TY - JOUR
T1 - Effects of inspiratory muscle training on autonomic activity, endothelial vasodilator function, and N-terminal pro-brain natriuretic peptide levels in chronic heart failure
AU - Laoutaris, ID
AU - Dritsas, A
AU - Brown, Margaret
AU - Manginas, A
AU - Kallistratos, MS
AU - Chaidaroglou, A
AU - Degiannis, D
AU - Alivizatos, PA
AU - Cokkinos, DV
PY - 2008/1/1
Y1 - 2008/1/1
N2 - PURPOSE: To assess the effects of inspiratory muscle training (IMT) on : autonomic activity, endothelial function, and N-terminal pro-brain natriuretic pepticle (NT-proBNP) levels in patients with chronic heart failure. 0 METHODS: Using age- and sex-matched controlled study, 23 patients (mean left ventricular ejection fraction 29 +/- 2%) were assigned to either a high-intensity training group (n = 14), New York Heart Association (NYHA) class II (n = 9)/III (n = 5), or a low-intensity training group (n = 9), NYHA class II (n = 6)/III (n = 3), exercising at 60% and 15% of sustained maximum inspiratory pressure (SPImax), respectively, 3 times per week for 10 weeks. Before and following IMT, patients underwent cardiopulmonary exercise testing and dyspnea evaluation on exertion. Sympathovagal balance was assessed by heart rate variability (HRV) from 24-hour electrocardiogram and endothelial function, using venous occlusion plethysmography. Serum levels of NT-proBNP were determined. RESULTS: High-intensity training group improved maximum inspiratory pressure (PImax, 105.4 +/- 5.3 vs 79.1 +/- 5 cm H2O, P = .001), SPImax (511 +/- 42 vs 308 +/- 28 cm H2O/sec/10(3), P = .001), peak oxygen consumption (19 +/- 1.2 vs 17.1 +/- 0.7 mL (.) kg(-1) (.) min(-1), P = .01) and dyspnea (17.6 +/- 0.2 vs 18.1 +/- 0.1, P = .02). Endothelium-dependent vasodilation, HRV, and NT-proBNP levels were not altered. Low-intensity training group increased only the Plmax (97.6 +/- 11.3 vs 84.2 +/- 8.7 cm H2O, P = .03). CONCLUSIONS: Improvement in dyspnea and exercise tolerance after IMT were not associated with changes in markers of HRV, endothelial function, and NT-proBNP in patients with mild to moderate chronic heart failure. Further studies on the effects of IMT in advanced heart failure would be worthwhile.
AB - PURPOSE: To assess the effects of inspiratory muscle training (IMT) on : autonomic activity, endothelial function, and N-terminal pro-brain natriuretic pepticle (NT-proBNP) levels in patients with chronic heart failure. 0 METHODS: Using age- and sex-matched controlled study, 23 patients (mean left ventricular ejection fraction 29 +/- 2%) were assigned to either a high-intensity training group (n = 14), New York Heart Association (NYHA) class II (n = 9)/III (n = 5), or a low-intensity training group (n = 9), NYHA class II (n = 6)/III (n = 3), exercising at 60% and 15% of sustained maximum inspiratory pressure (SPImax), respectively, 3 times per week for 10 weeks. Before and following IMT, patients underwent cardiopulmonary exercise testing and dyspnea evaluation on exertion. Sympathovagal balance was assessed by heart rate variability (HRV) from 24-hour electrocardiogram and endothelial function, using venous occlusion plethysmography. Serum levels of NT-proBNP were determined. RESULTS: High-intensity training group improved maximum inspiratory pressure (PImax, 105.4 +/- 5.3 vs 79.1 +/- 5 cm H2O, P = .001), SPImax (511 +/- 42 vs 308 +/- 28 cm H2O/sec/10(3), P = .001), peak oxygen consumption (19 +/- 1.2 vs 17.1 +/- 0.7 mL (.) kg(-1) (.) min(-1), P = .01) and dyspnea (17.6 +/- 0.2 vs 18.1 +/- 0.1, P = .02). Endothelium-dependent vasodilation, HRV, and NT-proBNP levels were not altered. Low-intensity training group increased only the Plmax (97.6 +/- 11.3 vs 84.2 +/- 8.7 cm H2O, P = .03). CONCLUSIONS: Improvement in dyspnea and exercise tolerance after IMT were not associated with changes in markers of HRV, endothelial function, and NT-proBNP in patients with mild to moderate chronic heart failure. Further studies on the effects of IMT in advanced heart failure would be worthwhile.
KW - endothelium
KW - inspiratory muscle training
KW - NT-proBNP
KW - exercise
KW - heart failure
KW - respiratory muscles
KW - autonomic function
U2 - 10.1097/01.HCR.0000314203.09676.b9
DO - 10.1097/01.HCR.0000314203.09676.b9
M3 - Article
C2 - 18360185
VL - 28
SP - 99
EP - 106
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
IS - 2
ER -