Inspiratory Muscle Training Reduces Sympathetic Nervous Activity and Improves Inspiratory Muscle Weakness and Quality of Life in Patients With Chronic Heart Failure

Mello, Priscila; Guerra, Grazia Maria; Borile, Suellen; Rondon, Maria Urbana Pinto Brandão; Alves, Maria Janieire de Nazaré Nunes; Negräo, Carlos Eduardo; Lago, Pedro Dal; Mostarda, Cristiano Teixeira; Irigoyen, Maria Cláudia; Consolim‐Colombo, Fernanda Marciano

doi:10.1097/hcr.0b013e31825828da

Cited by 84 publications

(133 citation statements)

References 30 publications

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“…In turn, respiratory muscle exercises are a nonpharmacological strategy widely used to improve functional capacity in several conditions associated with the impaired respiratory muscle strength, such as chronic obstructive pulmonary disease (Petrovic et al, 2012), chronic heart failure (Mello et al, 2012) and hypertension (Ferreira et al, 2013), along with another aging-associated conditions (Aznar-Lain et al, 2007). Furthermore, studies have demonstrated beneficial effects of inspiratory muscle exercise (IME) on cardiac autonomic function, indicated by reduced sympathetic modulation and increased vagal modulation in young smokers (Rodrigues et al, 2013), as well as hypertensive (Ferreira et al, 2013) and heart failure patients (Mello et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Effects of inspiratory muscle exercise in the pulmonary function, autonomic modulation, and hemodynamic variables in older women with metabolic syndrome

et al. 2017

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The aim of the present study was to investigate the effects of inspiratory muscle exercise (IME) on metabolic and hemodynamic parameters, cardiac autonomic modulation and respiratory function of older women with metabolic syndrome (MS). For this, sixteen older women with MS and 12 aged-matched controls participated of the present study. Two days before and 2 days after the main experiment, fasting blood samples (i.e., total cholesterol, triglycerides and blood glucose), cardiac autonomic modulation (i.e., heart rate variability), and respiratory muscle function were obtained and evaluated. The sessions of physical exercise was based on a IME, which was performed during 7 days. Each session of IME was performed during 20 min, at 30% of maximal static inspiratory pressure. In the results, MS group presented higher levels of triglycerides, blood glucose, and systolic blood pressure when compared to control group. IME was not able to change these variables. However, although MS group showed impaired respiratory muscle strength and function, as well as cardiac autonomic modulation, IME was able to improve these parameters. Thus, the data showed that seven days of IME are capable to improve respiratory function and cardiac autonomic modulation of older women with MS. These results indicate that IME can be a profitable therapy to counteracting the clinical markers of MS, once repeated sessions of acute IME can cause chronical alterations on respiratory function and cardiac autonomic modulation.

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Section: Introductionmentioning

confidence: 99%

“…Furthermore, studies have demonstrated beneficial effects of inspiratory muscle exercise (IME) on cardiac autonomic function, indicated by reduced sympathetic modulation and increased vagal modulation in young smokers (Rodrigues et al, 2013), as well as hypertensive (Ferreira et al, 2013) and heart failure patients (Mello et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

Effects of inspiratory muscle exercise in the pulmonary function, autonomic modulation, and hemodynamic variables in older women with metabolic syndrome

et al. 2017

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“…In addition, no adverse effects have been reported in CHF patients, indicating that IMT is a safe tool to improve inspiratory muscle strength [75]. Furthermore, IMT and ExT reduce sympathetic drive, which might lead to improvements in cardiac function and respiratory drive [76]. Most importantly, CHF and PAH patients report a better quality of life and decreased sensation of dyspnoea on exertion after IMT [69,70,74].…”

Section: Inspiratory Muscle Trainingmentioning

confidence: 93%

The striated muscles in pulmonary arterial hypertension: adaptations beyond the right ventricle

et al. 2015

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Pulmonary arterial hypertension (PAH) is a fatal lung disease characterised by progressive remodelling of the small pulmonary vessels. The daily-life activities of patients with PAH are severely limited by exertional fatigue and dyspnoea. Typically, these symptoms have been explained by right heart failure. However, an increasing number of studies reveal that the impact of the PAH reaches further than the pulmonary circulation. Striated muscles other than the right ventricle are affected in PAH, such as the left ventricle, the diaphragm and peripheral skeletal muscles. Alterations in these striated muscles are associated with exercise intolerance and reduced quality of life. In this Back to Basics article on striated muscle function in PAH, we provide insight into the pathophysiological mechanisms causing muscle dysfunction in PAH and discuss potential new therapeutic strategies to restore muscle dysfunction. @ERSpublications RV, LV, diaphragm and peripheral muscle dysfunction contributes to reduced quality of life in PAH patients

