Arq. Bras. Cardiol. 2020; 114(4): 656-663
Controlled Study of Central Hemodynamic Changes in Inspiratory Exercise with Different Loads in Heart Failure
Luana de Decco Marchese
, Sergio Chermont, Danielle Warol, Lucia Brandão de Oliveira, Sabrina Bernardez Pereira, Mônica Quintão, Evandro Tinoco Mesquita
This Original Article is referred by the Short Editorial "Inspiratory Muscle Training at Different Intensities in Heart Failure: Are There Differences in Central Hemodynamic Changes?".
Abstract
Background
Inspiratory muscle weakness contributes to exercise intolerance and decreased quality of life in patients with heart failure. Studies with inspiratory muscle training show improvement in inspiratory muscle strength, functional capacity and quality of life. However, little is known about the central hemodynamic response (CHR) during inspiratory exercise (IE).
Objective
To evaluate CHR in a single IE session with different loads (placebo, 30% and 60%) in heart failure.
Methods
Randomized placebo-controlled clinical trial in patients with heart failure with reduced ejection fraction, functional class II and III. Twenty patients aged 65 ± 11 years completed a single session of inspiratory exercise, in 3 cycles of 15 minutes, with a 1-hour washout, involving loads of 30% (C30), 60% (C60) and placebo, using a linear load resistor (PowerBreathe Light). The noninvasive hemodynamic study was performed by cardiothoracic bioimpedance (Niccomo™ CardioScreen®). Statistical analysis was performed with Student’s t-test and Pearson’s correlation, and P≤0.05 was considered significant.
Results
An increase in heart rate (HR) was observed with C30 (64 ± 15 vs 69 ± 15 bpm; p = 0.005) and C60 (67 ± 14 vs 73 ± 14 bpm, p = 0.002). A decrease was observed in systolic volume (SV) with C30 (73 ± 26 vs 64 ± 20 ml; p = 0.004). Cardiac output (CO), on its turn, increased only with C60 (4.6 ± 1.5 vs 5.3 ± 1.7 l/min; p = -0.001).
Conclusion
When using the 60% load, in a single IE session, changes in CHR were observed. HR and CD increased, as did the Borg scales and subjective sensation of dyspnea. The 30% load reduced the SV. (Arq Bras Cardiol. 2020; 114(4):656-663)
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