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Papers by Fabiana Marques

Revista da Sociedade de Cardiologia do Estado de São Paulo

Cardiovascular diseases (CVD) are the leading cause of death in Brazil and, among them, coronary ... more Cardiovascular diseases (CVD) are the leading cause of death in Brazil and, among them, coronary artery disease (CAD) was the leading cause of death in the country. CAD includes symptomatic and asymptomatic clinical conditions related to reduced blood flow to the heart muscle. Chest pain caused by myocardial ischemia, known as angina pectoris, is usually brought on by exertion or emotional stress. Physical exercise has numerous benefits on cardiovascular risk factors and the cardiovascular system, such as improvement in angina through increased myocardial oxygen delivery and increased exercise capacity, an independent predictor of increa-sed survival. Cardiovascular rehabilitation (CVR) based on physical exercises has consistently demonstrated its effectiveness in reducing cardiovascular mortality and hospitalizations in patients with CAD. CVR is recommended for a healthy lifestyle and for managing cardiovascular risk factors by prescribing 30 to 60 minutes of moderate-intensity aer...

Journal of Cardiac Failure, 2016

due to severe sepsis. All patients however did have decreasing lactic acid level which points to ... more due to severe sepsis. All patients however did have decreasing lactic acid level which points to resolving sepsis. Prospective studies with larger sample size may clarify the effect of larger volume of fluid in CHF patients with severe sepsis and septic shock.

Clinical Nutrition ESPEN, 2019

Background: We tested the hypothesis that a normal sodium diet could be associated with preservat... more Background: We tested the hypothesis that a normal sodium diet could be associated with preservation of serum sodium during treatment of acute decompensated heart failure (ADHF). Methods and results: Forty-four patients hospitalized for ADHF were blindly randomized by using block method to a low sodium diet (LS: 3 g/day of dietary sodium chloride; n ¼ 22, 59.5 ± 11.9 y.o., 50% males. LVEF ¼ 30.0 ± 13.6%); and a normal sodium diet (NS: 7 g/day; n ¼ 22, 56.4 ± 10.3 y.o., 68% males; LVEF ¼ 27.8 ± 11.7%), and both groups were submitted to fluid restriction of 1.000 mL/day. At the 7th day of intervention 16 patients of LS group and 15 patients of NS group were assessed for difference in serum sodium. Both groups had equivalent decongestion, reflected by similar percent reduction of body weight (LS: À5.0 ± 4.7% vs NS: À4.5 ± 5.2%. p ¼ 0.41). Reduction of the N terminal fragment of type B natriuretic peptide (NT-proBNP) was significant only in the NS (À1497.0 [À18843.0 À 1191.0]. p ¼ 0.04). The LS group showed lower levels of serum sodium (135.4 ± 3.5 mmol/L) compared to the NS group (137.5 ± 1.9 mmol/L; p ¼ 0.04). Four cases of hyponatremia were observed only in the LS group (22%). The NS group exhibited higher mean blood pressure values (79.4 ± 2.4 mmHg vs 75.5 ± 3.0 mmHg. p ¼ 0.03), and lower heart rate (73.2 ± 1.6 bpm vs 75.5 ± 2.1 bpm. p ¼ 0.02). Conclusions: These results suggest that a normal sodium diet, when compared to a low sodium diet, is associated with similar degrees of decongestion, but with higher levels of natremia, blood pressure and lower neurohormonal activation during ADHF treatment. Trial Registration: clinicaltrials.gov Identifier no. NCT03722069.

Arquivos brasileiros de cardiologia, 2018

Maintenance of orthostatism requires the interaction of autonomic and muscle responses for an eff... more Maintenance of orthostatism requires the interaction of autonomic and muscle responses for an efficient postural control, to minimize body motion and facilitate venous return in a common type of syncope called neurocardiogenic syncope (NCS). Muscle activity in standing position may be registered by surface electromyography, and body sway confirmed by displacement of the center of pressure (COP) on a force platform. These peripheral variables reflect the role of muscles in the maintenance of orthostatism during the active tilt test, which, compared with muscle activity during the passive test (head-up tilt test), enables the analyses of electromyographic activity of these muscles that may anticipate the clinical effects of CNS during these tests. to evaluate and compare the effects of a standardized protocol of active and passive tests for CNS diagnosis associated with the effects of Valsalva maneuver (VM). twenty-thee clinically stable female volunteers were recruited to undergo bot...

