Immune response to inspiratory muscle training in patients with chronic heart failure

BACKGROUND: The effects of inspiratory muscle training on plasma cytokines, C-reactive protein and the soluble apoptosis mediators Fas and Fas ligand in chronic heart failure are unknown. DESIGN AND METHODS: Thirty-eight patients with chronic heart failure, age 57+/-2 years, New York Heart Association classification II-III, were assigned to either a high intensity training group (n=15, age 53+/-2 years) exercised at 60% of sustained maximal inspiratory pressure, or a low intensity training group (n=23, age 59+/-2 years), exercised at 15% of sustained maximal inspiratory pressure, three times per week for 10 weeks. Patients in the high intensity training group and low intensity training group were matched for age, sex and New York Heart Association functional class. Plasma levels of tumor necrosis factor (TNF)-alpha, soluble TNF receptor I, interleukin-6, C-reactive protein, soluble apoptosis mediators Fas and Fas ligand were measured at baseline and at post-inspiratory muscle training. Pulmonary function was assessed by spirometry, exercise capacity by a cardiopulmonary exercise test and the 6 min walk test, whereas dyspnea by the Borg scale after the 6 min walk test. RESULTS: High intensity training group improved inspiratory muscle strength (105.1+/-4.9 vs. 79.8+/-4.7 cmH2O, P