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Predictors of inspiratory muscle weakness in patients with heart failure: clinical parameters, functional capacity and inflammatory and cardiovascular diseases biomarkers

Abstract

Chronic heart failure (HF) is commonly associated with inspiratory muscle weakness (IMW). However, few studies have investigated the risk factors for IMW in patients with HF and systolic dysfunction (left ventricular ejection fraction d 40%). The present cohort study aims to: (1) analyze risk factor among clinical, functional variables and inflammatory and cardiovascular diseases biomarkers associated with IMW in patients with HF; (2) validate the predictors of IMW in patients with HF considering ischemic and non ischemic ethiologies; and (3) to analyze associations between IMW and clinical outcomes such as infections, hospitalizations, surgeries and mortality along 12 months. Methods: We will assess 600 patients, NYHA II-III, LVEF d 45%, that will be consecutively recruited in a tertiary center. We will assess patients at baseline and after 12 months for the following parameters: demographics, clinical, smoking, peripheral muscle strength via dynamometer, 1-maximal resistance, lung function, functional capacity using the 6-minute walk test, quality of life using questionnaires the Minnesota Living with Heart Failure, sleep quality using Pittsburg Questionnaire, excessive diurnal sleepness using Epworth Scale and using the Berlin Questionnaire to identify patients at risk for the Sleep Apnea Syndrome. In a subgroup of 210 patients, at baseline, we will evaluated a functional capacity with cardiopulmonary test and analysis of inflammatory and cardiovascular diseases biomarkers. Patients will be divided in IMW and non-IMW considering maximum inspiratory pressure <70% of the predicted values and patients will be followed for 12 months to register infections, hospitalizations, surgeries and mortality. To assess possible associations between inspiratory muscle strength and demographic, clinical, functional variables inflammatory and cardiovascular diseases biomarkers and quality of life and sleep we will use the Pearson Correlation Coefficient or Spearman, t-test or Mann Whitney and Multivariate Logistic Regression. Results of this study will corroborate in the understanding of the predictors for IMW among demographic, clinical and biomolecular variables. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
NAKAGAWA, NAOMI K.; OLIVEIRA, KATIA M. G.; LOCKEY, ANDREW; SEMERARO, FEDERICO; AIKAWA, PRISCILA; MACCHIONE, MARIANGELA; CARVALHO-OLIVEIRA, REGIANI; GOUVEA, GABRIELA B.; BOAVENTURA, ANA PAULA; MAIWORM, I, ADALGISA; CALDERARO, MARCELO; HAJJAR, LUDHMILA A.; MOTTA, V, EDUARDO; SOUZA, HERALDO P.; DE ANDRE, CARMEN D. S.; SILVA, LUIZ F. F.; POLASTRI, THATIANE F.; TIMERMAN, SERGIO; CARMONA, MARIA JOSE C.; BOETTIGER, BERND W. Effectiveness of the 40-Minute Handmade Manikin Program to Teach Hands-on Cardiopulmonary Resuscitation at School Communities. AMERICAN JOURNAL OF CARDIOLOGY, v. 139, p. 126-130, JAN 15 2021. Web of Science Citations: 0.
GEISA NASCIMENTO DE ANDRADE; IRACEMA IOCO KIKUCHI UMEDA; ANGELA RUBIA CAVALCANTI NEVES FUCHS; LUIZ EDUARDO MASTROCOLA; JOÃO MANOEL ROSSI-NETO; DALMO ANTONIO RIBEIRO MOREIRA; PATRICIA ALVES DE OLIVEIRA; CARMEN DIVA SALDIVA DE ANDRÉ; LAWRENCE PATRICK CAHALIN; NAOMI KONDO NAKAGAWA. Home-based training program in patients with chronic heart failure and reduced ejection fraction: a randomized pilot study. Clinics, v. 76, p. -, 2021.
ARCAS, CAMILA DOS SANTOS; LIN-WANG, HUI TZU; KIKUCHI UMEDA, IRACEMA IOCO; DE SOUSA, MARCIO GONCALVES; ODAGIRI UTIYAMA, DANIELA MITIYO; MANSUR, ANTONIO DE PADUA; MACCHIONE, MARIANGELA; HIRATA, MARIO HIROYUKI; NAKAGAWA, NAOMI KONDO. Smoking load reduction is insufficient to downregulate miR-301b, a lung cancer promoter. SCIENTIFIC REPORTS, v. 10, n. 1 DEC 3 2020. Web of Science Citations: 1.

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