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


Autoria(s): Mello, Priscila R.; Guerra, Grazi M.; Borile, Suellen; Rondon, Maria U.; Alves, Maria J.; Negrao, Carlos E.; Dal Lago, Pedro; Mostarda, Cristiano; Irigoyen, Maria C.; Consolim-Colombo, Fernanda M.
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

07/11/2013

07/11/2013

2012

Resumo

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.

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [2005/59740-7]

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo

Fundacao Zerbini

Fundacao Zerbini

Conselho Nacional de Pesquisa [CNPq 301519/2008-0, 302146/2007-5, 303518/2008-1]

Conselho Nacional de Pesquisa

Identificador

JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION, PHILADELPHIA, v. 32, n. 5, supl. 1, Part 1, pp. 255-261, SEP-OCT, 2012

1932-7501

http://www.producao.usp.br/handle/BDPI/42791

10.1097/HCR.0b013e31825828da

http://dx.doi.org/10.1097/HCR.0b013e31825828da

Idioma(s)

eng

Publicador

LIPPINCOTT WILLIAMS & WILKINS

PHILADELPHIA

Relação

JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION

Direitos

restrictedAccess

Copyright LIPPINCOTT WILLIAMS & WILKINS

Palavras-Chave #AUTONOMIC NERVOUS SYSTEM #HEART FAILURE #HYPERTENSION #QUALITY OF LIFE #RESPIRATORY MUSCLE TRAINING #VENTILATORY EFFICIENCY #BLOOD-FLOW #EXERCISE #STIMULATION #WORK #ACTIVATION #CYTOKINES #CAPACITY #PATTERN #CARDIAC & CARDIOVASCULAR SYSTEMS
Tipo

article

original article

publishedVersion