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“…HR variability was analyzed in the frequency domains during the protocol, as previously described (Mello et al, 2012). The spectral bands for humans (very low frequency—VLF, 0.0–0.04 Hz; low frequency—LF, 0.04–0.15 Hz; and high frequency—HF, 0.15–0.4 Hz) were defined according to the literature (Pagani et al, 1986).…”

Section: Methodsmentioning

confidence: 99%

The Role of Acute Intermittent Hypoxia in Neutrophil-Generated Superoxide, Sympathovagal Balance, and Vascular Function in Healthy Subjects

et al. 2017

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Introduction: Recurrent hypoxia (HPX), a hallmark of the obstructive sleep apnea (OSA), impairs autonomic balance, and increases arterial blood pressure (BP). Oxidative stress is one of the mechanisms involved in these alterations. The cumulative effect of acute intermittent HPX and the chronicity may determine whether the response crosses the threshold from having protective value to pathology. However, the impact of acute intermittent HPX–reoxygenation on markers of oxidative stress in healthy individuals remains to be fully understood.Objective: To analyze the effects of the acute intermittent HPX on the generation of neutrophil-derived superoxide, sympathovagal balance, and vascular function in healthy subjects.Methods: We applied six cycles of intermittent HPX (10% O2 and 90% N2) for 5 min followed by 2 min of room-air in 15 healthy volunteers (34 ± 2 years; 22.3 ± 0.46 kg/m2), without OSA (polysomnography), during wakefulness. During the experimental protocol, we recorded O2 saturation, end-tidal CO2, heart rate (HR), systolic, and diastolic BP, cardiac output (CO) and peripheral resistance (PR). Cardiac sympathovagal balance was determined by HR variability analysis (low frequency and high frequency bands, LF/HF). Superoxide generation in polymorphonuclear neutrophil cells were established using relative luminescence units (PMNs RLU) at baseline (pre-HPX) and immediately after hypoxia induction (post-HPX6).Results: The studied subjects had normal levels of BP, plasma glucose, lipid profile, and inflammatory marker (C-reactive protein). Acute intermittent HPX increased HR, systolic BP, CO, and decreased PR. Additionally, acute intermittent HPX increased PMNs RLU, measured post-HPX6 (470 ± 50 vs. 741 ± 135, P < 0.05). We found a similar increase in LF/HF post-HPX6 (0.91 ± 0.11 vs. 2.85 ± 0.40, P < 0.05). PR was diminished from pre-HPX to post-HPX6 (1.0 ± 0.03 vs. 0.85 ± 0.06, P < 0.05). Further analysis showed significant association between O2 saturation and PMNs RLU (R = −0.62, P = 0.02), and with LF/HF (R = −0.79, P = 0.02) post-HPX6. In addition, an association was found between PMNs RLU and PR post-HPX6 (R = 0.58, P = 0.04).Conclusion: Acute exposure to intermittent HPX not only increased superoxide generation in neutrophils, but also impaired cardiac sympathovagal balance in healthy subjects. These data reinforce the role of intermittent HPX in superoxide generation on neutrophils, which may lead to an impairment in peripheral vascular resistance.

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Inspiratory Muscle Training Reduces Sympathetic Nervous Activity and Improves Inspiratory Muscle Weakness and Quality of Life in Patients With Chronic Heart Failure

Abstract: Home-based IMT represents an important strategy to improve cardiac and peripheral autonomic controls, functional capacity, and quality of life in patients with CHF.

Cited by 84 publications

References 30 publications

Effects of inspiratory muscle exercise in the pulmonary function, autonomic modulation, and hemodynamic variables in older women with metabolic syndrome

Effects of inspiratory muscle exercise in the pulmonary function, autonomic modulation, and hemodynamic variables in older women with metabolic syndrome

The striated muscles in pulmonary arterial hypertension: adaptations beyond the right ventricle

The Role of Acute Intermittent Hypoxia in Neutrophil-Generated Superoxide, Sympathovagal Balance, and Vascular Function in Healthy Subjects

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