Key result
Greater dyspnea, but not respiratory muscle strength, correlates with lower exercise capacity in HFrEF.
Why the study?
Studies evaluating factors linked to exercise intolerance in chronic heart failure show controversial results, and data in Arabic patients were lacking.
Is exercise capacity (6MWT) associated with breathlessness (mMRC) and respiratory muscle strength in stable male patients with chronic heart failure with reduced ejection fraction?
Cross-Sectional (n=84)
No
Is exercise capacity (6MWT) associated with breathlessness (mMRC) and respiratory muscle strength in stable male patients with chronic heart failure with reduced ejection fraction?
In stable male patients with HFrEF free of primary respiratory disease, reduced 6MWT exercise capacity is strongly linked to perceived dyspnea (mMRC) rather than respiratory muscle weakness, suggesting rehabilitation should target dyspnea perception alongside physical conditioning.
Answers are grounded in this paper and cite their sources.
Supports prioritizing symptom-targeted rehabilitation over isolated inspiratory muscle training in stable HFrEF; leaves open whether modifying dyspnea perception improves functional outcomes.
Background: Exercise intolerance in patients with chronic heart failure (CHF) is associated with a number of factors, including breathlessness and respiratory muscle weakness. However, many studies reported controversial results, and as yet there is no study on Arabic patients with CHF. This study aimed to examine the impact of breathlessness and respiratory muscle strength on exercise capacity in Arabic patients with CHF. Methods: This was a cross-sectional study, involving 42 stable adult male patients with CHF with a reduced ejection fraction and 42 controls who were free from cardiorespiratory and neuromuscular diseases. Patients with CHF and the controls underwent respiratory muscle strength tests and a six-minute walk test (6MWT), and the measurements were taken. Dyspnea was recorded using the modified Medical Research Council (mMRC) scale, along with the number of comorbidities. Results: Patients with CHF and controls were similar in age and sex. Patients with CHF had a greater number of comorbidities, a higher dyspnea score, a lower 6MWT score, and lower respiratory muscle strength (p < 0.001). Only 7% of patients with CHF had weak inspiratory muscle strength (<60% of that predicted) and 40% terminated the 6MWT due to dyspnea. The 6MWT was associated with mMRC (rs = −0.548, p < 0.001) but not with respiratory muscle strength (p > 0.05). Conclusions: Exercise intolerance in patients with CHF was associated with dyspnea and was independent of respiratory muscle strength.
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Albarrati et al. (2022) conducted a cross-sectional in Chronic heart failure with reduced ejection fraction (n=84). Dyspnea (mMRC scale) and respiratory muscle strength (MIP, MEP, SNIP) vs. Controls without cardiorespiratory or neuromuscular diseases was evaluated on Exercise capacity measured by six-minute walk test (6MWT) distance (rs = -0.548 (for mMRC correlation with 6MWT), p=<0.001). Dyspnea (mMRC) was inversely correlated with 6MWT exercise capacity in HFrEF patients (rs = -0.548, p < 0.001), whereas respiratory muscle strength showed no association (p > 0.05).
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