Why the study?
Although increased respiratory muscle strength improves exercise tolerance and quality of life in HF patients, the relationship between changes in respiratory muscle strength and prognosis remains unclear.
Does an increase in respiratory muscle strength following cardiac rehabilitation reduce the incidence of all-cause death or unplanned readmission in patients with heart failure?
Does an increase in respiratory muscle strength following cardiac rehabilitation reduce the incidence of all-cause death or unplanned readmission in patients with heart failure?
Improvements in respiratory muscle strength during cardiac rehabilitation are independently associated with a lower incidence of all-cause death or unplanned readmission in heart failure patients.
Increase in respiratory muscle strength after CR was associated with fewer events in HF; leaves open whether targeted training improves prognosis.
Respiratory muscle weakness, frequently observed in patients with heart failure (HF), is reported as a predictor for poor prognosis. Although increased respiratory muscle strength ameliorates exercise tolerance and quality of life in HF patients, the relationship between changes in respiratory muscle strength and patient prognosis remains unclear. A total of 456 patients with HF who continued a 5-month cardiac rehabilitation (CR) were studied. We measured maximal inspiratory pressure (PImax) at hospital discharge as the baseline and five months thereafter to assess the respiratory muscle strength. Changes in PImax during the 5-month observation period (⊿PImax) were examined. We investigated the composite multiple incidence of all-cause death or unplanned readmission after 5-month CR. The relationship between ⊿PImax and the incidence of clinical events was analyzed. Over a median follow-up of 1.8 years, 221 deaths or readmissions occurred, and their rate of incidence was 4.3/100 person-years. The higher ⊿PImax was significantly associated with lower incidence of clinical event. In multivariate Poisson regression model after adjustment for clinical confounding factors, ⊿PImax remained a significant and independent predictor for all-cause death/readmission (adjusted incident rate ratio for ⊿PImax increase of 10 cmH2O: 0.77, 95% confidence interval: 0.70–0.86). In conclusion, the changes in respiratory muscle strength independently predict the incidence of clinical events in patients with HF.
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Hamazaki et al. (2020) studied this question.
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