scholarly journals Changes in Respiratory Muscle Strength Following Cardiac Rehabilitation for Prognosis in Patients with Heart Failure

2020 ◽  
Vol 9 (4) ◽  
pp. 952
Author(s):  
Nobuaki Hamazaki ◽  
Kentaro Kamiya ◽  
Shohei Yamamoto ◽  
Kohei Nozaki ◽  
Takafumi Ichikawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Respiratory Muscle ◽  
Clinical Event ◽  
Unplanned Readmission ◽  
Respiratory Muscle Strength ◽  
Clinical Events ◽  
Patients With Heart Failure ◽  
The Relationship

Respiratory muscle weakness, frequently observed in patients with heart failure (HF), is reported as a predictor for poor prognosis. Although increased respiratory muscle strength ameliorates exercise tolerance and quality of life in HF patients, the relationship between changes in respiratory muscle strength and patient prognosis remains unclear. A total of 456 patients with HF who continued a 5-month cardiac rehabilitation (CR) were studied. We measured maximal inspiratory pressure (PImax) at hospital discharge as the baseline and five months thereafter to assess the respiratory muscle strength. Changes in PImax during the 5-month observation period (⊿PImax) were examined. We investigated the composite multiple incidence of all-cause death or unplanned readmission after 5-month CR. The relationship between ⊿PImax and the incidence of clinical events was analyzed. Over a median follow-up of 1.8 years, 221 deaths or readmissions occurred, and their rate of incidence was 4.3/100 person-years. The higher ⊿PImax was significantly associated with lower incidence of clinical event. In multivariate Poisson regression model after adjustment for clinical confounding factors, ⊿PImax remained a significant and independent predictor for all-cause death/readmission (adjusted incident rate ratio for ⊿PImax increase of 10 cmH2O: 0.77, 95% confidence interval: 0.70–0.86). In conclusion, the changes in respiratory muscle strength independently predict the incidence of clinical events in patients with HF.

scholarly journals Application of Inspiratory Muscle Training to Improve Physical Tolerance in Older Patients with Ischemic Heart Failure

2021 ◽  
Vol 18 (23) ◽  
pp. 12441
Author(s):  
Monika Piotrowska ◽  
Paulina Okrzymowska ◽  
Wojciech Kucharski ◽  
Krystyna Rożek-Piechura
Keyword(s):  
Heart Failure ◽  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Patients With Heart Failure

Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation. The study included 90 patients with HF who took part in the second-stage 8-week cycle of cardiac rehabilitation (CR). They were randomly divided into three groups: Group I underwent CR and IMT; Group II only CR; and patients in Group III underwent only the IMT. Before and after the 8-week cycle, participants were assessed for exercise tolerance and the functional parameters of respiratory muscle strength. Significant statistical improvement concerned the majority of the hemodynamic parameters, lung function parameters, and respiratory muscle strength in the first group. Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.

298Change in respiratory muscle strength predicts clinical events in patients with chronic heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Hamazaki ◽  
T Masuda ◽  
K Kamiya ◽  
R Matsuzawa ◽  
K Nozaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Respiratory Muscle ◽  
Proportional Hazard ◽  
Respiratory Muscle Strength ◽  
Free Survival ◽  
Clinical Events ◽  
Cox Proportional Hazard ◽  
All Cause Mortality

Abstract Background Respiratory muscle weakness, frequently observed in patients with chronic heart failure (CHF), has been documented as a predictor for poor prognosis. Several studies have reported that respiratory muscle training increases respiratory muscle strength and consequently improves exercise tolerance and quality of life in these patients. However, the relationship between the change in respiratory muscle strength and prognosis is still unclear. Purpose We aimed to investigate whether the change in respiratory muscle strength following cardiac rehabilitation predicts the incidence of clinical events in CHF patients. Methods We studied 348 patients with CHF who were hospitalized because of decompensated heart failure and received 5-month cardiac rehabilitation during hospitalization and after hospital discharge. Clinical characteristics including aetiology of heart failure, comorbidity conditions, medications, blood examination and echocardiographic variables were obtained from clinical records. We also measured maximal inspiratory pressure (PImax) as respiratory muscle strength at hospital discharge and 5 months later. The change of PImax (ΔPImax) between the 5-month observation period was examined. We followed up the patients after the observation period and investigated the incidence of all-cause mortality or all-cause unplanned readmission. In statistical analysis, patients were divided into two groups based on the median value of ΔPImax. We compared the event-free survival rate between the two groups using the Kaplan-Meier method with a log-rank test. We also performed the Cox proportional hazard model to clarify whether the ΔPImax was an independent predictor for the incidence of clinical events. Results Over a median follow-up of 1.6 years, 121 patients (34.8%) died or readmitted, and their rate of incidence was 21.7/100 person-years. The higher ΔPImax was associated significantly with a higher rate of event-free survival (Log-rank: 8.085, P=0.004, Figure 1). In univariate Cox proportional hazard model, ΔPImax was a significant predictor for the all-cause mortality/readmission (unadjusted hazard ratio for PImax increase of 10 cmH2O: 0.842, 95% CI: 0.763 - 0.931, P=0.001). Even after adjustment for clinical confounding factors including baseline PImax, ΔPImax remained significant and independent predictor for the all-cause mortality/readmission (adjusted hazard ratio for PImax increase of 10 cmH2O: 0.862, 95% CI: 0.763 - 0.974, P=0.017, Figure 2). Conclusion This study is the first to demonstrate that the change in respiratory muscle strength following cardiac rehabilitation independently predicts the incidence of clinical events in patients with CHF. The increase in PImax of 10 cmH2O was associated significantly with a 14% decrease in the rate of all-cause mortality or readmission. Acknowledgement/Funding JSPS KAKENHI JP16K16442

Respiratory Muscle Strength and Hemodynamics in Chronic Heart Failure

CHEST Journal ◽  
1994 ◽  
Vol 105 (2) ◽  
pp. 355-359 ◽  
Author(s):  
Yoshihiro Nishimura ◽  
Hitoshi Maeda ◽  
Katsuji Tanaka ◽  
Hirofumi Nakamura ◽  
Yukako Hashimoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Respiratory Muscle Strength

scholarly journals The Relationship between Work of Walking and Respiratory Muscle Strength in Patients with Lung Cancer

2019 ◽  
Vol 20 (-1) ◽  
pp. 417-417
Author(s):  
Naciye Vardar Yagli ◽  
◽  
Kubra Kilic ◽  
Melda Saglam ◽  
Deniz Inal Ince ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Respiratory Muscle Strength ◽  
The Relationship
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