{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T13:33:34Z","timestamp":1777988014484,"version":"3.51.4"},"reference-count":30,"publisher":"Sociedade Brasileira de Cardiologia","issue":"12","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  As evid\u00eancias sobre a seguran\u00e7a e os efeitos anti-isqu\u00eamicos da reabilita\u00e7\u00e3o card\u00edaca baseada em exerc\u00edcio (RCE) em pacientes com angina refrat\u00e1ria (AR) ainda s\u00e3o limitadas.  Objetivo  Avaliar a seguran\u00e7a e a efic\u00e1cia de um programa de RCE de 12 semanas em pacientes com AR, com foco na melhora dos sintomas, da capacidade funcional e da carga isqu\u00eamica avaliada por ecocardiografia de estresse com exerc\u00edcio (EEE).  M\u00e9todos  Estudo prospectivo, randomizado, controlado, e unic\u00eantrico, que avaliou um programa de RCE de 12 semanas em pacientes com AR. Quarenta e cinco pacientes foram randomizados para o grupo de reabilita\u00e7\u00e3o (GR), que recebeu RCE, ou para o grupo controle (GC), que recebeu apenas tratamento m\u00e9dico. Os desfechos avaliados inclu\u00edram mortalidade, eventos cardiovasculares, sintomas anginosos e par\u00e2metros da EEE e do teste cardiopulmonar de exerc\u00edcio (TCPE). O n\u00edvel de signific\u00e2ncia estat\u00edstica adotado foi p &lt; 0,05.  Resultados  Na EEE, a dura\u00e7\u00e3o do exerc\u00edcio foi significativamente maior no GRp\u00f3s (ap\u00f3s a RCE) em compara\u00e7\u00e3o com GRpr\u00e9 (antes da RCE) (\u2206 = 63,24 \u00b1 19,87 s; p &lt; 0,01). A quantifica\u00e7\u00e3o de angina foi menor no GRp\u00f3s em compara\u00e7\u00e3o ao GRpr\u00e9, ao GCp\u00f3s (ap\u00f3s tratamento m\u00e9dico isolado) e ao GCpr\u00e9 (antes do tratamento m\u00e9dico isolado) (\u2206 = \u20131,64 \u00b1 0,48 n, p &lt; 0,01; -3,10 \u00b1 0,97 n, p &lt; 0,01; e -2,73 \u00b1 0,92 n, p = 0,01, respectivamente). O limiar de angina foi maior em GRp\u00f3s em compara\u00e7\u00e3o ao GRpr\u00e9 e ao GRp\u00f3s (\u2206 = 89,66 \u00b1 33,16 s, p = 0,04; e 111,76 \u00b1 42,25 s, p = 0,04, respectivamente). A melhora na carga isqu\u00eamica na EEE foi demonstrada pelo aumento do tempo at\u00e9 o limiar isqu\u00eamico GRp\u00f3s em compara\u00e7\u00e3o ao GCpr\u00e9, e ao GCpr\u00e9 e GRp\u00f3s (\u2206 = 83,23 \u00b1 21,84 s, p &lt; 0,01; 98,44 \u00b1 35,11 s, p = 0,03; e 109,34 \u00b1 34,00 s, p &lt; 0,01, respectivamente). No TCPE, o GRp\u00f3s apresentou aumento na dura\u00e7\u00e3o do exerc\u00edcio (\u2206 = 104,54 \u00b1 28,09 s; p &lt; 0,01) e na dist\u00e2ncia percorrida (\u2206 = 131,23 \u00b1 30,48 m; p &lt; 0,01) em compara\u00e7\u00e3o ao GRpr\u00e9. N\u00e3o foram observadas diferen\u00e7as significativas no VO2 entre os grupos. Dois pacientes do grupo CG faleceram. Um paciente do GR apresentou angina prolongada durante o treinamento. N\u00e3o houve diferen\u00e7as significativas nos eventos cardiovasculares maiores entre os grupos.  Conclus\u00e3o  O programa de RCE de 12 semanas foi seguro e eficaz na melhora da dura\u00e7\u00e3o do exerc\u00edcio, da dist\u00e2ncia percorrida e da carga isqu\u00eamica na EEE em pacientes com AR.<\/jats:p>","DOI":"10.36660\/abc.20250331","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T18:15:27Z","timestamp":1770315327000},"source":"Crossref","is-referenced-by-count":0,"title":["Seguran\u00e7a e Efic\u00e1cia da Reabilita\u00e7\u00e3o Card\u00edaca Baseada em Exerc\u00edcio em Pacientes com Angina Refrat\u00e1ria"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3546-4166","authenticated-orcid":false,"given":"Luciana Oliveira Cascaes","family":"Dourado","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4060-4672","authenticated-orcid":false,"given":"Camila Paix\u00e3o","family":"Jord\u00e3o","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4561-5717","authenticated-orcid":false,"given":"Marcelo Luiz Campos","family":"Vieira","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil; Hospital Israelita Albert Einstein,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6785-7506","authenticated-orcid":false,"given":"Luis Henrique Wolff","family":"Gowdak","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4652-1226","authenticated-orcid":false,"given":"Carlos Eduardo","family":"Negr\u00e3o","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4436-1791","authenticated-orcid":false,"given":"Luiz Antonio Machado","family":"Cesar","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9852-3293","authenticated-orcid":false,"given":"Luciana Diniz Nagem Janot de","family":"Matos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"5","key":"ref1","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1053\/euhj.2001.2706","article-title":"The