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20/09/2017 Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction.

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Eur J Prev Cardiol. 2014 Dec;21(12):1465-73. doi: 10.1177/2047487313498832. Epub 2013 Jul 17.

Effects of inspiratory muscle training in patients with heart


failure with preserved ejection fraction.
Palau P1, Domnguez E2, Nez E3, Schmid JP4, Vergara P3, Ramn JM3, Mascarell B3, Sanchis
J3, Chorro FJ3, Nez J3.
Author information

Abstract
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is remarkably common in elderly people with
highly prevalent comorbid conditions. Despite its increasing in prevalence, there is no evidence-based
effective therapy for HFpEF. We sought to evaluate whether inspiratory muscle training (IMT) improves exercise
capacity, as well as left ventricular diastolic function, biomarker profile and quality of life (QoL) in patients with
advanced HFpEF and nonreduced maximal inspiratory pressure (MIP).
DESIGN AND METHODS: A total of 26 patients with HFpEF (median (interquartile range) age, peak exercise oxygen
uptake (peak VO2) and left ventricular ejection fraction of 73 years (66-76), 10ml/min/kg (7.6-10.5) and 72% (65-77),
respectively) were randomized to receive a 12-week programme of IMT plus standard care vs. standard care alone.
The primary endpoint of the study was evaluated by positive changes in cardiopulmonary exercise parameters and
distance walked in 6 minutes (6MWT). Secondary endpoints were changes in QoL, echocardiogram parameters of
diastolic function, and prognostic biomarkers.
RESULTS: The IMT group improved significantly their MIP (p<0.001), peak VO2 (p<0.001), exercise oxygen uptake
at anaerobic threshold (p=0.001), ventilatory efficiency (p=0.007), metabolic equivalents (p<0,001), 6MWT (p<
0.001), and QoL (p=0.037) as compared to the control group. No changes on diastolic function parameters or
biomarkers levels were observed between both groups.
CONCLUSIONS: In HFpEF patients with low aerobic capacity and non-reduced MIP, IMT was associated with
marked improvement in exercise capacity and QoL.
TRIAL REGISTRATION: ClinicalTrials.gov NCT01707277.
The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

KEYWORDS: Exercise capacity; heart failure with preserved ejection fraction; inspiratory muscle training
PMID: 23864363 DOI: 10.1177/2047487313498832
[Indexed for MEDLINE]

https://www.ncbi.nlm.nih.gov/pubmed/23864363 1/1