Akkus Oguz, Huzmeli Irem, Seker Taner, Bekler Ozkan, Sen Fatih, Kaypakli Onur, Yildiz Ozer Aysel, Yalcin Fatih
Department of Cardiology, Tayfur Ata Sokmen Faculty of Medicine.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay.
Acta Cardiol Sin. 2023 Sep;39(5):720-732. doi: 10.6515/ACS.202309_39(5).20230306E.
Chronic coronary syndrome (CCS) is one of the most life-restricting coronary artery diseases, and symptom relief is the main goal in CCS patients who suffer from angina.
To assess the potential benefits of device-guided breathing in CCS patients with angina in this randomized, controlled, single-blinded study.
Fifty-one patients with CCS received device-guided breathing for 7 days/8 weeks. Exercise capacity [exercise stress test], cardiac function [transthoracic echocardiography], and angina severity [Canadian Cardiovascular Society Classification] were evaluated initially and after the training. Device-guided breathing was performed at the lowest resistance of the device (POWERbreathe® Classic LR) for the control group (n = 17). The low load training group (LLTG; n = 18) and high load training group (HLTG; n = 16) were trained at 30% and 50% of maximal inspiratory pressure. Baseline characteristics were compared using one-way ANOVA and Kruskal-Wallis test. Categorical data were compared using the chi-square test. ANCOVA was performed to compare changes between three groups. A p value < 0.05 was considered statistically significant.
Metabolic equivalent values were significantly improved in both HLTG and LLTG groups (p < 0.001, p = 0.003). The Duke treadmill score significantly improved and shifted to low-risk both in the HLTG (p < 0.001) and LLTG (p < 0.001) groups. Angina severity significantly alleviated after the training in both HLTG and LLTG groups (p < 0.001, p = 0.002).
An 8-week long program of short-term respiratory muscle training provided positive gains in exercise capacity and angina severity in CCS patients with angina. The effects of long-term training programs on CCS patients should be investigated clinically because of the possibility of helping to decrease the need for invasive treatments.
慢性冠状动脉综合征（CCS）是最限制生活的冠状动脉疾病之一，缓解症状是患有心绞痛的CCS患者的主要目标。
在这项随机、对照、单盲研究中，评估设备引导呼吸对患有心绞痛的CCS患者的潜在益处。
51例CCS患者接受设备引导呼吸治疗7天/8周。在训练开始时和训练后评估运动能力[运动应激试验]、心功能[经胸超声心动图]和心绞痛严重程度[加拿大心血管学会分级]。对照组（n = 17）在设备（POWERbreathe® Classic LR）的最低阻力下进行设备引导呼吸。低负荷训练组（LLTG；n = 18）和高负荷训练组（HLTG；n = 16）分别在最大吸气压力的30%和50%下进行训练。使用单因素方差分析和Kruskal-Wallis检验比较基线特征。使用卡方检验比较分类数据。进行协方差分析以比较三组之间的变化。p值<0.05被认为具有统计学意义。
HLTG组和LLTG组的代谢当量值均显著改善（p < 0.001，p = 0.003）。HLTG组（p < 0.001）和LLTG组（p < 0.001）的杜克运动平板评分均显著改善并转为低风险。HLTG组和LLTG组训练后心绞痛严重程度均显著减轻（p < 0.001，p = 0.002）。
为期8周的短期呼吸肌训练计划使患有心绞痛 的CCS患者的运动能力和心绞痛严重程度得到了积极改善。由于长期训练计划可能有助于减少侵入性治疗的需求，因此应在临床上研究其对CCS患者的影响。
