Key result
Inspiratory muscle weakness (MIP < 70% predicted) in patients with chronic thromboembolic pulmonary hypertension was associated with significantly lower peak oxygen uptake (10.5 vs 13.1 mL/Kg/min) and worse exertional dyspnea.
Why the study?
Does inspiratory muscle weakness correlate with reduced exercise capacity and increased exertional dyspnea in patients with chronic thromboembolic pulmonary hypertension?
Cross-Sectional (n=39)
No
Does inspiratory muscle weakness correlate with reduced exercise capacity and increased exertional dyspnea in patients with chronic thromboembolic pulmonary hypertension?
Absolute Event Rate: 10.5% vs 13.1%
p-value: p=0.005
Inspiratory muscle weakness is highly prevalent in CTEPH and independently contributes to reduced exercise capacity and heightened exertional dyspnea.
May warrant inspiratory muscle assessment in CTEPH; leaves open whether training improves exercise capacity.
Determination of potentially-reversible factors contributing to exertional dyspnea remains an unmet clinical need in chronic thromboembolic pulmonary hypertension (CTEPH). Therefore, we aimed to evaluate the influence of inspiratory muscle weakness (IMW) on exercise capacity and dyspnea during effort in patients with CTEPH. We performed a prospective cross-sectional study that included thirty-nine consecutive patients with CTEPH (48 ± 15 yrs, 61% female) confirmed by right heart catheterization that underwent an incremental cardiopulmonary exercise test, 6-minute walk test and maximum inspiratory pressure (MIP) measurement. MIP < 70%pred was found in 46% of patients. On a multiple linear regression analysis, MIP was independently associated with 6MWD and [Formula: see text]. Patients with MIP < 70% presented greater [Formula: see text] than those with MIP ≥ 70%. Additionally, they also presented stronger sensations of dyspnea throughout exercise, even when adjusted for ventilation. At rest and at different levels of exercise, mean inspiratory flow (VT/TI) was significantly higher in patients with MIP < 70%. In conclusion, IMW is associated with a rapid increase of dyspnea, higher inspiratory load and poor exercise capacity in patients with CTEPH.
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Rolim et al. (2018) conducted a cross-sectional in Chronic thromboembolic pulmonary hypertension (n=39). Inspiratory muscle weakness (MIP < 70% predicted) vs. Preserved inspiratory muscle strength (MIP ≥ 70% predicted) was evaluated on Peak oxygen uptake (VO2PEAK) in mL/Kg/min (p=0.005). Inspiratory muscle weakness (MIP < 70% predicted) in patients with chronic thromboembolic pulmonary hypertension was associated with significantly lower peak oxygen uptake (10.5 vs 13.1 mL/Kg/min) and worse exertional dyspnea.
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