Long-term effects of device-guided slow breathing in stable heart failure patients with reduced ejection fraction

Abstract

SLOWB training improves cardiorespiratory capacity and appears to slow the progression of HFrEF. Further long-term outcome studies are required to confirm the benefits of paced breathing in HFrEF.

Slow breathing improves cardiovascular reactivity to mental stress and health-related quality of life in heart failure patients with reduced ejection fraction

“…While pharmacological blockade of neurohumoral hyperactivation provides a biological rationale for HF management, the increasing number of hospitalizations for HF decompensation and associated death suggests the necessity for additional treatment options. In this context, our recent findings and others of beneficial effects of SLOWB home training are likely to be associated with breaking or weakening the vicious cycle in patients with severe HFrEF [29]. Previous studies have demonstrated that both exaggerated (likely occurring at an earlier stage of disease) and blunted (likely occurring in an advanced stage of disease) CV and hormonal reactivity to psychological stress bear negative prognostic health outcomes [46,47].…”

“…775201235). The sample size and power calculation for this patient cohort had been published previously [29]. An additional analysis revealed that 10 patients would have 80% power for a paired t-test in detecting an increase in systolic BP (SBP) in response to mental stress of 3.4 mmHg at the level of significance 0.05 and an estimated SD of 3.4.…”

“…Recent reports documenting the effectiveness of SLOWB home training in improving oxygen saturation, cardiorespiratory capacity, functional performance, vagal activity, LVEF and reducing pulmonary pressure and breathlessness highlight the important role of breathing frequency in HF patients [23,25,26,28,29,[38][39][40].…”

“…The study was approved by the Institutional Ethics Committee and written informed consent was obtained from all patients. This prospective study was previously described in detail [29] and included a total of 21 non-smoking patients (16 males, 5 females) with stable chronic HFrEF diagnosed as per European Society of Cardiology (ESC) guidelines [4,30]. Patients were recruited from a larger cohort of HF patients following the CONSORT guidelines.…”

“…The feasibility and therapeutic effectiveness of the slow breathing (SLOWB) technique has been documented in chronic HF [23][24][25][26][27][28]. Very recently, it was documented that SLOWB home training improves clinical symptoms, physical and cardiorespiratory capacity, and vagal activity in patients with severe HF with reduced ejection fraction (HFrEF) irrespective of HF etiology [29]. However, health-related QoL in response to SLOWB is less known, demonstrating an overall improvement without a clear trend toward a reduction of any specific component [25] or a non-significant tendency toward improved QoL [27].…”