A randomized controlled trial of inspiratory muscle training in patients with chronic thromboembolic pulmonary hypertension

• Grant number: 16/18497-7
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2017
• End date: January 31, 2019
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Roberta Pulcheri Ramos
• Grantee: Roberta Pulcheri Ramos
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: Eloara Vieira Machado Ferreira Alvares da Silva Campos ; Jaquelina Sonoe Ota Arakaki ; Luiz Eduardo Nery ; Priscila Cristina de Abreu Sperandio ; Wladimir Musetti Medeiros

Abstract

INTRODUCTION: Despite therapeutic advances, patients with chronic thromboembolic pulmonary hypertension (CTEPH) may present significant limitations during effort. In addition to central hemodynamic impairment and a reduction of oxygen delivery, systemic inflammation may lead to abnormalities in peripheral striated muscles, with particular impact on muscle groups placed under high demand conditions. Given the excessive ventilatory response in patients with CTEPH with possible influence of metaboreceptors activation, increased sympathetic activity and blood flow steal from the peripheral muscles, it is possible that inspiratory muscle training (IMT) could be a useful strategy in improving exercise tolerance of these patients. OBJECTIVES: To evaluate the effects of IMT on the strength and endurance of the respiratory muscles and exercise capacity as assessed by the tolerance time during constant work-rate cardiopulmonary exercise test on a cycle ergometer (CPET) and the distance walked during the 6 minute walk test (6MWT). METHODS: 32 patients with CTEPH confirmed by right heart catheterization and imaging tests will perform lung function tests, measurements of maximal inspiratory and expiratory pressures, assessment of peripheral muscle strength, 6MWT, incremental CPET and constant work-rate CPET with noninvasive evaluation of hemodynamics and peripheral oxygenation. They will undergo IMT consisting of 2 daily training sessions of 30 breaths (~ 50% of maximal inspiratory pressure; 4-5 minutes per session) for 8 weeks. The SHAM group will run two daily sessions of 30 breaths without inspiratory load throughout the study period. (AU)

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)

ROLLM, JOAO VICTOR; OTA-ARAKAKI, JAQUELINA SONOE; FERREIRA, ELOARA V. M.; FIGLIOLINO, GABRIELA A. M.; IVANAGA, IVAN; VIEIRA, ELAINE BRITO; FONSECA, ANGELO X. C.; MESSINA, CAROLINA M. S.; COSTA, CAMILA MELO; ALBERTO NEDER, J.; et al. Inspiratory muscle weakness contributes to exertional dyspnea in chronic thromboembolic pulmonary hypertension. PLoS One, v. 13, n. 9, SEP 27 2018. (16/18497-7)