Li Hui, Tao Lingling, Huang Yuewi, Li Ziyang, Zhao Jianrong
Department of Cardiovascular Medicine, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Ultrasound, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2022 Oct 19;9:993846. doi: 10.3389/fcvm.2022.993846. eCollection 2022.
OBJECTIVE: To explore the effect of inspiratory muscle training (IMT) on patients with heart failure and further explore the impact of IMT on patients with heart failure with preserved ejection fraction. METHODS: PubMed, EMBASE, Cochrane Library, CNKI, Wanfang and VIP databases were systematically searched. Randomized controlled trials of inspiratory muscle training in patients with heart failure were included. Revman 5.3 software was used to calculate the weighted mean difference (MD) of the combined effect size. The effects of IMT on the maximum oxygen uptake (peakVO2), maximum inspiratory pressure ( ), ventilation efficiency ( / ), six-minute walking distance (6MWD), forced expiratory volume (FEV), forced vital capacity (FVC) and quality of life in patients with heart failure were compared and analyzed. RESULTS: After systematic retrieval and screening, 17 studies were included in this study, and the quality of the included studies was good. The results showed that IMT could increase peakVO2 (MD 2.53; 95% CI 1. 54, 3. 51; < 0.0001) and (MD 17.25; 95% CI 13. 75, 20. 75; < 0.00001); improve the V/VCO (MD -4.22; 95% CI -6.78, -1.66; = 0.001) and significantly improve the quality of life in patients with heart failure (MD -13.34; 95% CI -20.42, -6.26; = 0.0002). However, the effect of IMT on 6MWD in patients with heart failure was not statistically significant (MD 74.45; 95% CI -12.88,161.79; = 0.09), and the effect on lung function (FEV and FVC) was also not statistically significant ( = 0.08; = 0.86). IMT had a more significant positive effect on peakVO2 (MD 2.98; 95% CI 1.63, 4.34; < 0.0001) and quality of life (MD -14.52; 95% CI -18.53, -10.52; < 0.00001) in patients with heart failure with preserved ejection fraction. Descriptive analysis suggested that IMT may positively affect dyspnoea in patients with heart failure. In addition, the choice of evaluation scale may affect the evaluation results of quality of life and dyspnoea. CONCLUSION: IMT has a significant positive effect on respiratory status in patients with heart failure, but different dyspnoea and quality of life evaluation scales can affect the final evaluation results.
目的：探讨吸气肌训练（IMT）对心力衰竭患者的影响，并进一步探究IMT对射血分数保留的心力衰竭患者的影响。 方法：系统检索PubMed、EMBASE、Cochrane图书馆、中国知网、万方和维普数据库。纳入心力衰竭患者吸气肌训练的随机对照试验。使用Revman 5.3软件计算合并效应量的加权均数差（MD）。比较并分析IMT对心力衰竭患者最大摄氧量（peakVO2）、最大吸气压力（ ）、通气效率（ / ）、六分钟步行距离（6MWD）、用力呼气量（FEV）、用力肺活量（FVC）和生活质量的影响。 结果：经过系统检索和筛选，本研究纳入17项研究，纳入研究质量良好。结果显示，IMT可提高peakVO2（MD 2.53；95%CI 1.54，3.51； < 0.0001）和 （MD 17.25；95%CI 13.75，20.75； < 0.00001）；改善V/VCO（MD -4.22；95%CI -6.78，-1.66； = 0.001），并显著改善心力衰竭患者的生活质量（MD -13.34；95%CI -20.42，-6.26； = 0.0002）。然而，IMT对心力衰竭患者6MWD的影响无统计学意义（MD 74.45；95%CI -12.88，161.79； = 0.09），对肺功能（FEV和FVC）的影响也无统计学意义（ = 0.08； = 0.86）。IMT对射血分数保留的心力衰竭患者的peakVO2（MD 2.98；95%CI 1.63，4.34； < 0.0001）和生活质量（MD -14.52；95%CI -18.53，-10.52； < 0.00001）有更显著的积极影响。描述性分析表明，IMT可能对心力衰竭患者的呼吸困难有积极影响。此外，评估量表的选择可能会影响生活质量和呼吸困难的评估结果。 结论：IMT对心力衰竭患者的呼吸状况有显著的积极影响，但不同的呼吸困难和生活质量评估量表会影响最终评估结果。
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