PMID- 18360185
OWN - NLM
STAT- MEDLINE
DCOM- 20080701
LR  - 20080324
IS  - 1932-7501 (Print)
IS  - 1932-7501 (Linking)
VI  - 28
IP  - 2
DP  - 2008 Mar-Apr
TI  - Effects of inspiratory muscle training on autonomic activity, endothelial 
      vasodilator function, and N-terminal pro-brain natriuretic peptide levels in 
      chronic heart failure.
PG  - 99-106
LID - 10.1097/01.HCR.0000314203.09676.b9 [doi]
AB  - PURPOSE: To assess the effects of inspiratory muscle training (IMT) on autonomic 
      activity, endothelial function, and N-terminal pro-brain natriuretic peptide 
      (NT-proBNP) levels in patients with chronic heart failure. METHODS: Using age- 
      and sex-matched controlled study, 23 patients (mean left ventricular ejection 
      fraction 29 +/- 2%) were assigned to either a high-intensity training group (n = 
      14), New York Heart Association (NYHA) class II (n = 9)/III (n = 5), or a 
      low-intensity training group (n = 9), NYHA class II (n = 6)/III (n = 3), 
      exercising at 60% and 15% of sustained maximum inspiratory pressure (SPImax), 
      respectively, 3 times per week for 10 weeks. Before and following IMT, patients 
      underwent cardiopulmonary exercise testing and dyspnea evaluation on exertion. 
      Sympathovagal balance was assessed by heart rate variability (HRV) from 24-hour 
      electrocardiogram and endothelial function, using venous occlusion 
      plethysmography. Serum levels of NT-proBNP were determined. RESULTS: 
      High-intensity training group improved maximum inspiratory pressure (PImax, 105.4 
      +/- 5.3 vs 79.1 +/- 5 cm H2O, P = .001), SPImax (511 +/- 42 vs 308 +/- 28 cm 
      H2O/sec/10, P = .001), peak oxygen consumption (19 +/- 1.2 vs 17.1 +/- 0.7 
      mL.kgmin, P = .01) and dyspnea (17.6 +/- 0.2 vs 18.1 +/- 0.1, P = .02). 
      Endothelium-dependent vasodilation, HRV, and NT-proBNP levels were not altered. 
      Low-intensity training group increased only the PImax (97.6 +/- 11.3 vs 84.2 +/- 
      8.7 cm H2O, P = .03). CONCLUSIONS: Improvement in dyspnea and exercise tolerance 
      after IMT were not associated with changes in markers of HRV, endothelial 
      function, and NT-proBNP in patients with mild to moderate chronic heart failure. 
      Further studies on the effects of IMT in advanced heart failure would be 
      worthwhile.
FAU - Laoutaris, Ioannis D
AU  - Laoutaris ID
AD  - Onassis Cardiac Surgery Center, Athens, Greece. ylaoutaris@yahoo.gr
FAU - Dritsas, Athanasios
AU  - Dritsas A
FAU - Brown, Margaret D
AU  - Brown MD
FAU - Manginas, Athanassios
AU  - Manginas A
FAU - Kallistratos, Manolis S
AU  - Kallistratos MS
FAU - Chaidaroglou, Antigoni
AU  - Chaidaroglou A
FAU - Degiannis, Dimitrios
AU  - Degiannis D
FAU - Alivizatos, Peter A
AU  - Alivizatos PA
FAU - Cokkinos, Dennis V
AU  - Cokkinos DV
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - J Cardiopulm Rehabil Prev
JT  - Journal of cardiopulmonary rehabilitation and prevention
JID - 101291247
RN  - 0 (N-terminal proatrial natriuretic peptide)
RN  - 0 (Protein Precursors)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Atrial Natriuretic Factor/*blood
MH  - Autonomic Nervous System/physiopathology
MH  - *Breathing Exercises
MH  - Endothelium, Vascular/*physiopathology
MH  - Exercise Tolerance
MH  - Forearm/blood supply
MH  - Heart Failure/*physiopathology/rehabilitation
MH  - Heart Rate
MH  - Humans
MH  - Plethysmography
MH  - Protein Precursors/*blood
MH  - Regional Blood Flow
MH  - Respiratory Function Tests
MH  - Respiratory Muscles/physiopathology
RF  - 29
EDAT- 2008/03/25 09:00
MHDA- 2008/07/02 09:00
CRDT- 2008/03/25 09:00
PHST- 2008/03/25 09:00 [pubmed]
PHST- 2008/07/02 09:00 [medline]
PHST- 2008/03/25 09:00 [entrez]
AID - 01273116-200803000-00004 [pii]
AID - 10.1097/01.HCR.0000314203.09676.b9 [doi]
PST - ppublish
SO  - J Cardiopulm Rehabil Prev. 2008 Mar-Apr;28(2):99-106. doi: 
      10.1097/01.HCR.0000314203.09676.b9.