Home-based Inspiratory Muscle Training in Patients With Heart Failure and Preserved Ejection Fraction: A Preliminary Study

Kinugasa, Yoshiharu; Sota, Takeshi; Ishiga, Natsuko; Nakamura, Kensuke; Kamitani, Hiroko; Hirai, Masayuki; Yanagihara, Kiyotaka; Kato, Masahiko; Yamamoto, Kazuhide

doi:10.1016/j.cardfail.2020.08.006

Cited by 6 publications

(8 citation statements)

References 2 publications

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“…In a study by Winkelmann et al, the addition of both IMT and aerobic exercise has shown to improve peak VO 2 by 40% as compared to the 20% improvement with aerobic exercise alone in patients with heart failure [17]. Even though the RCT included in our metaanalysis showed a consistent benefit, we need a bigger sample size to strongly recommend IMT and prove its benefit in preventing cardiovascular mortality and increasing survival [8,10,[11][12].…”

Section: Imt and Cardiovascular Mortalitymentioning

confidence: 76%

“…By improving ventilation and oxidation capacity, endothelial function, and IMW, IMT may play a role in improving the Peak VO 2 , 6MWD, and cardiorespiratory fitness in patients with stable HFpEF. In our metaanalysis of three RCTs and one prospective study, the pooled increase in Peak VO 2 of 2.82 ml/kg/min and increase in 6MWD of 83.97 meters at 12 weeks of IMT and increase in Peak VO 2 of 2.18 ml/kg/ml at 24 weeks of IMT as compared to SC is not only statistically significant but also clinically significant [8,10,11,12]. In a study by Mancini et al, an increase in Peak VO 2 from 10 ml/kg/min to 14 ml/kg/min in heart failure patients was associated with a high increase in cumulative survival as shown in Figure 5 [13].…”

Section: Summary Of Imt In Hfpefmentioning

confidence: 79%

“…All four of our studies showed benefit at 12 weeks of IMT and two of our studies compared the changes in peak oxygen consumption after 24 weeks of therapy and the pooled effect showed improvement in the peak oxygen consumption as compared to SC. This answers that IMT should not be stopped at 12 weeks of therapy and continued till 24 weeks for a prolonged benefit [10][11].…”

Section: Duration Of Imtmentioning

confidence: 98%

“…In all the included studies, the patients were instructed to train at home twice daily, for 20 minutes each session during 12 weeks, using a threshold inspiratory muscle trainer at a resistance equal to 25%-30% of their maximal inspiratory pressure (MIP). The MIP was measured weekly in the study done by Palau to monthly in a study done by Kinusaga et al [10]. Outcomes included pre-and post-intervention 6MWD and peak VO 2 .…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…The non-pharmacological treatment didn't include IMT. It included usual lifestyle modifications like diet and exercise [8,[10][11][12].…”

Section: Standard Carementioning

confidence: 99%

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Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Baral

Changezi

Khan

et al. 2020

Cureus

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To explore the role of inspiratory muscle training (IMT) in improving cardiorespiratory fitness of stable heart failure with preserved ejection fraction (HFpEF) patients. BackgroundThere is a paucity of data on the role of IMT in patients with HFpEF. HFpEF is a growing problem in the developed world, especially in the aging population. MethodsWe conducted a systematic literature search for English studies in PubMed, EMBASE, and Cochrane Central Register of Controlled Trials. We searched databases using terms relating to or describing breathing exercise, IMT, and HFpEF. RevMan 5.4 (The Cochrane Collaboration, 2020) was used for data analysis, and two independent investigators performed literature retrieval and data extraction. ResultsWe identified three randomized controlled trials (RCTs) and one prospective study on the role of IMT in HFpEF. We calculated the pooled mean difference of peak oxygen consumption (Peak VO 2 ) and six-min walk distance (6MWD) between the IMT and standard care (SC) groups. Our meta-analysis showed that compared with SC, IMT could significantly improve peak VO 2 with a mean difference (MD) of 2.82 ml/kg/min, 95% CI

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Section: Imt and Cardiovascular Mortalitymentioning

confidence: 76%

Section: Summary Of Imt In Hfpefmentioning

confidence: 79%

Section: Duration Of Imtmentioning

confidence: 98%

Section: Exclusion Criteriamentioning

confidence: 99%

“…The non-pharmacological treatment didn't include IMT. It included usual lifestyle modifications like diet and exercise [8,[10][11][12].…”

Section: Standard Carementioning

confidence: 99%

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Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Baral

Changezi

Khan

et al. 2020

Cureus

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Nonpharmacological Strategies in Heart Failure with Preserved Ejection Fraction

Bohmke¹,

Billingsley²,

Kirkman³

et al. 2022

Cardiology Clinics

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Exercise training improves exercise capacity and quality of life in heart failure with preserved ejection fraction: a systematic review and meta-analysis of randomized controlled trials

Baral,

Ho,

Soroya

et al. 2024

European Heart Journal Open

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Aims Heart failure with preserved ejection fraction (HFpEF) is associated with high morbidity and mortality, and there are limited proven therapeutic strategies. Exercise has been shown to be beneficial in several studies. We aimed to evaluate the efficacy of exercise on functional, physiological, and quality-of-life measures. Methods and results A comprehensive search of Medline and Embase was performed. Randomized controlled trials (RCTs) of adult HFpEF patients with data on exercise intervention were included. Using meta-analysis, we produced pooled mean difference (MD) estimates with 95% confidence intervals (CIs) with Review Manager (RevMan) software for the peak oxygen uptake (VO2), Minnesota living with heart failure (MLWHF) and, other diastolic dysfunction scores. A total of 14 studies on 629 HFpEF patients were included (63.2% female) with a mean age of 68.1 years. Exercise was associated with a significant improvement in the peak VO2 (MD 1.96 mL/kg/min, 95% CI 1.25–2.68; P < 0.00001) and MLWHF score (MD −12.06, 95% CI −17.11 to −7.01; P < 0.00001) in HFpEF. Subgroup analysis showed a small but significant improvement in peak VO2 with high-intensity interval training (HIIT) vs. medium-intensity continuous exercise (MCT; MD 1.25 mL/kg/min, 95% CI 0.41–2.08, P = 0.003). Conclusion Exercise increases the exercise capacity and quality of life in HFpEF patients, and high-intensity exercise is associated with a small but statistically significant improvement in exercise capacity than moderate intensity. Further studies with larger participant populations and longer follow-up are needed to confirm these findings and elucidate potential differences between high- and medium-intensity exercise.

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Home-based Inspiratory Muscle Training in Patients With Heart Failure and Preserved Ejection Fraction: A Preliminary Study

Cited by 6 publications

References 2 publications

Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Nonpharmacological Strategies in Heart Failure with Preserved Ejection Fraction

Exercise training improves exercise capacity and quality of life in heart failure with preserved ejection fraction: a systematic review and meta-analysis of randomized controlled trials

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