Highlights
- •Inspiratory muscle training (IMT) improved quality of life and ventilatory performance during a respiratory fatigue protocol in patients with chronic heart failure.
- •The reduction of oxygen saturation in intercostal and forearm muscles during respiratory fatigue was attenuated by IMT in patients with chronic heart failure.
- •IMT attenuated the increase in blood lactate during respiratory fatigue in patients with chronic heart failure.
Abstract
Background
The impact of inspiratory muscle training (IMT) on respiratory and peripheral muscle
oxygenation and perfusion during inspiratory muscle fatigue in patients with chronic
heart failure (HF) has not been established.
Methods and Results
Twenty-six patients with chronic HF were randomly assigned to either 8 weeks of IMT
or a control group. Inspiratory fatigue was induced by means of a progressive inspiratory
resistive loading protocol until there was an inability to sustain inspiratory pressure,
when the inspiratory muscle metaboreflex should be activated. The main outcomes were
intercostal and forearm muscle oxygen saturation and deoxygenation as measured by
means of near-infrared spectroscopy (NIRS) and blood lactate levels. Inspiratory muscle
strength was increased by 78% (P < .001) after 8 weeks of participation in the IMT group. IMT attenuated the reduction
of oxygen saturation in intercostal and forearm muscles and the increase in blood
lactate during respiratory fatigue (P < .001 and P < .05, respectively). These changes were different from the control group (P < .01, P < .05, and P < .05, respectively). After 8 weeks, similar increases in oxygen consumption, mean arterial
pressure, heart rate, stroke volume, and cardiac output were observed in both groups
during respiratory fatigue.
Conclusions
This randomized controlled clinical trial demonstrates that IMT attenuates the respiratory
muscle oxygen demand-delivery mismatch during respiratory fatigue in patients with
chronic HF.
Key Words
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Article info
Publication history
Published online: May 09, 2017
Accepted:
May 5,
2017
Received in revised form:
April 13,
2017
Received:
August 25,
2016
Footnotes
Funding: This work was supported by a grant from Fundação de Amparo à Pesquisa no Estado do Rio de Janeiro (E-26/111.838/2011).
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
