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Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction.
Eur J Prev Cardiol 2014; 21(12):1465-73EJ

Abstract

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.

Authors+Show Affiliations

University of Valencia. Valencia, Spain patri.palau@gmail.com.Hospital General de Castellón, Castellón, Spain.University of Valencia. Valencia, Spain.University Hospital and University of Bern, Bern, Switzerland.University of Valencia. Valencia, Spain.University of Valencia. Valencia, Spain.University of Valencia. Valencia, Spain.University of Valencia. Valencia, Spain.University of Valencia. Valencia, Spain.University of Valencia. Valencia, Spain.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23864363

Citation

Palau, Patricia, et al. "Effects of Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction." European Journal of Preventive Cardiology, vol. 21, no. 12, 2014, pp. 1465-73.
Palau P, Domínguez E, Núñez E, et al. Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. Eur J Prev Cardiol. 2014;21(12):1465-73.
Palau, P., Domínguez, E., Núñez, E., Schmid, J. P., Vergara, P., Ramón, J. M., ... Núñez, J. (2014). Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. European Journal of Preventive Cardiology, 21(12), pp. 1465-73. doi:10.1177/2047487313498832.
Palau P, et al. Effects of Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction. Eur J Prev Cardiol. 2014;21(12):1465-73. PubMed PMID: 23864363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. AU - Palau,Patricia, AU - Domínguez,Eloy, AU - Núñez,Eduardo, AU - Schmid,Jean-Paul, AU - Vergara,Pedro, AU - Ramón,Jose María, AU - Mascarell,Beatriz, AU - Sanchis,Juan, AU - Chorro,F Javier, AU - Núñez,Julio, Y1 - 2013/07/17/ PY - 2013/7/19/entrez PY - 2013/7/19/pubmed PY - 2015/7/15/medline KW - Exercise capacity KW - heart failure with preserved ejection fraction KW - inspiratory muscle training SP - 1465 EP - 73 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 21 IS - 12 N2 - 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. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/23864363/Effects_of_inspiratory_muscle_training_in_patients_with_heart_failure_with_preserved_ejection_fraction_ L2 - http://journals.sagepub.com/doi/full/10.1177/2047487313498832?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -