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Inspiratory Muscle Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction.
J Card Fail 2017; 23(6):480-484JC

Abstract

BACKGROUND

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by impaired exercise capacity resulting from dyspnea and fatigue. The pathophysiological mechanisms underlying the exercise intolerance in HFpEF are not well established. We sought to evaluate the effects of inspiratory muscle function on exercise tolerance in symptomatic patients with HFpEF.

METHODS AND RESULTS

A total of 74 stable symptomatic patients with HFpEF and New York Heart Association class II-III underwent a cardiopulmonary exercise test between June 2012 and May 2016. Inspiratory muscle weakness was defined as maximum inspiratory pressure (MIP) <70% of normal predicted values. Pearson correlation coefficient and multivariate linear regression analysis were used to assess the association between percent of predicted MIP (pp-MIP) and maximal exercise capacity [measured by peak oxygen uptake (peak VO2) and percent of predicted peak VO2 (pp-peak VO2)]. Thirty-one patients (42%) displayed inspiratory muscle weakness. Mean (standard deviation) age was 72.5 ± 9.1 years, 53% were women, and 35.1% displayed New York Heart Association class III. Mean peak VO2 and pp-peak VO2 were 10 ± 2.8 mL•min•kg and 57.3 ± 13.8%, respectively. The median (interquartile range) of pp-MIP was 72% (58%-90%). pp-MIP was not correlated with peak VO2 (r = -0.047, P = .689) nor pp-peak VO2 (r = -0.078, P = .509). Furthermore, in multivariable analysis, pp-MIP showed no association with peak VO2 (β coefficient = 0.01, 95% confidence interval -0.01 to 0.03, P = .241) and pp-peak VO2 (β coefficient = -0.00, 95% confidence interval -0.10 to 0.10, P = .975).

CONCLUSIONS

In symptomatic elderly patients with HFpEF, we found that pp-MIP was not associated with either peak VO2 or pp-peak VO2.

Authors+Show Affiliations

Cardiology Department, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain.Cardiology Department, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain.Cardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de València, Valencia, Spain.Cardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de València, Valencia, Spain.Facultat de Fisioteràpia, Universitat de València, Spain.Cardiology Department, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain.Cardiology Department, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain.Cardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de València, Valencia, Spain.Cardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de València, Valencia, Spain.Cardiology Service and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain; CIBER Cardiovascular, Madrid, Spain.Cardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de València, Valencia, Spain; CIBER Cardiovascular, Madrid, Spain.Cardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de València, Valencia, Spain; CIBER Cardiovascular, Madrid, Spain. Electronic address: yulnunez@gmail.com.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28449951

Citation

Palau, Patricia, et al. "Inspiratory Muscle Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction." Journal of Cardiac Failure, vol. 23, no. 6, 2017, pp. 480-484.
Palau P, Domínguez E, Núñez E, et al. Inspiratory Muscle Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction. J Card Fail. 2017;23(6):480-484.
Palau, P., Domínguez, E., Núñez, E., Ramón, J. M., López, L., Melero, J., ... Núñez, J. (2017). Inspiratory Muscle Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction. Journal of Cardiac Failure, 23(6), pp. 480-484. doi:10.1016/j.cardfail.2017.04.016.
Palau P, et al. Inspiratory Muscle Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction. J Card Fail. 2017;23(6):480-484. PubMed PMID: 28449951.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inspiratory Muscle Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction. AU - Palau,Patricia, AU - Domínguez,Eloy, AU - Núñez,Eduardo, AU - Ramón,Jose María, AU - López,Laura, AU - Melero,Joana, AU - Bellver,Alejandro, AU - Chorro,Francisco J, AU - Bodí,Vicent, AU - Bayés-Genis,Antoni, AU - Sanchis,Juan, AU - Núñez,Julio, Y1 - 2017/04/24/ PY - 2016/12/16/received PY - 2017/04/19/revised PY - 2017/04/20/accepted PY - 2017/4/30/pubmed PY - 2018/7/10/medline PY - 2017/4/29/entrez KW - Heart failure with preserved ejection fraction KW - exercise capacity KW - inspiratory muscle function SP - 480 EP - 484 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 23 IS - 6 N2 - BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by impaired exercise capacity resulting from dyspnea and fatigue. The pathophysiological mechanisms underlying the exercise intolerance in HFpEF are not well established. We sought to evaluate the effects of inspiratory muscle function on exercise tolerance in symptomatic patients with HFpEF. METHODS AND RESULTS: A total of 74 stable symptomatic patients with HFpEF and New York Heart Association class II-III underwent a cardiopulmonary exercise test between June 2012 and May 2016. Inspiratory muscle weakness was defined as maximum inspiratory pressure (MIP) <70% of normal predicted values. Pearson correlation coefficient and multivariate linear regression analysis were used to assess the association between percent of predicted MIP (pp-MIP) and maximal exercise capacity [measured by peak oxygen uptake (peak VO2) and percent of predicted peak VO2 (pp-peak VO2)]. Thirty-one patients (42%) displayed inspiratory muscle weakness. Mean (standard deviation) age was 72.5 ± 9.1 years, 53% were women, and 35.1% displayed New York Heart Association class III. Mean peak VO2 and pp-peak VO2 were 10 ± 2.8 mL•min•kg and 57.3 ± 13.8%, respectively. The median (interquartile range) of pp-MIP was 72% (58%-90%). pp-MIP was not correlated with peak VO2 (r = -0.047, P = .689) nor pp-peak VO2 (r = -0.078, P = .509). Furthermore, in multivariable analysis, pp-MIP showed no association with peak VO2 (β coefficient = 0.01, 95% confidence interval -0.01 to 0.03, P = .241) and pp-peak VO2 (β coefficient = -0.00, 95% confidence interval -0.10 to 0.10, P = .975). CONCLUSIONS: In symptomatic elderly patients with HFpEF, we found that pp-MIP was not associated with either peak VO2 or pp-peak VO2. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/28449951/Inspiratory_Muscle_Function_and_Exercise_Capacity_in_Patients_With_Heart_Failure_With_Preserved_Ejection_Fraction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(17)30109-4 DB - PRIME DP - Unbound Medicine ER -