Chronic Heart Failure
Conditions
Keywords
muscle training, walking test, chronic heart failure, functional capacity
Brief summary
Heart failure is a clinical syndrome that is the common end of several cardiac diseases with symptoms such as muscle fatigue, dyspnea and reduction of quality of life. To improve respiratory and general functional capacity of these patients, there are strategies that can be used such as inspiratory muscle training and peripheral muscle training (dynamic resistance training).
Detailed description
After agreement with the written informed consent, 35 subjects with severe heart failure were included in this study. They were randomized in three groups: controls, low-intensity and moderate-intensity group. All volunteers were assessed at Baseline and 8-weeks intervention. Cardiac events were registered following two years from baseline. The present study aimed to assess the effects of a combined program of inspiratory and peripheral muscle training on respiratory and general functional capacity and quality of life in patients with chronic heart failure.
Interventions
OTHERcontrol
No intervention during the 8-weeks period of the study because of awaiting evaluation for cardiac rehabilitation or transplantation
Patients will be submitted to a 8-weeks training program with inspiratory muscle trained at 30% of the maximal inspiratory pressure (30 minutes/session/7 days/week) + peripheral muscle trained with exercises of upper limbs and lower limbs (50% 1 RM, increased every 2-weeks).
OTHERlow-intensity group
Patients will be submited to a 8 weeks training program, with inspiratory muscle trained at 15% of the maximal inspiratory pressure (30 minutes/session/7 days/week) + peripheral muscle trained with exercises of upper limbs and lower limbs (0,5 kg each)
Sponsors
Fundação de Amparo à Pesquisa do Estado de São Paulo
Instituto Dante Pazzanese de Cardiologia
Naomi Kondo Nakagawa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* chronic heart failure (functional class from NYHA II and III), * left ventricle ejection fraction bellow or equal 40%.
Exclusion criteria
* uncontrolled arrhythmia * pulmonary edema or pulmonary congestion in the last 30 days * peripheral oxygen saturation bellow 92% in resting condition * respiratory infection in the previous 30 days to the enrollment into the study * cognitive, neurological or orthopedic limitations
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in respiratory muscle strength (in centimeters of water) | Before and after 8-weeks | Inspiratory and expiratory muscle strength was assessed by using a pressure transducer (MVD-300 Microhard System, GlobalMed, Porto Alegre, Brazil). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| walking distance | Before and after 8-weeks | To assess functional capacity using walking distance (6-min walk test accordingly to ATS and ERS guidelines) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Inflammation in the upper airway by cytokines in blood | Before and after 8-weeks | MMP2, myoglobin, p-selectin, MPO, NGAL, sVCAM, IL-2, IL-3, IL-4, IL-8,MIP1-alpha, 17, VEGF by Multiplex analysis. Inflammatory cells in nasal lavage will be also investigated. |
| Change in heart rate variability (HRV) | Before and after 8-weeks | HRV is obtained from the spectral analysis of R-R intervals obtained from a heart rate monitor (Polar, S810, Kempele, Finland) |
| Prevalence of cardiac events and arrhythmia | Before and after 8-weeks | by a 24-hours holter system for continuous recording of ambulatory electrocardiographic signs |
| Change in pulmonary function | Before and after 8-weeks | Pulmonary function will be assessed by spirometry. |
| Change in quality of life using Minnesota Questionnaire | Before and after 8-weeks | by Short Form-36 and by Minnesota Living with Heart Failure Questionnaire \- Minnesota living with heart failure questionaire: contains 21 questions of physical, social, economic and emotional aspects. Each question ranges from zero to five points, with a total score of 105 points which is the maximum severity degree related to personal perception of quality of life. |
| Change in brain natriuretic peptide (BNP) analysis | Before and after 8-weeks | A blood sample of 5 ml will be collected in a tube and BNP measured |
| Change in international Physical Activity Questionnaire (IPAQ) | Before and after 8-weeks | Patients will be classified as sedentary, irregularly active, active or verry active according to Matsudo's classification (2001). |
| Change in functional capacity | Before and after 8-weeks | 1RM |
Countries
Brazil
Outcome results
None listed