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心力衰竭患者的吸气肌训练

Inspiratory Muscle Training in Patients with Heart Failure.

作者信息

Fernandez-Rubio Hugo, Becerro-de-Bengoa-Vallejo Ricardo, Rodríguez-Sanz David, Calvo-Lobo César, Vicente-Campos Davinia, Chicharro J L

机构信息

Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain.

Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain.

出版信息

J Clin Med. 2020 Jun 2;9(6):1710. doi: 10.3390/jcm9061710.

Abstract

BACKGROUND

Prior systematic reviews and meta-analysis addressed that inspiratory muscle training (IMT) improved inspiratory muscle weakness, cardiorespiratory fitness and quality of life similar to conventional exercise training as a first alternative in deconditioned patients with heart failure (HF) lead to a better adaptation to posterior exercise training. The heterogeneity and variability in a wide range of new studies about this topic led to the necessity of an updated and comprehensive narrative review. The present review aimed to analyze and update the most relevant studies about IMT in patients who suffer from HF.

METHODS

A narrative review was carried out about IMT in HF patients including 26 experimental studies divided into 21 clinical trials and 5 quasi-experimental studies identified through database searching in PubMed, Cochrane and PEDro.

RESULTS

There is enough evidence to state that IMT produces improvements in functional capacity of patients with HF. Nevertheless, there is not enough evidence to support that IMT could improve cardiovascular parameters, blood biomarkers or quality of life in these patients.

CONCLUSIONS

Thus, IMT may be recommended to improve functional capacity in patients who suffer from HF; nevertheless, more evidence is needed regarding cardiovascular parameters, biomarkers and quality of life. Furthermore, mortality or HF hospitalization was not evaluated and most studies were not longer than 3 months. According to IMT protocols and study designs heterogeneity and mid-term follow-up, further investigations through high-quality long-term randomized clinical trials should be performed to achieve systematic reviews and meta-analysis to support strong evidence for IMT in HF patients.

摘要

背景

先前的系统评价和荟萃分析表明,吸气肌训练(IMT)可改善吸气肌无力、心肺适能和生活质量,与传统运动训练效果相似,作为心力衰竭(HF)失健患者的首选替代方案,可使其更好地适应后续运动训练。关于该主题的大量新研究存在异质性和变异性,因此有必要进行更新且全面的叙述性综述。本综述旨在分析和更新有关HF患者IMT的最相关研究。

方法

对HF患者的IMT进行了叙述性综述,包括通过在PubMed、Cochrane和PEDro数据库检索确定的26项实验研究,其中分为21项临床试验和5项准实验研究。

结果

有足够的证据表明IMT可改善HF患者的功能能力。然而,没有足够的证据支持IMT能改善这些患者的心血管参数、血液生物标志物或生活质量。

结论

因此,可推荐IMT来改善HF患者的功能能力;然而,关于心血管参数、生物标志物和生活质量还需要更多证据。此外,未评估死亡率或HF住院情况,且大多数研究时长不超过3个月。根据IMT方案、研究设计的异质性和中期随访情况,应通过高质量的长期随机临床试验进行进一步研究,以进行系统评价和荟萃分析,为HF患者的IMT提供有力证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fe6/7356942/13ebf71d57d7/jcm-09-01710-g001.jpg

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