Inspiratory muscle strength is related to exertional dyspnoea in heart failure with preserved ejection fraction

Warner, Brit; Bruhn, Eric J.; Olson, Thomas P.; Bissen, Thomas G.; Borlaug, Barry A.; Smith, Joshua R.

doi:10.1002/ejhf.2980

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…A recent study has reported that HFpEF patients have abnormal cardiovascular responses to isolated metaboreflex activation via post-exercise circulatory occlusion following forearm exercise compared with controls (Roberto et al, 2017). Recent studies have also found respiratory muscle and pulmonary system abnormalities in HFpEF patients including lower inspiratory muscle strength (which was related to higher exertional dyspnoea during low-intensity exercise), lower inspiratory muscle endurance, exaggerated cardiovascular responses to inspiratory muscle metaboreflex activation and higher work of breathing during exercise (Hammer et al, 2022;Villarraga et al, 2023;Warner et al, 2023). patients (e.g., Antunes-Correa et al, 2014;Chiappa et al, 2008;Piepoli et al, 1996;Smith & Taylor, 2022;Wang, Pan et al, 2010;Winkelmann et al, 2009).…”

Section: Summary and Future Directionsmentioning

confidence: 99%

Consequences of group III/IV afferent feedback and respiratory muscle work on exercise tolerance in heart failure with reduced ejection fraction

Smith,

Senefeld,

Larson

et al. 2023

Experimental Physiology

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Exercise intolerance and exertional dyspnoea are the cardinal symptoms of heart failure with reduced ejection fraction (HFrEF). In HFrEF, abnormal autonomic and cardiopulmonary responses arising from locomotor muscle group III/IV afferent feedback is one of the primary mechanisms contributing to exercise intolerance. HFrEF patients also have pulmonary system and respiratory muscle abnormalities that impair exercise tolerance. Thus, the primary impetus for this review was to describe the mechanistic consequences of locomotor muscle group III/IV afferent feedback and respiratory muscle work in HFrEF. To address this, we first discuss the abnormal autonomic and cardiopulmonary responses mediated by locomotor muscle afferent feedback in HFrEF. Next, we outline how respiratory muscle work impairs exercise tolerance in HFrEF through its effects on locomotor muscle O2 delivery. We then discuss the direct and indirect evidence supporting an interaction between locomotor muscle group III/IV afferent feedback and respiratory muscle work during exercise in HFrEF. Last, we outline future research directions related to locomotor and respiratory muscle abnormalities to progress the field forward in understanding the pathophysiology of exercise intolerance in HFrEF.New Findings What is the topic of this review? This review is focused on understanding the role that locomotor muscle group III/IV afferent feedback and respiratory muscle work play in the pathophysiology of exercise intolerance in patients with heart failure. What advances does it highlight? This review proposes that the concomitant effects of locomotor muscle afferent feedback and respiratory muscle work worsen exercise tolerance and exacerbate exertional dyspnoea in patients with heart failure.

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Section: Summary and Future Directionsmentioning

confidence: 99%

Consequences of group III/IV afferent feedback and respiratory muscle work on exercise tolerance in heart failure with reduced ejection fraction

Smith,

Senefeld,

Larson

et al. 2023

Experimental Physiology

Self Cite

View full text Add to dashboard Cite

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Imaging and mechanisms of heart failure with preserved ejection fraction: a state-of-the-art review

Harada,

Tada,

Borlaug

2024

European Heart Journal - Cardiovascular Imaging

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Summary Understanding of the pathophysiology of heart failure with preserved ejection fraction (HFpEF) has advanced rapidly over the past two decades. Currently, HFpEF is recognized as a heterogeneous syndrome, and there is a growing movement towards developing personalized treatments based on phenotype-guided strategies. Left ventricular dysfunction is a fundamental pathophysiological abnormality in HFpEF; however, recent evidence also highlights significant roles for the atria, right ventricle, pericardium, and extracardiac contributors. Imaging plays a central role in characterizing these complex and highly integrated domains of pathophysiology. This review focuses on established evidence, recent insights, and the challenges that need to be addressed concerning the pathophysiology of HFpEF, with a focus on imaging-based evaluations and opportunities for further research.

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Inspiratory muscle strength is related to exertional dyspnoea in heart failure with preserved ejection fraction

Cited by 2 publications

References 10 publications

Consequences of group III/IV afferent feedback and respiratory muscle work on exercise tolerance in heart failure with reduced ejection fraction

Consequences of group III/IV afferent feedback and respiratory muscle work on exercise tolerance in heart failure with reduced ejection fraction

Imaging and mechanisms of heart failure with preserved ejection fraction: a state-of-the-art review

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