Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction

Palau, Patricia; Domínguez, Eloy; Núñez, Eduardo; Schmid, Jean-Paul; Vergara, Pedro; Ramón, Jose María; Mascarell, Beatriz; Sanchis, Juan; Chorro, F. Javier; Núñez, Julio (2014). Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. European journal of preventive cardiology, 21(12), pp. 1465-1473. SAGE Publications 10.1177/2047487313498832

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BACKGROUND Heart failure with preserved ejection fraction (HFpEF) is remarkably common in elderly people with highly prevalent comorbid conditions. Despite its increasing in prevalence, there is no evidence-based effective therapy for HFpEF. We sought to evaluate whether inspiratory muscle training (IMT) improves exercise capacity, as well as left ventricular diastolic function, biomarker profile and quality of life (QoL) in patients with advanced HFpEF and nonreduced maximal inspiratory pressure (MIP). DESIGN AND METHODS A total of 26 patients with HFpEF (median (interquartile range) age, peak exercise oxygen uptake (peak VO2) and left ventricular ejection fraction of 73 years (66-76), 10 ml/min/kg (7.6-10.5) and 72% (65-77), respectively) were randomized to receive a 12-week programme of IMT plus standard care vs. standard care alone. The primary endpoint of the study was evaluated by positive changes in cardiopulmonary exercise parameters and distance walked in 6 minutes (6MWT). Secondary endpoints were changes in QoL, echocardiogram parameters of diastolic function, and prognostic biomarkers. RESULTS The IMT group improved significantly their MIP (p < 0.001), peak VO2 (p < 0.001), exercise oxygen uptake at anaerobic threshold (p = 0.001), ventilatory efficiency (p = 0.007), metabolic equivalents (p < 0,001), 6MWT (p < 0.001), and QoL (p = 0.037) as compared to the control group. No changes on diastolic function parameters or biomarkers levels were observed between both groups. CONCLUSIONS In HFpEF patients with low aerobic capacity and non-reduced MIP, IMT was associated with marked improvement in exercise capacity and QoL.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Schmid, Jean-Paul

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2047-4873

Publisher:

SAGE Publications

Language:

English

Submitter:

Prisca Eser

Date Deposited:

02 May 2014 10:53

Last Modified:

15 Nov 2014 01:30

Publisher DOI:

10.1177/2047487313498832

PubMed ID:

23864363

URI:

https://boris.unibe.ch/id/eprint/47876

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