Journal of Cardiac Failure, 2016

Introduction: Iron deficiency (ID) is a common comorbidity in chronic heart failure patients that... more Introduction: Iron deficiency (ID) is a common comorbidity in chronic heart failure patients that can be routinely diagnosed by serum laboratorial tests showing reduced ferritin and/or transferrin saturation (TSAT) levels. However, it is not clear the impact on survival of different biochemical tests widely used for ID diagnosis. Hypothesis: We hypothesized that different laboratorial tests for ID diagnosis also implies in different prognostic values in heart failure patients. Methods: We performed a cohort study with 108 chronic and stable heart failure patients, attended in an outpatient clinic. The mean age was 59 ± 14 years, 53% were male, 31% had Chagas Disease, and 35% were NYHA functional class III/IV. The mean follow-up time was 712 ± 277 days, and the primary endponint investigated was all-cause death. We analysed biochemical levels of ferritin, serum iron, and latent iron binding capacity, which were used to estimate TSAT. Cutoff values for serum ferritin was <100 ng/dL and TSAT <20%. Combined values of ferritin and TSAT determined three metabolic states: iron depleted stores (ferritin <100 ng/dL with TSAT >20%), functional iron deficiency (TSAT <20% ferritin >100 ng/dL), and absolute iron deficiency (ferritin <100 ng/dL to TSAT <20%). Results: During the study, 31 (28.7%) deaths were reported. A univariate analysis showed a higher mortality rate in patients with serum sodium <130 mmol/L (P < .001), advanced NYHA functional class (III/IV) (P < .05), systolic blood pressure <90 mmHg (P < .01), and creatinine clearance <60 mL/min (P < .01). In the univariate analysis for ID assessments, only TSAT <20% was associated with poor survival (P < .01). On metabolic iron states investigation, functional (P < .05) and absolute iron deficiency (P < .01) were associated with worse prognosis. In a multivariate model TSAT <20% (HR 2.15-P < .005) and functional iron deficiency (TSAT <20% with ferritin >100 ng/dL) (P < .005; HR 1.81) remained independent prognostic factors. Iron depleted stores, diagnosed solely by ferritin <100 ng/dL, had no correlation with survival. Conclusions: Iron deficiency, diagnosed when TSAT parameter <20%, identified heart failure patients with higher mortality, independent of ferritin values.

Arquivos Brasileiros de Cardiologia, 2016

Background: Numerous studies show the benefits of exercise training after myocardial infarction (... more Background: Numerous studies show the benefits of exercise training after myocardial infarction (MI). Nevertheless, the effects on function and remodeling are still controversial. Objectives: To evaluate, in patients after (MI), the effects of aerobic exercise of moderate intensity on ventricular remodeling by cardiac magnetic resonance imaging (CMR). Methods: 26 male patients, 52.9 ± 7.9 years, after a first MI, were assigned to groups: trained group (TG), 18; and control group (CG), 8. The TG performed supervised aerobic exercise on treadmill twice a week, and unsupervised sessions on 2 additional days per week, for at least 3 months. Laboratory tests, anthropometric measurements, resting heart rate (HR), exercise test, and CMR were conducted at baseline and follow-up. Results: The TG showed a 10.8% reduction in fasting blood glucose (p = 0.01), and a 7.3-bpm reduction in resting HR in both sitting and supine positions (p < 0.0001). There was an increase in oxygen uptake only in the TG (35.4 ± 8.1 to 49.1 ± 9.6 mL/kg/min, p < 0.0001). There was a statistically significant decrease in the TG left ventricular mass (LVmass) (128.7 ± 38.9 to 117.2 ± 27.2 g, p = 0.0032). There were no statistically significant changes in the values of left ventricular end-diastolic volume (LVEDV) and ejection fraction in the groups. The LVmass/EDV ratio demonstrated a statistically significant positive remodeling in the TG (p = 0.015). Conclusions: Aerobic exercise of moderate intensity improved physical capacity and other cardiovascular variables. A positive remodeling was identified in the TG, where a left ventricular diastolic dimension increase was associated with LVmass reduction.

