Jaenisch Rodrigo Boemo, Bertagnolli Mariane, Borghi-Silva Audrey, Arena Ross, Lago Pedro Dal
Laboratory of Experimental Physiology, Post-Graduation Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal de São Carlos (UFSCAR), São Carlos, SP, Brazil.
Braz J Cardiovasc Surg. 2017 Mar-Apr;32(2):104-110. doi: 10.21470/1678-9741-2017-0002.
: Enhanced respiratory muscle strength in patients with heart failure positively alters the clinical trajectory of heart failure. In an experimental model, respiratory muscle training in rats with heart failure has been shown to improve cardiopulmonary function through mechanisms yet to be entirely elucidated.
: The present report aimed to evaluate the respiratory muscle training effects in diaphragm citrate synthase activity and hemodynamic function in rats with heart failure.
: Wistar rats were divided into four experimental groups: sedentary sham (Sed-Sham, n=8), trained sham (RMT-Sham, n=8), sedentary heart failure (Sed-HF, n=7) and trained heart failure (RMT-HF, n=7). The animals were submitted to a RMT protocol performed 30 minutes a day, 5 days/week, for 6 weeks.
: In rats with heart failure, respiratory muscle training decreased pulmonary congestion and right ventricular hypertrophy. Deleterious alterations in left ventricular pressures, as well as left ventricular contractility and relaxation, were assuaged by respiratory muscle training in heart failure rats. Citrate synthase activity, which was significantly reduced in heart failure rats, was preserved by respiratory muscle training. Additionally, a negative correlation was found between citrate synthase and left ventricular end diastolic pressure and positive correlation was found between citrate synthase and left ventricular systolic pressure.
: Respiratory muscle training produces beneficial adaptations in the diaphragmatic musculature, which is linked to improvements in left ventricular hemodynamics and blood pressure in heart failure rats. The RMT-induced improvements in cardiac architecture and the oxidative capacity of the diaphragm may improve the clinical trajectory of patients with heart failure.
心力衰竭患者呼吸肌力量增强可积极改变心力衰竭的临床进程。在一个实验模型中，已证明对心力衰竭大鼠进行呼吸肌训练可通过尚未完全阐明的机制改善心肺功能。
本报告旨在评估呼吸肌训练对心力衰竭大鼠膈肌柠檬酸合酶活性和血流动力学功能的影响。
将Wistar大鼠分为四个实验组：久坐假手术组（Sed-Sham，n = 8）、训练假手术组（RMT-Sham，n = 8）、久坐心力衰竭组（Sed-HF，n = 7）和训练心力衰竭组（RMT-HF，n = 7）。动物每天接受30分钟的呼吸肌训练方案，每周5天，共6周。
在心力衰竭大鼠中，呼吸肌训练减少了肺淤血和右心室肥大。心力衰竭大鼠的左心室压力、左心室收缩性和舒张性的有害改变通过呼吸肌训练得到缓解。心力衰竭大鼠中显著降低的柠檬酸合酶活性通过呼吸肌训练得以保留。此外，发现柠檬酸合酶与左心室舒张末期压力之间呈负相关，与左心室收缩压之间呈正相关。
呼吸肌训练在膈肌肌肉组织中产生有益的适应性变化，这与心力衰竭大鼠左心室血流动力学和血压的改善有关。呼吸肌训练引起的心脏结构和膈肌氧化能力的改善可能会改善心力衰竭患者的临床进程。
