Inspiratory Muscle Weakness Is Associated With Exercise Intolerance in Patients With Heart Failure With Preserved Ejection Fraction: A Preliminary Study

Yamada, Kensaku; Kinugasa, Yoshiharu; Sota, Takeshi; Miyagi, Mari; Sugihara, Shinobu; Kato, Masahiko; Yamamoto, Keiji

doi:10.1016/j.cardfail.2015.10.010

Cited by 53 publications

(65 citation statements)

References 27 publications

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“…Approximately 30% of patients with HFpEF have inspiratory muscle weakness 20. In an HFpEF rat model, the diaphragm is associated with molecular, mitochondrial, histological and functional alterations, which are different from those of the soleus 21.…”

Section: Sarcopenia Of Each Type Of Skeletal Musclementioning

confidence: 99%

“…In addition, ageing is associated with diaphragm muscle weakness and fibre atrophy, which is so-called diaphragm muscle sarcopenia 22. We recently showed that diaphragm muscle atrophy, as assessed by ultrasonography, was accompanied by inspiratory muscle weakness and associated with exercise intolerance in patients with HFpEF 20. Therefore, diaphragm muscle sarcopenia may be one of the major causes of physical frailty through inspiratory muscle weakness in HFpEF.…”

Section: Sarcopenia Of Each Type Of Skeletal Musclementioning

confidence: 99%

“…However, resistance training might improve muscle strength and balance ability for preventing fall fractures in patients with frailty and HFpEF. Another potential intervention is inspiratory muscle training, because frail patients with HFpEF often have impaired function of inspiratory muscles, as well as limb muscles 20. We recently reported that inspiratory muscle weakness was associated with exercise intolerance independent of lower limb muscle weakness 20.…”

Section: Treatment Of Frailty In Hfpefmentioning

confidence: 99%

“…Another potential intervention is inspiratory muscle training, because frail patients with HFpEF often have impaired function of inspiratory muscles, as well as limb muscles 20. We recently reported that inspiratory muscle weakness was associated with exercise intolerance independent of lower limb muscle weakness 20. A clinical study with a small number of subjects showed that 12-week, home-based, inspiratory muscle training improved exercise capacity in HFpEF 25.…”

Section: Treatment Of Frailty In Hfpefmentioning

confidence: 99%

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The challenge of frailty and sarcopenia in heart failure with preserved ejection fraction

Kinugasa

Yamamoto

2016

Heart

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Frailty is a clinical state in which there is an increase in an individual's vulnerability for developing increased dependency and/or mortality when exposed to stressors. Frailty is often accompanied by heart failure with preserved ejection fraction (HFpEF), and frailty is likely to affect its clinical features and outcomes. Frail patients with HFpEF are frequently associated with sarcopenia (ie, muscle loss and weakness), which is a major component of the pathophysiology of frailty. Sarcopenia is a systemic skeletal muscle disease that impairs the function of limb skeletal muscles, as well as respiratory muscles, and this results in further functional decline. In addition, sarcopenia may contribute to cardiovascular remodelling and dysfunction, leading to the development of HFpEF through several metabolic and endocrine abnormalities. Although there is no established strategy for frail patients with HFpEF, a multidisciplinary approach, including various types of muscular training and nutritional intervention, may provide beneficial effects for these patients.

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Section: Sarcopenia Of Each Type Of Skeletal Musclementioning

confidence: 99%

Section: Sarcopenia Of Each Type Of Skeletal Musclementioning

confidence: 99%

Section: Treatment Of Frailty In Hfpefmentioning

confidence: 99%

Section: Treatment Of Frailty In Hfpefmentioning

confidence: 99%

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The challenge of frailty and sarcopenia in heart failure with preserved ejection fraction

Kinugasa

Yamamoto

2016

Heart

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“…Inspiratory muscle weakness (IMW), as determined by maximal inspiratory pressure (MIP), is associated with FC in some populations that suffer from muscle wasting [13, 14]. In ESRD, uremic myopathy may influence the loss of strength and endurance in inspiratory muscles, as well as in muscles of the locomotor system [15].…”

Section: Introductionmentioning

confidence: 99%

The role of the inspiratory muscle weakness in functional capacity in hemodialysis patients

et al. 2017

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IntroductionInspiratory muscle function may be affected in patients with End-Stage Renal Disease (ESRD), further worsening the functional loss in these individuals. However, the impact of inspiratory muscle weakness (IMW) on the functional capacity (FC) of hemodialysis patients remains unknown. Thus, the present study aimed to evaluate the impact of IMW on FC in ESRD patients undergoing hemodialysis.Materials and methodsESRD patients on hemodialysis treatment for more than six months were evaluated for inspiratory muscle strength and FC. Inspiratory muscle strength was evaluated based on maximal inspiratory pressure (MIP). IMW was defined as MIP values less than 70% of the predicted value. FC was evaluated using the Incremental Shuttle Walk test (ISWT). Patients whose predicted peak oxygen uptake (VO2peak) over the distance walked during the ISWT was less than 16mL/kg/min were considered to have FC impairment. Associations between variables were assessed by linear and logistic regression, with adjustment for age, sex, body mass index (BMI), presence of diabetes and hemoglobin level. Receiver-operating characteristic (ROC) analysis was used to determine different cutoff values of the MIP for normal inspiratory muscle strength and FC.ResultsSixty-five ERSD patients (67.7% male), aged 48.2 (44.5–51.9) years were evaluated. MIP was an independent predictor of the distance walked during the ISWT (R2 = 0.44). IMW was an independent predictor of VO2peak < 16mL/kg/min. (OR = 5.7; p = 0.048) in adjusted logistic regression models. ROC curves showed that the MIP cutoff value of 82cmH2O had a sensitivity of 73.5% and specificity of 93.7% in predicting normal inspiratory strength and a sensitivity and specificity of 76.3% and 70.4%, respectively, in predicting VO2peak ≥ 16mL/kg/min.ConclusionsIMW is associated with reduced FC in hemodialysis patients. Evaluation of the MIP may be important to functional monitoring in clinical practice and can help in the stratification of patients eligible to perform exercise testing.

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Skeletal muscle alterations and exercise intolerance in heart failure with preserved ejection fraction patients: ultrasonography assessment of diaphragm and quadriceps

Andriopoulou

Dimaki

Kallistratos

et al. 2022

European J of Heart Fail

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Inspiratory Muscle Weakness Is Associated With Exercise Intolerance in Patients With Heart Failure With Preserved Ejection Fraction: A Preliminary Study

Cited by 53 publications

References 27 publications

The challenge of frailty and sarcopenia in heart failure with preserved ejection fraction

The challenge of frailty and sarcopenia in heart failure with preserved ejection fraction

The role of the inspiratory muscle weakness in functional capacity in hemodialysis patients

Skeletal muscle alterations and exercise intolerance in heart failure with preserved ejection fraction patients: ultrasonography assessment of diaphragm and quadriceps

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