Journal of Cardiac Failure, 2012

Background: In patients who are treated with diuretics, blood urea nitrogen (BUN) to serum creati... more Background: In patients who are treated with diuretics, blood urea nitrogen (BUN) to serum creatinine (Scr) ratio is frequently used to evaluate intravascular volume status. Objective: We aimed to investigate the correlation between BUN to Scr ratio and invasive hemodynamic assessment of intravascular volume status. Methods: Data from patients who underwent right heart catheterization (RHC) at our center from 2008 to 2011 were reviewed. We obtained BUN, Scr and BUN to Scr ratio from Lab collected within 24 hour from the RHC. We obtained right atria (RA) pressure and pulmonary capillary wedge pressure from the RHC. A total of 501 patients were included in the analysis. 213 patients had BUN/Cr ratio more than 20. There was no correlation between high BUN to Scr ratio with RA pressure. Linear regression analysis was used, adjusted R-squared 5 0.0157. Conclusion: High BUN to Scr ratio did not predict intravascular volume status in our population, and this could be due to rapid diuresis, and diuretics therapy in patients with symptomatic heart failure should not be based on this ratio.

Arquivos Brasileiros de Cardiologia, 2010

Background: Large clinical trials using the betablockers carvedilol, metoprolol, bisoprolol and n... more Background: Large clinical trials using the betablockers carvedilol, metoprolol, bisoprolol and nebivolol have demonstrated improvement of survival and symptoms in patients with heart failure. Despite the lack of scientific evidence, it is plausible that their beneficial effects are extensible to other betablockers. Objective: To evaluate the impact of the replacement of carvedilol for propranolol on left ventricular function, functional capacity, quality of life, pressure levels, and cardiac autonomic control in patients with heart failure. Methods: Twenty nine patients receiving optimized drug therapy including maximum tolerated doses of carvedilol were divided into two groups: replacement of carvedilol for propranolol (n = 15) and continued carvedilol (n = 14). At baseline and 6 months later, clinical and laboratorial assessments were carried out with radionuclide ventriculography, echocardiography, Minnesota questionnaire, walk test, APBM and Holter monitoring. Results: The clinical and demographic characteristics were similar in the two groups at baseline. Individualized propranolol dose adjustment ensured a similar degree of beta-blockade, as assessed by resting heart rate and chronotropic reserve. The mean propranolol dose used was 109 ± 43 mg/day. Only one patient presented with intolerance to propranolol, thus carvedilol was reintroduced. One death was recorded in group propranolol. Ejection fraction significantly increased in the propranolol group. No significant change was observed in the other cardiovascular variables after betablocker replacement. Conclusion: Our results indicate that replacement of carvedilol for propranolol in patients with heart failure is not associated with deterioration of the ejection fraction, functional capacity, quality of life, and other cardiovascular variables related to autonomic and blood pressure control.

Arquivos Brasileiros de Cardiologia, 2011

Background: Chronic heart failure (HF) is a syndrome characterized by reduced cardiac output in r... more Background: Chronic heart failure (HF) is a syndrome characterized by reduced cardiac output in relation to the metabolic needs of the organism, as well as metabolic and neurohormonal axis abnormalities. Symptoms such as fatigue and dyspnoea are notorious and stress tests are widely used to assess functional capacity, prognosis and effectiveness of therapeutic interventions in this syndrome. Objective: To evaluate the reproducibility of the six-minute walk test (6MW) in patients with HF and correlate the magnitude of the variables reached at peak exercise of the 6MWT with a cardiopulmonary exercise test (CPET). Methods: We studied 16 patients (12 men and 4 women) diagnosed with HF FC I-II (NYHA). The volunteers underwent two 6MWT (6MWT'1 and 6MWT'2) with 30-minute interval between them; then, they underwent a maximum CPET. Results: All variables obtained in the two 6MWT' proved to be significant with high correlations: distance walked (DW) (r = 0.93, p < 0.0001), heart rate (HR) (r = 0.89, p < 0.0001), oxygen consumption (VO 2) (r = 0.93, p < 0.0001) and scale of perceived exertion (r = 0.85, p < 0.0001). In turn, all variables analyzed in the 6MWT' showed significant and moderate correlations with the variables obtained from the CPET, namely: peak HR (r = 0.66; p = 0.005); VO 2 (r = 0.57; p = 0.02) and VO 2 in the CPET and DT in the 6MWT'2 (r = 0.70; p = 0.002). Conclusion: The 6MWT was reproducible in this group of patients with HF (NYHA-I-II) and correlated with the CPET. Therefore, it is a tool for reliable evaluation, and a suitable, safe and low-cost alternative for the prescription of aerobic exercise in patients with HF.

