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Objective: Translation, cultural adaptation and validation of the Brazilian Portuguese version of the Edinburgh Claudication Questionnaire (ECQ) a specific tool to assess intermittent claudication., Methods: The Brazilian Portuguese version of the ECQ was developed after authorization by the University of Edinburgh. It was applied to 217 individuals: São Paulo Capital District residents with complaints of leg pain. Individuals under research were invited through mass communication media to participate in the I Campaign to Fight Peripheral Arterial Disease (PAD). In stage 1, participants filled out the ECQ and another questionnaire on risk factors and cardiovascular history. In stage 2, participants had anthropometric measures and ankle-brachial index (ABI) at rest measured by vascular Doppler. In case of doubt, vascular treadmill test was applied (VTT). PAD condition was defined by ABI < or = 0.90 and/or positive VTT and/or documented PAD. Statistical analysis--which included performance assessment and the comparison between proportions and means--was performed using SAS software, version 8.2., Results: Mean age of participants was 60+/-11.5 years, female sex predominated in the sample studied (53.4%). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 85%, 93%, 80%, 95% and 91%, respectively. No differences in performance were found between elderly (> or = 65 years) and non-elderly subjects., Conclusion: The Brazilian Portuguese version of the Edinburgh claudication questionnaire maintained good sensitivity and specificity and can be recommended for screening of PAD in clinical practice and epidemiological research in Brazil.

Objective: Patients who underwent heart transplantation (HTX) experience a reduction in the elevation that is usual in systolic blood pressure during exercise testing. Of unknown origin, this phenomenon varies in frequency and intensity. The aim of this study was to analyze the relationship between systolic blood pressure increase (delta SBP) and clinical aspects, as well as variables measured during exercise testing (ET) and dobutamine stress echocardiography (DSE) in patients in the late post-transplantation course., Methods: Forty-five men, mean age 49.04 +/- 10.19, underwent clinical assessment, ET and DSE 40.91 +/- 27.46 months after heart transplantation. Left ventricular wall motion score index and ejection fraction were assessed. Delta SBP < 35 mmHg during ET was considered abnormal (SBC,1995)., Results: No significant correlation was found between delta SBP and post-transplantation time, graft ischemic time, history of rejection, diltiazem dosage, oxygen uptake, ejection fraction, and wall motion score index (WMSI). Delta SBP was normal in 17 patients (Group I) and abnormal in 28 (Group II). Patients of both groups did not differ significantly in regard to clinical features and ET and DSE results., Conclusion: Unlike other populations, no correlation was found between delta SBP during exercise testing and clinical condition or left ventricular function in heart transplant patients. Pathophysiological factors associated with delta SBP reduction during exercise testing remain unknown.

Purpose: To evaluate the early and late cardiorespiratory responses after balloon mitral valvuloplasty., Methods: Nine female patients aged 35 +/- 9 years with mitral stenosis, in class II or III (NYHA) underwent up-right ergoespirometric test, resting electrocardiogram and echocardiogram before, 3 to 5 days (early evaluation) and 8 to 12 months (late evaluation) after mitral valvuloplasty. All patients were treated with digitalis and diuretics., Results: During late evaluation, 44% patients were in class II and 56% were in class I (NYHA). The resting heart rate decreased (87 +/- 11 bpm vs 85 +/- 7 bpm vs 75 +/- 9 bpm) and the number of steps increased (4 +/- 1 steps vs 5 +/- 2 steps vs 6 +/- 1 steps); the peak oxygen uptake improved only in the late evaluation (16 +/- 3 mL/kg/min vs 18 +/- 4 mL/kg/min vs 22 +/- 7 mL/kg/min). The anaerobic threshold, minute ventilation (VE) and ventilatory equivalent for oxygen showed no change. The heart rate (1st step: 124 +/- 18 bpm vs 112 +/- 13 bpm vs 87 +/- 15 bpm), O2 uptake (1st step: 10 +/- 2 mL/ kg/min vs 8 +/- 2 mL/kg/min vs 8 +/- 2 mL/kg/min) and VE decreased during submaximal exercise in early and late phases. The mitral valve area decreased in the late evaluation (0.94 cm2 vs 1.66 cm2 vs 1.20 cm2)., Conclusion: Although partial restenosis tended to occur in these patients, they improved the functional class and cardiorespiratory performance and cardiocirculatory load during submaximal exercise.

Purpose: To evaluate the cardiorespiratory response of heart transplant (HT) recipients., Methods: Nine HT recipients (GI) underwent ergospirometric tests and were compared to 9 apparently healthy, sedentary subjects with similar sex, age, weight and height (GII). All were male patients aging 48 +/- 12 years, in functional class I (NYHA) an average of 23 +/- 21 months after HT. They were receiving cyclosporin, azathioprine, prednisone, dipyridamole and antihypertensive drugs. The tests were symptom-limited and they were interrupted due to exhaustion., Results: During peak exercise, GI had a significantly lower physical performance related to lower VO2, VE, VEO2, HR, endurance time and work load. At the anaerobic threshold, VO2, endurance time and work load levels were also significantly lower in GI. The physical performance was similar between the groups in the 40W load., Conclusion: The cardiorespiratory performance in GI was significantly lower at peak exercise and similar to GII in the 40W load, showing the HT benefits cardiac patients during usual activities.