Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure

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Nakagawa, Naomi Kondo ^[1] ; Diz, Mariana Abreu ^[1] ; Kawauchi, Tatiana Satie ^[1] ; de Andrade, Geisa Nascimento ^[1] ; Kikuchi Umeda, Iracema Ioco ^[2] ; Murakami, Fernanda Murata ^[1] ; Oliveira-Maul, Janaina Proenca ^[1] ; Nascimento, Juliana Araujo ^[1] ; Nunes, Newton ^[3] ; Takada, Julio Yoshio ^[3] ; Mansur, Antonio de Padua ^[3] ; Cahalin, Lawrence Patrick ^[4]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Physiotherapy, Fac Med, LIM 54, Sao Paulo - Brazil

^[2] Dante Pazzanese Inst Cardiol Sao Paulo State, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Heart Inst, Div Cardiol, Hosp Clin, Fac Med, Sao Paulo - Brazil

^[4] Univ Miami, Miller Sch Med, Dept Phys Therapy, Miami, FL 33136 - USA

• Tipo de documento: Artigo Científico
• Fonte: Respiratory Care; v. 65, n. 4, p. 507-516, APR 1 2020.
• Citações Web of Science: 0

Resumo

BACKGROUND: Chronic heart failure is commonly associated with inspiratory muscle weakness. However, few studies have investigated the risk factors for inspiratory muscle weakness in individuals with chronic heart failure and systolic dysfunction (left-ventricular ejection fraction {[}LVEF] <40%). METHODS: Seventy subjects were recruited in a cardiac center. We assessed clinical parameters, smoking history, peripheral muscle strength, pulmonary function, echocardiographic variables, and brain natriuretic peptide. The subjects were classified with inspiratory muscle weakness when the maximum inspiratory pressure was <70% of predicted values. RESULTS: Thirty-six subjects (51%) had inspiratory muscle weakness. The subjects with inspiratory muscle weakness and the subjects with no inspiratory muscle weakness were similar in age, sex, body mass index, medication use, and physical activity. However, the subjects with inspiratory muscle weakness had lower LVEF (P = .003), systolic blood pressure (P = .01), diastolic blood pressure (P = .042), quadriceps muscle strength (P = .02), lung function (P = .035), increased brain natriuretic peptide (P = .02), smoking history (P = .01), and pulmonary hypertension incidence (P = .03). Multivariate logistic regression analysis found a lower LVEF, increased smoking history, and lower systolic blood pressure as significant independent predictors for inspiratory muscle weakness. CONCLUSIONS: The combination of lower LVEF, lower systolic blood pressure, and smoking history predicted inspiratory muscle weakness. Patients with suspected inspiratory muscle weakness should be examined and, if inspiratory muscle weakness exists, then inspiratory muscle training should be provided. Reducing inspiratory muscle weakness has the potential to improve many of the deleterious effects of chronic heart failure. (AU)

• Processo FAPESP: 13/13598-1 - Fisioterapia: funcionalidade e estudo celular e biomolecular no tratamento de pacientes com disfunções cardiorrespiratórias
• Beneficiário: Naomi Kondo Nakagawa
• Modalidade de apoio: Auxílio à Pesquisa - Regular