Effect of inspiratory muscle training in patients with chronic heart failure: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

The effect of inspiratory muscle training (IMT) in chronic heart failure (CHF) patients remains unclear now. This study aimed to comprehensively identify the therapeutic effects of IMT among CHF patients based on current evidence of randomized controlled trials (RCTs).

METHODS

Several databases were searched up to January 2, 2024 for RCTs investigating the clinical application of IMT in CHF patients. Primary outcomes were maximal inspiratory pressure (MIP) and pulmonary function. Secondary outcomes were exercise performance, including the six-minute walk test (6MWT) and Borg dyspnea index, quality of life evaluated by the Minnesota Living with Heart Failure Questionnaire (MLWHF) and N terminal-pro brain natriuretic peptide (NT-proBNP). Statistical analyses were conducted by the RevMan 5.3 software.

RESULTS

Fifteen RCTs with 494 cases were included in this meta-analysis. Pooled results demonstrated that IMT significantly increased the MIP [mean difference (MD) =16.36 cmHO, 95% confidence interval (CI): 12.26 to 20.46, P<0.001] and VOpeak (MD =1.66 mL/kg/min, 95% CI: 0.27 to 3.05, P=0.02). Besides, patients receiving the IMT showed increased 6MWT (MD =37.40 m, 95% CI: 16.46 to 58.35, P<0.001) and decreased Borg dyspnea index (MD =-0.63, 95% CI: -0.83 to -0.44, P<0.001), MLWHF (MD =-8.51, 95% CI: -13.60 to -3.42, P=0.001) and NT-proBNP (MD =-81.67 pg/mL, 95% CI: -124.88 to -38.45, P<0.001).

CONCLUSIONS

IMT plays a role in improving the clinical outcomes including the inspiratory muscle function, exercise performance, quality of life and NT-proBNP among CHF patients.