Unfortunately, an incorrect figure was provided in the original manuscript. Figure 1 has to be substituted by Fig. 2. A new Fig. 2 is now provided. The correct Figs. 1 and 2 with according captions are given below. After the NYHA functional class analysis using the McNemar test, the p value is missing in the Results section of the Abstract. The correct text is reproduced below. Results All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class (p = 0.031) in HF patients. The online version of the original article can be found under
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.
Heart rate variability (HRV) analysis is a useful method to assess abnormal functioning in the autonomic nervous system and to predict cardiac events in patients with heart failure (HF). HRV measurements with heart rate monitors have been validated with an electrocardiograph in healthy subjects but not in patients with HF. We explored the reproducibility of HRV in two consecutive six-minute walk tests (6MW), 60-minute apart, using a heart rate monitor (PolarS810i) and a portable electrocardiograph (called Holter) in 50 HF patients (mean age 59 years, NYHA II, left ventricular ejection fraction ~35%). The reproducibility for each device was analysed using a paired t-test or the Wilcoxon signed-rank test. Additionally, we assessed the agreement between the two devices based on the HRV indices at rest, during the 6MW and during recovery using concordance correlation coefficients (CCC), 95% confidence intervals and Bland-Altman plots. The test-retest for the HRV analyses was reproducible using Holter and PolarS810i at rest but not during recovery. In the second 6MW, patients showed significant increases in rMSSD and walking distance. The PolarS810i measurements had remarkably high concordance correlation [0.86
Objective: To compare the effects of two physical therapy exercise in-hospital programs in pulmonary function and functional capacity of patients in the postoperative period of heart transplantation.Methods: Twenty-two heart transplanted patients were randomized to the control group (CG, n=11) and training group (TG, n=11). The control group conducted the exercise program adopted as routine in the institution and the training group has had a protocol consisting of 10 stages, with incremental exercises: breathing exercises, resistance training, stretching and walking. The programs began on the first day after extubation and stretched until hospital discharge. Assessed pulmonary function, distance walked in six minutes walk test (6MWT) and peripheral muscle strength by one repetition maximum test (1RM).Results Rev Bras Cir Cardiovasc 2013;28(3):338-46
Unfortunately, an incorrect figure was provided in the original manuscript. After the NYHA functional class analysis using the McNemar test, the p value is missing in the Results section of the Abstract. The correct text is reproduced below.Results All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class (p = 0.031) in HF patients.The online version of the original article can be found under
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