Inspiratory Muscle Training Reduces Sympathetic Nervous Activity and Improves Inspiratory Muscle Weakness and Quality of Life in Patients With Chronic Heart Failure A CLINICAL TRIAL

Author(s)

Mello, Priscila R. ^[1] ; Guerra, Grazi M. ^[1] ; Borile, Suellen ^[1] ; Rondon, Maria U. ^[1] ; Alves, Maria J. ^[1] ; Negrao, Carlos E. ^{[1, 2]} ; Dal Lago, Pedro ^[3] ; Mostarda, Cristiano ^[1] ; Irigoyen, Maria C. ^[1] ; Consolim-Colombo, Fernanda M. ^{[4, 1]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Heart Inst InCor, BR-05508 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Phys Educ & Sport, BR-05508 Sao Paulo - Brazil

^[3] UFCSPA, Dept Phys Therapy, Porto Alegre, RS - Brazil

^[4] Nove Julho Univ, Sao Paulo - Brazil

• Document type: Journal article
• Source: Journal of Cardiopulmonary Rehabilitation and Prevention; v. 32, n. 5, p. 255-261, SEP-OCT 2012.
• Web of Science Citations: 30

Abstract

PURPOSE: To evaluate the effect of inspiratory muscle training (IMT) on cardiac autonomic modulation and on peripheral nerve sympathetic activity in patients with chronic heart failure (CHF). METHODS: Functional capacity, low-frequency (LF) and high-frequency (HF) components of heart rate variability, muscle sympathetic nerve activity inferred by microneurography, and quality of life were determined in 27 patients with CHF who had been sequentially allocated to 1 of 2 groups: (1) control group (with no intervention) and (2) IMT group. Inspiratory muscle training consisted of respiratory exercises, with inspiratory threshold loading of seven 30-minute sessions per week for a period of 12 weeks, with a monthly increase of 30% in maximal inspiratory pressure (PImax) at rest. Multivariate analysis was applied to detect differences between baseline and followup period. RESULTS: Inspiratory muscle training significantly increased PImax (59.2 +/- 4.9 vs 87.5 +/- 6.5 cmH(2)O, P = .001) and peak oxygen uptake (14.4 +/- 0.7 vs 18.9 +/- 0.8 mL.kg(-1).min(-1), P = .002); decreased the peak ventilation (V. E) +/- carbon dioxide production (V-CO2) ratio (35.8 +/- 0.8 vs 32.5 +/- 0.4, P = .001) and the (V) over dotE +/-(V) over dotCO(2) slope (37.3 +/- 1.1 vs 31.3 +/- 1.1, P = .004); increased the HF component (49.3 +/- 4.1 vs 58.4 +/- 4.2 normalized units, P = .004) and decreased the LF component (50.7 +/- 4.1 vs 41.6 +/- 4.2 normalized units, P = .001) of heart rate variability; decreased muscle sympathetic nerve activity (37.1 +/- 3 vs 29.5 +/- 2.3 bursts per minute, P = .001); and improved quality of life. No significant changes were observed in the control group. CONCLUSION: Home-based IMT represents an important strategy to improve cardiac and peripheral autonomic controls, functional capacity, and quality of life in patients with CHF. (AU)

• FAPESP's process: 05/59740-7 - Physical exercise and autonomic control in cardiovascular physiopathology
• Grantee: Carlos Eduardo Negrão
• Support Opportunities: Research Projects - Thematic Grants