Problem of Chronic Refractory Angina; Report from the ESC Joint Study Group on the Treatment of Refractory Angina","volume":"23","author":"Mannheimer C","year":"2002","journal-title":"Eur Heart J"},{"issue":"2","key":"ref2","first-page":"S50","article-title":"Patients with Coronary Artery Disease Unsuitable for Revascularization: Definition, General Principles, and a Classification","volume":"28","author":"Jolicoeur EM","year":"2012","journal-title":"Can J Cardiol"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1378\/chest.13-2885","article-title":"OSA and Depression are Common and Independently Associated with Refractory Angina in Patients with Coronary Artery Disease","volume":"146","author":"Geovanini GR","year":"2014","journal-title":"Chest"},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/eurheartj\/ehaa820","article-title":"Management of Refractory Angina: An Update","volume":"42","author":"Davies A","year":"2021","journal-title":"Eur Heart J"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcin.2019.08.055","article-title":"Refractory Angina: From Pathophysiology to New Therapeutic Nonpharmacological Technologies","volume":"13","author":"Gallone G","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"issue":"5","key":"ref6","first-page":"943","article-title":"Brazilian Cardiovascular Rehabilitation Guideline - 2020","volume":"114","author":"Carvalho T","year":"2020","journal-title":"Arq Bras Cardiol"},{"issue":"9","key":"ref7","article-title":"Guideline for Chronic Coronary Syndrome - 2025","volume":"122","author":"Cesar LAM","year":"2025","journal-title":"Arq Bras Cardiol"},{"issue":"1","key":"ref8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/eurheartj\/ehaa605","article-title":"2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease","volume":"42","author":"Pelliccia A","year":"2021","journal-title":"Eur Heart J"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1161\/CIRCRESAHA.117.305205","article-title":"Exercise and the Cardiovascular System: Clinical Science and Cardiovascular Outcomes","volume":"117","author":"Lavie CJ","year":"2015","journal-title":"Circ Res"},{"issue":"15","key":"ref10","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1161\/CIRCULATIONAHA.115.016442","article-title":"Coronary Collateral Growth Induced by Physical Exercise: Results of the Impact of Intensive Exercise Training on Coronary Collateral Circulation in Patients with Stable Coronary Artery Disease (EXCITE) Trial","volume":"133","author":"M\u00f6bius-Winkler S","year":"2016","journal-title":"Circulation"},{"key":"ref11","article-title":"Physical Activity, Cardiorespiratory Fitness, and Cardiovascular Health: A Clinical Practice Statement of the ASPC Part I: Bioenergetics, Contemporary Physical Activity Recommendations, Benefits, Risks, Extreme Exercise Regimens, Potential Maladaptations","volume":"12","author":"Franklin BA","year":"2022","journal-title":"Am J Prev Cardiol"},{"issue":"11","key":"ref12","article-title":"Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease","volume":"11","author":"Dibben G","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"ref13","first-page":"754","article-title":"Refractory Angina Referral to Cardiovascular Rehabilitation: A Neglected Patient","volume":"119","author":"Milani M","year":"2022","journal-title":"Arq Bras Cardiol"},{"issue":"3","key":"ref14","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1159\/000339224","article-title":"Cardiac Rehabilitation to Improve Physical Functioning in Refractory Angina: A Pilot Study","volume":"122","author":"Asbury EA","year":"2012","journal-title":"Cardiology"},{"issue":"5","key":"ref15","first-page":"747","article-title":"Does Myocardial Injury Occur after an Acute Aerobic Exercise Session in Patients with Refractory Angina?","volume":"119","author":"Montenegro CGSP","year":"2022","journal-title":"Arq Bras Cardiol"},{"key":"ref16","article-title":"Cardiopulmonary Exercise Test in Patients with Refractory Angina: Functional and Ischemic Evaluation","volume":"77","author":"Assump\u00e7\u00e3o CRA","year":"2022","journal-title":"Clinics"},{"issue":"3","key":"ref17","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1161\/circ.54.3.947585","article-title":"Letter: Grading of Angina Pectoris","volume":"54","author":"Campeau L","year":"1976","journal-title":"Circulation"},{"issue":"3","key":"ref18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/01.HCR.0000270696.01635.aa","article-title":"Core Components of Cardiac Rehabilitation\/Secondary Prevention Programs: 2007 Update: A Scientific Statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation","volume":"27","author":"Balady