Acute and subacute hemodynamic responses and perception of effort in subjects with chronic Chagas cardiomyopathy submitted to different protocols of inspiratory muscle training: a cross-over trial

Frota, Aline Xavier; Mendes, Fernanda de Souza Nogueira Sardinha; Vieira, Marcelo Carvalho; Saraiva, Roberto Magalhães; Veloso, Henrique Horta; Silva, Paula Simplício da; Silva, Gilberto Marcelo Sperandio da; Sousa, Andréa Silvestre de; Mazzoli‐Rocha, Flavia; Costa, Henrique Silveira; Júnior, Luiz Fernando Rodrigues; Mediano, Mauro Felippe Felix

doi:10.1080/09638288.2020.1800837

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Currently, a total of 30 papers have studied the IMT effects in HF patients [ 28 , 39 , 40 , 44 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ]. From these 30 studies, only 5 studies [ 28 , 66 , 67 , 74 , 85 ] analyzed the IMT effects on respiratory muscle metaboreflex.…”

Section: Resultsmentioning

confidence: 99%

Unraveling the Role of Respiratory Muscle Metaboloreceptors under Inspiratory Training in Patients with Heart Failure

Fernández-Rubio

Becerro‐de‐Bengoa‐Vallejo

Rodríguez‐Sanz

et al. 2021

IJERPH

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Exercise intolerance may be considered a hallmark in patients who suffer from heart failure (HF) syndrome. Currently, there is enough scientific evidence regarding functional and structural deterioration of skeletal musculature in these patients. It is worth noting that muscle weakness appears first in the respiratory muscles and then in the musculature of the limbs, which may be considered one of the main causes of exercise intolerance. Functional deterioration and associated atrophy of these respiratory muscles are related to an increased muscle metaboreflex leading to sympathetic–adrenal system hyperactivity and increased pulmonary ventilation. This issue contributes to increased dyspnea and/or fatigue and decreased aerobic function. Consequently, respiratory muscle weakness produces exercise limitations in these patients. In the present review, the key role that respiratory muscle metaboloreceptors play in exercise intolerance is accurately addressed in patients who suffer from HF. In conclusion, currently available scientific evidence seems to affirm that excessive metaboreflex activity of respiratory musculature under HF is the main cause of exercise intolerance and sympathetic–adrenal system hyperactivity. Inspiratory muscle training seems to be a useful personalized medicine intervention to reduce respiratory muscle metaboreflex in order to increase patients’ exercise tolerance under HF condition.

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Section: Resultsmentioning

confidence: 99%

Unraveling the Role of Respiratory Muscle Metaboloreceptors under Inspiratory Training in Patients with Heart Failure

Fernández-Rubio

Becerro‐de‐Bengoa‐Vallejo

Rodríguez‐Sanz

et al. 2021

IJERPH

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“…In addition to low aerobic capacity and peripheral muscle weakness, inspiratory muscle weakness is estimated in 30% to 50% of patients with CHD[ 107 ]. Inspiratory muscle training (IMT) alone and associated with aerobic training[ 108 , 109 ] may improve exercise capacity in HF patients by reducing diaphragmatic metaboreflex activity and respiratory muscle fatigue[ 110 ].…”

Section: Non-pharmacological Strategiesmentioning

confidence: 99%

“…Despite the growing recommendation of IMT to become a part of CR, little is known about this strategy for CHD. Recently, two IMT protocols (30% and 60% of MIP) have been safely tested in patients with CHD[ 107 ].…”

Section: Non-pharmacological Strategiesmentioning

confidence: 99%

Chagas heart disease: An overview of diagnosis, manifestations, treatment, and care

Saraiva¹,

Mediano²,

Mendes³

et al. 2021

WJC

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Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi . CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical criteria. CHD presents with a myriad of clinical manifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%–60%), followed by heart failure (25%–30%) and stroke (10%–15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.

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Inspiratory muscle endurance is similarly reduced in the early and late stages of chronic Chagas heart disease

Pinto Diniz,

Felix Mediano,

Rodrigues Junior

et al. 2024

Tropical Med Int Health

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ObjectiveInspiratory muscle strength (IMS) appears to be reduced in subjects with chronic Chagas heart disease (CHD), especially in the presence of heart failure (HF). However, only one study about IMS and inspiratory muscle endurance (IME) in those with CHD without heart failure is available. This study aimed to compare IMS and IME in subjects with CHD in the presence and absence of HF.MethodsThis is a cross‐sectional study in which 30 CHD adult patients were divided into CHD‐CC group (initial phase of CHD, without HF; n = 15) and CHD‐HF group (advanced phase of CHD, with HF; n = 15). We assessed IMS by maximum inspiratory pressure (MIP) and IME by incremental (Pthmax) and constant load (TLim) tests. Reduced IMS and IME were considered by predicted MIP values <70% and Pthmax/MIP <75%, respectively.ResultsInspiratory muscle weakness (IMW) was more frequent in CHD‐HF than in CHD‐CC (46.7% vs. 13.3%; p = 0.05), and both groups had high frequencies of reduced IME (93.3% CHD‐CC vs. 100.0% CHD‐HF; p = 0.95). Age‐adjusted logistic regression analysis using HF as a dependent variable showed that HF was associated with an increased chance of IMW compared with the CHD‐CC group (OR = 7.47; p = 0.03; 95% CI 1.20–46.19).ConclusionThis study suggests that, in patients with CHD, HF is associated with IMW, and that reduction of IME is already present in the initial phase, similar to the advanced phase with HF.

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Acute and subacute hemodynamic responses and perception of effort in subjects with chronic Chagas cardiomyopathy submitted to different protocols of inspiratory muscle training: a cross-over trial

Cited by 3 publications

References 30 publications

Unraveling the Role of Respiratory Muscle Metaboloreceptors under Inspiratory Training in Patients with Heart Failure

Unraveling the Role of Respiratory Muscle Metaboloreceptors under Inspiratory Training in Patients with Heart Failure

Chagas heart disease: An overview of diagnosis, manifestations, treatment, and care

Inspiratory muscle endurance is similarly reduced in the early and late stages of chronic Chagas heart disease

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