventory (BDI-II), for evaluation of depression symptoms. The collection was performed at the Cardiac Transplant Outpatient Clinic of the referred hospital, through individual interviews. The data collected was entered in the program Microsoft Excel version 2010 and the Statistical Package for the Social Sciences - SPSS 13.0 Software for Windows was used. All tests were applied with 95% confidence. This study is based on Resolution 466/2012 of the National Health Council. This research was approved in the Ethics Committee of the Institute of Integral Medicine Professor Fernando Figueira with CAAE n°66851517.7.0000.5201. Results: The sample consisted of 50 patients, 76% male (38 of 50), mean age of 47.76 years and 48% (24 of 50) had low education level. Data obtained by the application of BDI-II (n = 50) presented a mean of 13.36, median of 13.00, standard deviation of 12.76. Of the sample, 70% (35 of 50) were considered to have symptoms of depression, reaching scores with more than 9 points, the difference of genres being of little statistical significance. Among the variables related to the symptoms of depression, only the need for anxiolytic after transplantation was statistically relevant. In the comparison of the SF-36 with the 35 symptomatic patients for depression, of their eight scales only limitation by physical aspects and emotional aspects were not statistically relevant. Conclusion: The symptoms of depression could be verified in the sample with a significant impact on quality of life, when associated with functional capacity, pain, general health, vitality, social aspects and mental health. Patients who underwent heart transplantation should receive multidisciplinary care in order to minimize their vulnerabilities.

Introduction: Cardiac allograft vasculopathy (CAV) is the main cause of chronic graft failure in cardiac transplant patients and plays a significant role in overall morbimortality of the post-transplantation population. In spite of the many available exams currently able to detect CAV subclinical development, they generally display important clinical limitations and lack early diagnosis sensibility. Therefore, the investigation of alternative technologies is essential for the better recognition and prevention of such condition. Methods: Exploratory study on the use of peripheral arterial tonometry as assessment of endothelial health of post-transplant patients. Patients were enrolled from Brazil’s 3rd largest heart transplant center, Instituto de Medicina Integral Professor Fernando Figueira, and subsequently evaluated with EndoPAT2000 between August 2019 and February 2020, when COVID-19 pandemic prematurely concluded the study. Eligible patients had at least 2 years of transplant afterlife and were regularly hospital monitored. The patients’ cardiac catheterism records were collected for more accurate comparison with endothelial results. Medications, preexisting conditions, and transplant information were acquired from medical records. The main outcomes consisted of peripheral arterial tonometry detection capability of endothelial abnormality degree and CAV. Results: Sample size of 22 patients (mean age 50.9, 90.9% men) submitted for EndoPAT2000 exam. Of these, 14 had prior catheterism records (3 had confirmed CAV, 2 coronary fistulas, 9 no abnormalities) and 9 didn′t. When compared with the non catheterism group (2.25 ± 0.41, 0.80 ± 0.19, 8.13 ± 12.21, 16.49 ± 13.87) patients who underwent the procedure (1.89 ± 0.56, 0.60 ± 0.28, 0.72 ± 10.78, 8.54 ± 12.69) had reasonably lower RHI, LnRHI, AI, and AI@75 respectively. CAV confirmed patients (1.99 ± 0.69, 0.65 ± 0.34, -2.07 ± 3.72, 4.40 ± 6.74) had no significant RHI differences, yet displayed slightly lower AI values. Conclusion: The findings of this study suggest there was no significant difference of endothelial health per peripheral arterial tonometry examination between the average catheterism population and CAV patients. Larger studies are needed to confirm such findings.