GJ","year":"2007","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"18","key":"ref19","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1161\/CIR.0b013e31826fb946","article-title":"EACPR\/AHA Scientific Statement. Clinical Recommendations for Cardiopulmonary Exercise Testing Data Assessment in Specific Patient Populations","volume":"126","author":"Guazzi M","year":"2012","journal-title":"Circulation"},{"issue":"3","key":"ref20","doi-asserted-by":"crossref","DOI":"10.36660\/abc.20240110i","article-title":"Brazilian Guideline for Exercise Test in the Adult Population - 2024","volume":"121","author":"Carvalho T","year":"2024","journal-title":"Arq Bras Cardiol"},{"issue":"1","key":"ref21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2019.07.001","article-title":"Guidelines for Performance, Interpretation, and Application of Stress Echocardiography in Ischemic Heart Disease: From the American Society of Echocardiography","volume":"33","author":"Pellikka PA","year":"2020","journal-title":"J Am Soc Echocardiogr"},{"issue":"5","key":"ref22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0066-782X2010002400001","article-title":"III Guidelines of Sociedade Brasileira de Cardiologia on the Exercise Test","volume":"95","year":"2010","journal-title":"Arq Bras Cardiol"},{"issue":"3","key":"ref23","first-page":"574","article-title":"Measurement of Pain Using the Visual Numeric Scale","volume":"33","author":"Ritter PL","year":"2006","journal-title":"J Rheumatol"},{"issue":"11","key":"ref24","first-page":"1701","article-title":"Do Clinical Exercise Tests Permit Exercise Threshold Identification in Patients Referred to Cardiac Rehabilitation?","volume":"39","author":"Keltz RR","year":"2023","journal-title":"Can J Cardiol"},{"issue":"5","key":"ref25","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1161\/CIRCULATIONAHA.107.185214","article-title":"Resistance Exercise in Individuals with and without Cardiovascular Disease: 2007 Update: A Scientific Statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism","volume":"116","author":"Williams MA","year":"2007","journal-title":"Circulation"},{"issue":"7","key":"ref26","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1519\/JSC.0b013e3181e501e9","article-title":"Control of Resistance Training Intensity by the OMNI Perceived Exertion Scale","volume":"25","author":"Naclerio F","year":"2011","journal-title":"J Strength Cond Res"},{"issue":"3","key":"ref27","doi-asserted-by":"crossref","first-page":"2316","DOI":"10.1002\/ehf2.13335","article-title":"Cardiac Rehabilitation with Intermittent Myocardial Ischaemia as a New Therapeutic Option in Refractory Angina?","volume":"8","author":"Corre J","year":"2021","journal-title":"ESC Heart Fail"},{"issue":"2","key":"ref28","first-page":"166","article-title":"Prognostic Value of 6-Minute Walk Test in Stable Outpatients with Heart Failure","volume":"34","author":"Arslan S","year":"2007","journal-title":"Tex Heart Inst J"},{"issue":"3","key":"ref29","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1007\/s00421-020-04567-3","article-title":"The Knowns and Unknowns of Neural Adaptations to Resistance Training","volume":"121","author":"\u0160karabot J","year":"2021","journal-title":"Eur J Appl Physiol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.amjcard.2023.07.133","article-title":"Exercise Training on Anginal Threshold does Not Improve Endothelial Function in Refractory Angina Patients","volume":"204","author":"Jord\u00e3o CP","year":"2023","journal-title":"Am J Cardiol"}],"container-title":["Arquivos Brasileiros de Cardiologia"],"original-title":["Safety and Efficacy of Exercise-based Cardiac Rehabilitation in Patients with Refractory Angina"],"link":[{"URL":"https:\/\/abccardiol.org\/wp-content\/uploads\/articles_xml\/0066-782x-abc-122-12-e20250331\/0066-782x-abc-122-12-e20250331.x47208.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T18:15:32Z","timestamp":1770315332000},"score":1,"resource":{"primary":{"URL":"https:\/\/abccardiol.org\/article\/seguranca-e-eficacia-da-reabilitacao-cardiaca-baseada-em-exercicio-em-pacientes-com-angina-refrataria\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":30,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0066-782X2025001200306"],"URL":"https:\/\/doi.org\/10.36660\/abc.20250331","relation":{"is-translation-of":[{"id-type":"doi","id":"10.36660\/abc.20250331i","asserted-by":"subject"},{"id-type":"doi","id":"10.36660\/abc.20250331i","asserted-by":"object"}]},"ISSN":["1678-4170","0066-782X"],"issn-type":[{"value":"1678-4170","type":"electronic"},{"value":"0066-782X","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e20250331"}}