Revista da Sociedade de Cardiologia do Estado de São Paulo

Cardiovascular diseases (CVD) are the leading cause of death in Brazil and, among them, coronary ... more Cardiovascular diseases (CVD) are the leading cause of death in Brazil and, among them, coronary artery disease (CAD) was the leading cause of death in the country. CAD includes symptomatic and asymptomatic clinical conditions related to reduced blood flow to the heart muscle. Chest pain caused by myocardial ischemia, known as angina pectoris, is usually brought on by exertion or emotional stress. Physical exercise has numerous benefits on cardiovascular risk factors and the cardiovascular system, such as improvement in angina through increased myocardial oxygen delivery and increased exercise capacity, an independent predictor of increa-sed survival. Cardiovascular rehabilitation (CVR) based on physical exercises has consistently demonstrated its effectiveness in reducing cardiovascular mortality and hospitalizations in patients with CAD. CVR is recommended for a healthy lifestyle and for managing cardiovascular risk factors by prescribing 30 to 60 minutes of moderate-intensity aer...

Journal of Cardiac Failure, 2016

due to severe sepsis. All patients however did have decreasing lactic acid level which points to ... more due to severe sepsis. All patients however did have decreasing lactic acid level which points to resolving sepsis. Prospective studies with larger sample size may clarify the effect of larger volume of fluid in CHF patients with severe sepsis and septic shock.

Clinical Nutrition ESPEN, 2019

Background: We tested the hypothesis that a normal sodium diet could be associated with preservat... more Background: We tested the hypothesis that a normal sodium diet could be associated with preservation of serum sodium during treatment of acute decompensated heart failure (ADHF). Methods and results: Forty-four patients hospitalized for ADHF were blindly randomized by using block method to a low sodium diet (LS: 3 g/day of dietary sodium chloride; n ¼ 22, 59.5 ± 11.9 y.o., 50% males. LVEF ¼ 30.0 ± 13.6%); and a normal sodium diet (NS: 7 g/day; n ¼ 22, 56.4 ± 10.3 y.o., 68% males; LVEF ¼ 27.8 ± 11.7%), and both groups were submitted to fluid restriction of 1.000 mL/day. At the 7th day of intervention 16 patients of LS group and 15 patients of NS group were assessed for difference in serum sodium. Both groups had equivalent decongestion, reflected by similar percent reduction of body weight (LS: À5.0 ± 4.7% vs NS: À4.5 ± 5.2%. p ¼ 0.41). Reduction of the N terminal fragment of type B natriuretic peptide (NT-proBNP) was significant only in the NS (À1497.0 [À18843.0 À 1191.0]. p ¼ 0.04). The LS group showed lower levels of serum sodium (135.4 ± 3.5 mmol/L) compared to the NS group (137.5 ± 1.9 mmol/L; p ¼ 0.04). Four cases of hyponatremia were observed only in the LS group (22%). The NS group exhibited higher mean blood pressure values (79.4 ± 2.4 mmHg vs 75.5 ± 3.0 mmHg. p ¼ 0.03), and lower heart rate (73.2 ± 1.6 bpm vs 75.5 ± 2.1 bpm. p ¼ 0.02). Conclusions: These results suggest that a normal sodium diet, when compared to a low sodium diet, is associated with similar degrees of decongestion, but with higher levels of natremia, blood pressure and lower neurohormonal activation during ADHF treatment. Trial Registration: clinicaltrials.gov Identifier no. NCT03722069.

Arquivos brasileiros de cardiologia, 2018

Maintenance of orthostatism requires the interaction of autonomic and muscle responses for an eff... more Maintenance of orthostatism requires the interaction of autonomic and muscle responses for an efficient postural control, to minimize body motion and facilitate venous return in a common type of syncope called neurocardiogenic syncope (NCS). Muscle activity in standing position may be registered by surface electromyography, and body sway confirmed by displacement of the center of pressure (COP) on a force platform. These peripheral variables reflect the role of muscles in the maintenance of orthostatism during the active tilt test, which, compared with muscle activity during the passive test (head-up tilt test), enables the analyses of electromyographic activity of these muscles that may anticipate the clinical effects of CNS during these tests. to evaluate and compare the effects of a standardized protocol of active and passive tests for CNS diagnosis associated with the effects of Valsalva maneuver (VM). twenty-thee clinically stable female volunteers were recruited to undergo bot...

