Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure.

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  • Additional Information
    • Affiliation:
      The Department of Physiotherapy, LIM-54, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
      Division of Cardiology, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil. Dr
      Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      BACKGROUND: Chronic heart failure is commonly associated with inspiratory muscle weakness. However, few studies have investigated the risk factors for inspiratory muscle weakness in individuals with chronic heart failure and systolic dysfunction (left-ventricular ejection fraction [LVEF] <40%). METHODS: Seventy subjects were recruited in a cardiac center. We assessed clinical parameters, smoking history, peripheral muscle strength, pulmonary function, echocardiographic variables, and brain natriuretic peptide. The subjects were classified with inspiratory muscle weakness when the maximum inspiratory pressure was <70% of predicted values. RESULTS: Thirty-six subjects (51%) had inspiratory muscle weakness. The subjects with inspiratory muscle weakness and the subjects with no inspiratory muscle weakness were similar in age, sex, body mass index, medication use, and physical activity. However, the subjects with inspiratory muscle weakness had lower LVEF (P = .003), systolic blood pressure (P = .01), diastolic blood pressure (P = .042), quadriceps muscle strength (P = .02), lung function (P = .035), increased brain natriuretic peptide (P = .02), smoking history (P = .01), and pulmonary hypertension incidence (P = .03). Multivariate logistic regression analysis found a lower LVEF, increased smoking history, and lower systolic blood pressure as significant independent predictors for inspiratory muscle weakness. CONCLUSIONS: The combination of lower LVEF, lower systolic blood pressure, and smoking history predicted inspiratory muscle weakness. Patients with suspected inspiratory muscle weakness should be examined and, if inspiratory muscle weakness exists, then inspiratory muscle training should be provided. Reducing inspiratory muscle weakness has the potential to improve many of the deleterious effects of chronic heart failure.
    • Journal Subset:
      Allied Health; Blind Peer Reviewed; Double Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
    • ISSN:
      0020-1324
    • MEDLINE Info:
      NLM UID: 7510357
    • Publication Date:
      20200402
    • Publication Date:
      20200407
    • DOI:
      http://dx.doi.org/10.4187/respcare.06766
    • Accession Number:
      142481249
  • Citations
    • ABNT:
      NAKAGAWA, N. K. et al. Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure. Respiratory Care, [s. l.], v. 65, n. 4, p. 507–516, 2020. DOI 10.4187/respcare.06766. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=142481249. Acesso em: 15 ago. 2020.
    • AMA:
      Nakagawa NK, Abreu Diz M, Satie Kawauchi T, et al. Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure. Respiratory Care. 2020;65(4):507-516. doi:10.4187/respcare.06766
    • APA:
      Nakagawa, N. K., Abreu Diz, M., Satie Kawauchi, T., de Andrade, G. N., Kikuchi Umeda, I. I., Murakami, F. M., Oliveira-Maul, J. P., Nascimento, J. A., Nunes, N., Julio Yoshio Takada, de Padua Mansur, A., & Cahalin, L. P. (2020). Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure. Respiratory Care, 65(4), 507–516. https://doi.org/10.4187/respcare.06766
    • Chicago/Turabian: Author-Date:
      Nakagawa, Naomi Kondo, Mariana Abreu Diz, Tatiana Satie Kawauchi, Geisa Nascimento de Andrade, Iracema Ioco Kikuchi Umeda, Fernanda Murata Murakami, Janaina Proenca Oliveira-Maul, et al. 2020. “Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure.” Respiratory Care 65 (4): 507–16. doi:10.4187/respcare.06766.
    • Harvard:
      Nakagawa, N. K. et al. (2020) ‘Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure’, Respiratory Care, 65(4), pp. 507–516. doi: 10.4187/respcare.06766.
    • Harvard: Australian:
      Nakagawa, NK, Abreu Diz, M, Satie Kawauchi, T, de Andrade, GN, Kikuchi Umeda, II, Murakami, FM, Oliveira-Maul, JP, Nascimento, JA, Nunes, N, Julio Yoshio Takada, de Padua Mansur, A & Cahalin, LP 2020, ‘Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure’, Respiratory Care, vol. 65, no. 4, pp. 507–516, viewed 15 August 2020, .
    • MLA:
      Nakagawa, Naomi Kondo, et al. “Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure.” Respiratory Care, vol. 65, no. 4, Apr. 2020, pp. 507–516. EBSCOhost, doi:10.4187/respcare.06766.
    • Chicago/Turabian: Humanities:
      Nakagawa, Naomi Kondo, Mariana Abreu Diz, Tatiana Satie Kawauchi, Geisa Nascimento de Andrade, Iracema Ioco Kikuchi Umeda, Fernanda Murata Murakami, Janaina Proenca Oliveira-Maul, et al. “Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure.” Respiratory Care 65, no. 4 (April 2020): 507–16. doi:10.4187/respcare.06766.
    • Vancouver/ICMJE:
      Nakagawa NK, Abreu Diz M, Satie Kawauchi T, de Andrade GN, Kikuchi Umeda II, Murakami FM, et al. Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure. Respiratory Care [Internet]. 2020 Apr [cited 2020 Aug 15];65(4):507–16. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=142481249