Respiratory muscles trainings are effective in lowering the pneumonia frequency in patients with heart failure and chronic obstructive pulmonary disease

Abstract

Purpose: To study the effect of long-term respiratory muscles trainings (RMT) in patients with HF and chronic obstructive pulmonary disease (COPD) on the frequency of pneumonia and heart faailure progression.

Methods: 73 patients 63,5±3,7 yrs old with NYHA III-IV HF and COPD were randomized to either an exercise training group (EG)(37pts) or to a control group. The CG patients had standard CR according to the national guidelines. The EG participated additionally in a RMT with gradual increase of inspire and expire resistance. Trainings were held for 20-30 min 1-2 times every day for 12 months. VO2 peak, maximal inspiratory mouth pressure (PImax) and the frequency of hospitalizations and lethal events were evaluated at baseline and every 12 weeks during 1 year.

Results: RMT as a part of comprehensive rehabilitation increased physical capacity (VOat baseline 9.06 ±2,35 ml/kg/min in EG vs 9.11±4,04 ml/kg/min in CG, p>0,05; 12,87±2,75 ml/kg/min in EG vs 7,69±2,16 ml/kg/min in CG, p<0,05, in 12 months), enhanced ventilation (VC at baseline 56.7± 3.9% in TG vs 57.01±4.5% in CG; 59.4±1.2% vs 51,9 ±2.8% p<0,05, in 12 months; FVC 44.8±3.1% vs 45.1±1.4% at baseline; 48.2±2.4% in TG vs 43.1±2.1% in CG, p<0,05, in 12 months). 12% of TG patients had pneumonia during 1 year vs 19% of patients in CG. In CG pneumonia provoked HF progression, in TG there was no statistically significant correlation between pneumonia and HF.

Conclusion: RMT in patients with NYHA class III-IV HF and COPD increase physical capacity, enhanced ventilation and reduce frequency of pneumonia and related HF progression.