Journal of Cardiac Failure, 2016

Introduction: Iron deficiency (ID) is a common comorbidity in chronic heart failure patients that... more Introduction: Iron deficiency (ID) is a common comorbidity in chronic heart failure patients that can be routinely diagnosed by serum laboratorial tests showing reduced ferritin and/or transferrin saturation (TSAT) levels. However, it is not clear the impact on survival of different biochemical tests widely used for ID diagnosis. Hypothesis: We hypothesized that different laboratorial tests for ID diagnosis also implies in different prognostic values in heart failure patients. Methods: We performed a cohort study with 108 chronic and stable heart failure patients, attended in an outpatient clinic. The mean age was 59 ± 14 years, 53% were male, 31% had Chagas Disease, and 35% were NYHA functional class III/IV. The mean follow-up time was 712 ± 277 days, and the primary endponint investigated was all-cause death. We analysed biochemical levels of ferritin, serum iron, and latent iron binding capacity, which were used to estimate TSAT. Cutoff values for serum ferritin was <100 ng/dL and TSAT <20%. Combined values of ferritin and TSAT determined three metabolic states: iron depleted stores (ferritin <100 ng/dL with TSAT >20%), functional iron deficiency (TSAT <20% ferritin >100 ng/dL), and absolute iron deficiency (ferritin <100 ng/dL to TSAT <20%). Results: During the study, 31 (28.7%) deaths were reported. A univariate analysis showed a higher mortality rate in patients with serum sodium <130 mmol/L (P < .001), advanced NYHA functional class (III/IV) (P < .05), systolic blood pressure <90 mmHg (P < .01), and creatinine clearance <60 mL/min (P < .01). In the univariate analysis for ID assessments, only TSAT <20% was associated with poor survival (P < .01). On metabolic iron states investigation, functional (P < .05) and absolute iron deficiency (P < .01) were associated with worse prognosis. In a multivariate model TSAT <20% (HR 2.15-P < .005) and functional iron deficiency (TSAT <20% with ferritin >100 ng/dL) (P < .005; HR 1.81) remained independent prognostic factors. Iron depleted stores, diagnosed solely by ferritin <100 ng/dL, had no correlation with survival. Conclusions: Iron deficiency, diagnosed when TSAT parameter <20%, identified heart failure patients with higher mortality, independent of ferritin values.

Arquivos Brasileiros de Cardiologia, 2016

Background: Numerous studies show the benefits of exercise training after myocardial infarction (... more Background: Numerous studies show the benefits of exercise training after myocardial infarction (MI). Nevertheless, the effects on function and remodeling are still controversial. Objectives: To evaluate, in patients after (MI), the effects of aerobic exercise of moderate intensity on ventricular remodeling by cardiac magnetic resonance imaging (CMR). Methods: 26 male patients, 52.9 ± 7.9 years, after a first MI, were assigned to groups: trained group (TG), 18; and control group (CG), 8. The TG performed supervised aerobic exercise on treadmill twice a week, and unsupervised sessions on 2 additional days per week, for at least 3 months. Laboratory tests, anthropometric measurements, resting heart rate (HR), exercise test, and CMR were conducted at baseline and follow-up. Results: The TG showed a 10.8% reduction in fasting blood glucose (p = 0.01), and a 7.3-bpm reduction in resting HR in both sitting and supine positions (p < 0.0001). There was an increase in oxygen uptake only in the TG (35.4 ± 8.1 to 49.1 ± 9.6 mL/kg/min, p < 0.0001). There was a statistically significant decrease in the TG left ventricular mass (LVmass) (128.7 ± 38.9 to 117.2 ± 27.2 g, p = 0.0032). There were no statistically significant changes in the values of left ventricular end-diastolic volume (LVEDV) and ejection fraction in the groups. The LVmass/EDV ratio demonstrated a statistically significant positive remodeling in the TG (p = 0.015). Conclusions: Aerobic exercise of moderate intensity improved physical capacity and other cardiovascular variables. A positive remodeling was identified in the TG, where a left ventricular diastolic dimension increase was associated with LVmass reduction.

