Kensaku Yamada1, Yoshiharu Kinugasa2, Takeshi Sota1, Mari Miyagi1, Shinobu Sugihara1, Masahiko Kato1, Kazuhiro Yamamoto1. 1. Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan. 2. Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan. Electronic address: ykinugasa-circ@umin.ac.jp.
Abstract
BACKGROUND: The relationship between inspiratory muscle weakness (IMW) and exercise intolerance in patients with heart failure with preserved ejection fraction (HFpEF) remains unestablished. METHODS AND RESULTS: The present study enrolled 40 patients with HFpEF (EF ≥45%). IMW was defined as maximum inspiratory pressure <70% normal predicted values. The function of the diaphragm was assessed by means of ultrasound measurement of muscle thickening of the diaphragm. IMW was prevalent in 27.5% of patients. Patients with IMW had significantly lower vital capacity relative to normal predicted values (%VC), lower knee extensor muscle strength in relation to body weight (%KEMS), poorer nutritional status as assessed by means of the Geriatric Nutritional Risk Index, and shorter 6-minute walk distance (6MWD) compared with patients without IMW (all P < .05). Impaired diaphragm muscle thickening at end-inspiration (median value < 3.9 mm) was significantly associated with a high prevalence of IMW and reduced 6MWD (all P < .05). Subgroup analysis showed that IMW was accompanied by a further decrease in 6MWD in patients with restrictive pulmonary dysfunction (%VC <80%) or lower-limb muscle weakness (median %KEMS <30%; all P < .05). CONCLUSIONS: IMW is associated with exercise intolerance in patients with HFpEF.
BACKGROUND: The relationship between inspiratory muscle weakness (IMW) and exercise intolerance in patients with heart failure with preserved ejection fraction (HFpEF) remains unestablished. METHODS AND RESULTS: The present study enrolled 40 patients with HFpEF (EF ≥45%). IMW was defined as maximum inspiratory pressure <70% normal predicted values. The function of the diaphragm was assessed by means of ultrasound measurement of muscle thickening of the diaphragm. IMW was prevalent in 27.5% of patients. Patients with IMW had significantly lower vital capacity relative to normal predicted values (%VC), lower knee extensor muscle strength in relation to body weight (%KEMS), poorer nutritional status as assessed by means of the Geriatric Nutritional Risk Index, and shorter 6-minute walk distance (6MWD) compared with patients without IMW (all P < .05). Impaired diaphragm muscle thickening at end-inspiration (median value < 3.9 mm) was significantly associated with a high prevalence of IMW and reduced 6MWD (all P < .05). Subgroup analysis showed that IMW was accompanied by a further decrease in 6MWD in patients with restrictive pulmonary dysfunction (%VC <80%) or lower-limb muscle weakness (median %KEMS <30%; all P < .05). CONCLUSIONS: IMW is associated with exercise intolerance in patients with HFpEF.
Authors: Rachel C Kelley; Lauren Betancourt; Andrea M Noriega; Suzanne C Brinson; Nuria Curbelo-Bermudez; Dongwoo Hahn; Ravi A Kumar; Eliza Balazic; Derek R Muscato; Terence E Ryan; Robbert J van der Pijl; Shengyi Shen; Coen A C Ottenheijm; Leonardo F Ferreira Journal: J Appl Physiol (1985) Date: 2021-11-18
Authors: Matthew Nayor; Nicholas E Houstis; Mayooran Namasivayam; Jennifer Rouvina; Charles Hardin; Ravi V Shah; Jennifer E Ho; Rajeev Malhotra; Gregory D Lewis Journal: JACC Heart Fail Date: 2020-06-10 Impact factor: 12.035
Authors: T Scott Bowen; Dominic Brauer; Natale P L Rolim; Fredrik H Bækkerud; Angela Kricke; Anne-Marie Ormbostad Berre; Tina Fischer; Axel Linke; Gustavo Justo da Silva; Ulrik Wisloff; Volker Adams Journal: J Am Heart Assoc Date: 2017-10-24 Impact factor: 5.501
Authors: Jens Spiesshoefer; Matthias Boentert; Izabela Tuleta; Alberto Giannoni; Daniel Langer; Hans Joachim Kabitz Journal: Front Physiol Date: 2019-10-24 Impact factor: 4.566
Authors: Ever Espino-Gonzalez; Peter G Tickle; Alan P Benson; Roger W P Kissane; Graham N Askew; Stuart Egginton; T Scott Bowen Journal: J Physiol Date: 2021-01-04 Impact factor: 5.182