Respiratory muscle function and exercise intolerance in heart failure

Abstract

Inspiratory muscle weakness (IMW) is prevalent in patients with chronic heart failure (CHF) caused by left ventricular systolic dysfunction, which contributes to reduced exercise capacity and the presence of dyspnea during daily activities. Inspiratory muscle strength (estimated by maximal inspiratory pressure) has independent prognostic value in CHF. Overall, the results of trials with inspiratory muscle training (IMT) indicate that this intervention improves exercise capacity and quality of life, particularly in patients with CHF and IMW. Some benefit from IMT may be accounted for by the attenuation of the inspiratory muscle metaboreflex. Moreover, IMT results in improved cardiovascular responses to exercise and to those obtained with standard aerobic training. These findings suggest that routine screening for IMW is advisable in patients with CHF, and specific IMT and/or aerobic training are of practical value in the management of these patients.

Respiratory muscle endurance training in obese patients

“…[15][16][17] This effect on respiratory muscle function was shown to be greater compared with whole-body exercise training (cycling or running). 18 In addition to improving respiratory muscle capacity, respiratory muscle training has also been shown to reduce the perception of adverse respiratory sensations and to increase the exercise performance in healthy subjects [19][20][21] as well as in patients with impaired lung function.…”

“…18 In addition to improving respiratory muscle capacity, respiratory muscle training has also been shown to reduce the perception of adverse respiratory sensations and to increase the exercise performance in healthy subjects [19][20][21] as well as in patients with impaired lung function. 15,17,22,23 Whether respiratory muscle training in obese patients may also improve respiratory muscle capacity, reduce dyspnea and increase exercise tolerance remains unknown.…”

A classe da NYHA tem relação com a condição funcional e qualidade de vida na insuficiência cardíaca

“…Em indivíduos com IC, a sensação de dispneia pode estar relacionada a anormalidades da função muscular respiratória. Estudos relatam redução na resistência dos músculos respiratórios que contribui para a sensação de dispneia 24 . Também já foi evidenciado que a capacidade respiratória representada pela PImax e pela função pulmonar se correlaciona com a condição funcional em pacientes com IC 13 .…”

Força muscular respiratória de mulheres obesas mórbidas e eutróficas

“…Uma vez que as alterações funcionais da musculatura respiratória, tais como diminuição da força e resistência, decorrentes da IC, são processos muito bem documentados na literatura 26,27 e o treinamento muscular respiratório apresenta resultados satisfatórios no que diz respeito à melhora no consumo de oxigênio, aumento na distância percorrida em teste de caminhada de seis minutos, e melhora na qualidade de vida [28][29][30] …”