Yang Mengxuan, Huang Wei, Luo Zeruxin, Zhang Xiu, Su Jianhua, Yu Pengming
Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
J Thorac Dis. 2025 Aug 31;17(8):6242-6253. doi: 10.21037/jtd-2025-519. Epub 2025 Aug 28.
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).
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.
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).
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.
目前，吸气肌训练（IMT）对慢性心力衰竭（CHF）患者的影响尚不清楚。本研究旨在基于随机对照试验（RCT）的现有证据，全面确定IMT对CHF患者的治疗效果。
检索多个数据库至2024年1月2日，查找调查IMT在CHF患者中临床应用的RCT。主要结局指标为最大吸气压（MIP）和肺功能。次要结局指标为运动能力，包括六分钟步行试验（6MWT）和Borg呼吸困难指数、通过明尼苏达心力衰竭生活问卷（MLWHF）评估的生活质量以及N末端脑钠肽前体（NT-proBNP）。采用RevMan 5.3软件进行统计分析。
本荟萃分析纳入了15项RCT，共494例患者。汇总结果表明，IMT显著提高了MIP[平均差值（MD）=16.36 cmH₂O，95%置信区间（CI）：12.26至20.46，P<0.001]和峰值摄氧量（VO₂peak，MD =1.66 mL/kg/min，95%CI：0.27至3.05，P=0.02）。此外，接受IMT的患者6MWT增加（MD =37.40 m，95%CI：16.46至58.35，P<0.001），Borg呼吸困难指数降低（MD = -0.63，95%CI：-0.83至-0.44，P<0.001），MLWHF降低（MD = -8.51，95%CI：-13.60至-3.42，P=0.001），NT-proBNP降低（MD = -81.67 pg/mL，95%CI：-124.88至-38.45，P<0.001）。
IMT在改善CHF患者的临床结局方面发挥作用，包括吸气肌功能、运动能力、生活质量和NT-proBNP。
