Key result
Inspiratory muscle training cuts the MAP increase during inspiratory loading by ~40% in HFpEF.
Why the study?
Patients with HFpEF have exaggerated cardiovascular responses to inspiratory muscle metaboreflex activation, but the effect of inspiratory muscle training on these responses was unknown.
Does inspiratory muscle training improve inspiratory muscle metaboreflex-mediated cardiovascular responses in patients with HFpEF?
Does inspiratory muscle training improve inspiratory muscle metaboreflex-mediated cardiovascular responses in patients with HFpEF?
Inspiratory muscle training attenuates exaggerated cardiovascular responses to inspiratory muscle metaboreflex activation in HFpEF, potentially improving exercise tolerance.
Answers are grounded in this paper and cite their sources.
May blunt metaboreflex pressor responses in HFpEF; leaves open effects on exercise tolerance or outcomes.
INTRODUCTION: High inspiratory muscle work elicits respiratory muscle metaboreflex activation, contributing to increases in mean arterial pressure (MAP) and decreases in leg blood flow in adults at rest. Patients with heart failure with preserved ejection fraction (HFpEF) have exaggerated cardiovascular responses with inspiratory muscle metaboreflex activation. The purpose of this study was to investigate the effect of inspiratory muscle training (IMT) on respiratory muscle metaboreflex-mediated cardiovascular responses in patients with HFpEF. METHODS: 13 patients with HFpEF (6M/7F; 69±9 years; 33±5kg/m 2 ) underwent evaluation of cardiovascular responses to inspiratory resistive breathing tasks (IRBT) at 60% maximal inspiratory pressure (MIP) pre- and post-IMT. Beat-by-beat blood pressure and heart rate were measured using finger plethysmography. Vastus lateralis blood flow index (BFI) was measured using near infrared spectroscopy and indocyanine green dye. Vastus lateralis vascular resistance index was calculated. IMT consisted of 30 repetitions/day, 7 days/week for 8 weeks at 40% MIP. RESULTS: MIP increased from 71±21 to 95±25cmH 2 O following IMT (p<0.01). Following 8 weeks of IMT, the increases in MAP (Pre-IMT: 15±6 vs. Post-IMT: 9±6mmHg; p<0.01) and heart rate (Pre-IMT: 9±6 vs. Post-IMT: 6±5 beats/min, p=0.03) during the 60% IRBT were attenuated compared to pre-IMT. The % increase in vastus lateralis vascular resistance index during the 60% IRBT was smaller post-IMT than pre-IMT (Pre-IMT: 87±53 vs. Post-IMT: 47±34%, p<0.01). The % decrease in vastus lateralis BFI during the 60% IRBT was attenuated post-IMT than pre-IMT (Pre-IMT: -33±14 vs. Post-IMT: -23±12%; p<0.01). CONCLUSION: IMT attenuates the inspiratory muscle metaboreflex-mediated cardiovascular responses in patients with HFpEF.
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Miller et al. (2026) studied Heart Failure with Preserved Ejection Fraction (HFpEF) (n=13). Inspiratory muscle training (IMT) vs. Pre-IMT baseline was evaluated on Increase in mean arterial pressure (MAP) during 60% inspiratory resistive breathing task (IRBT) (p=<0.01). Inspiratory muscle training for 8 weeks significantly attenuated the increase in mean arterial pressure during high-intensity inspiratory loading from 15 mmHg to 9 mmHg in patients with HFpEF.
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