Journal of Cardiac Failure, 2012

Background: In patients who are treated with diuretics, blood urea nitrogen (BUN) to serum creati... more Background: In patients who are treated with diuretics, blood urea nitrogen (BUN) to serum creatinine (Scr) ratio is frequently used to evaluate intravascular volume status. Objective: We aimed to investigate the correlation between BUN to Scr ratio and invasive hemodynamic assessment of intravascular volume status. Methods: Data from patients who underwent right heart catheterization (RHC) at our center from 2008 to 2011 were reviewed. We obtained BUN, Scr and BUN to Scr ratio from Lab collected within 24 hour from the RHC. We obtained right atria (RA) pressure and pulmonary capillary wedge pressure from the RHC. A total of 501 patients were included in the analysis. 213 patients had BUN/Cr ratio more than 20. There was no correlation between high BUN to Scr ratio with RA pressure. Linear regression analysis was used, adjusted R-squared 5 0.0157. Conclusion: High BUN to Scr ratio did not predict intravascular volume status in our population, and this could be due to rapid diuresis, and diuretics therapy in patients with symptomatic heart failure should not be based on this ratio.

Arquivos Brasileiros de Cardiologia, 2010

Background: Large clinical trials using the betablockers carvedilol, metoprolol, bisoprolol and n... more Background: Large clinical trials using the betablockers carvedilol, metoprolol, bisoprolol and nebivolol have demonstrated improvement of survival and symptoms in patients with heart failure. Despite the lack of scientific evidence, it is plausible that their beneficial effects are extensible to other betablockers. Objective: To evaluate the impact of the replacement of carvedilol for propranolol on left ventricular function, functional capacity, quality of life, pressure levels, and cardiac autonomic control in patients with heart failure. Methods: Twenty nine patients receiving optimized drug therapy including maximum tolerated doses of carvedilol were divided into two groups: replacement of carvedilol for propranolol (n = 15) and continued carvedilol (n = 14). At baseline and 6 months later, clinical and laboratorial assessments were carried out with radionuclide ventriculography, echocardiography, Minnesota questionnaire, walk test, APBM and Holter monitoring. Results: The clinical and demographic characteristics were similar in the two groups at baseline. Individualized propranolol dose adjustment ensured a similar degree of beta-blockade, as assessed by resting heart rate and chronotropic reserve. The mean propranolol dose used was 109 ± 43 mg/day. Only one patient presented with intolerance to propranolol, thus carvedilol was reintroduced. One death was recorded in group propranolol. Ejection fraction significantly increased in the propranolol group. No significant change was observed in the other cardiovascular variables after betablocker replacement. Conclusion: Our results indicate that replacement of carvedilol for propranolol in patients with heart failure is not associated with deterioration of the ejection fraction, functional capacity, quality of life, and other cardiovascular variables related to autonomic and blood pressure control.

Arquivos Brasileiros de Cardiologia, 2011

Background: Chronic heart failure (HF) is a syndrome characterized by reduced cardiac output in r... more Background: Chronic heart failure (HF) is a syndrome characterized by reduced cardiac output in relation to the metabolic needs of the organism, as well as metabolic and neurohormonal axis abnormalities. Symptoms such as fatigue and dyspnoea are notorious and stress tests are widely used to assess functional capacity, prognosis and effectiveness of therapeutic interventions in this syndrome. Objective: To evaluate the reproducibility of the six-minute walk test (6MW) in patients with HF and correlate the magnitude of the variables reached at peak exercise of the 6MWT with a cardiopulmonary exercise test (CPET). Methods: We studied 16 patients (12 men and 4 women) diagnosed with HF FC I-II (NYHA). The volunteers underwent two 6MWT (6MWT'1 and 6MWT'2) with 30-minute interval between them; then, they underwent a maximum CPET. Results: All variables obtained in the two 6MWT' proved to be significant with high correlations: distance walked (DW) (r = 0.93, p < 0.0001), heart rate (HR) (r = 0.89, p < 0.0001), oxygen consumption (VO 2) (r = 0.93, p < 0.0001) and scale of perceived exertion (r = 0.85, p < 0.0001). In turn, all variables analyzed in the 6MWT' showed significant and moderate correlations with the variables obtained from the CPET, namely: peak HR (r = 0.66; p = 0.005); VO 2 (r = 0.57; p = 0.02) and VO 2 in the CPET and DT in the 6MWT'2 (r = 0.70; p = 0.002). Conclusion: The 6MWT was reproducible in this group of patients with HF (NYHA-I-II) and correlated with the CPET. Therefore, it is a tool for reliable evaluation, and a suitable, safe and low-cost alternative for the prescription of aerobic exercise in patients with HF.