Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial
Por:
Palau P, Domínguez E, López L, Ramón JM, Heredia R, González J, Santas E, Bodí V, Miñana G, Valero E, Mollar A, Bertomeu González V, Chorro FJ, Sanchis J, Lupón J, Bayés-Genís A and Núñez J
Publicada:
1 abr 2019
Ahead of Print:
16 mar 2018
Categoría:
Cardiology and cardiovascular medicine
Resumen:
Introduction and objectives: Despite the prevalence of heart failure with preserved ejection fraction (HFpEF), there is currently no evidence-based effective therapy for this disease. This study sought to evaluate whether inspiratory muscle training (IMT), functional electrical stimulation (FES), or a combination of both (IMT + FES) improves 12- and 24-week exercise capacity as well as left ventricular diastolic function, biomarker profile, and quality of life in HFpEF.
Methods: A total of 61 stable symptomatic patients (New York Heart Association II-III) with HFpEF were randomized (1:1:1:1) to receive a 12-week program of IMT, FES, or IMT + FES vs usual care. The primary endpoint of the study was to evaluate change in peak exercise oxygen uptake at 12 and 24 weeks. Secondary endpoints were changes in quality of life, echocardiogram parameters, and prognostic biomarkers. We used a mixed-effects model for repeated-measures to compare endpoints changes.
Results: Mean age and peak exercise oxygen uptake were 74 +/- 9 years and 9.9 +/- 2.5 mL/min/kg, respectively. The proportion of women was 58%. At 12 weeks, the mean increase in peak exercise oxygen uptake (mL/kg/min) compared with usual care was 2.98, 2.93, and 2.47 for IMT, FES, and IMT + FES, respectively (P < .001) and this beneficial effect persisted after 6 months (1.95, 2.08, and 1.56; P < .001). Significant increases in quality of life scores were found at 12 weeks (P < .001). No other changes were found.
Conclusions: In HFpEF patients with low aerobic capacity, IMT and FES were associated with a significant improvement in exercise capacity and quality of life. (C) 2018 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
:
Servicio de Cardiología, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain
:
Servicio de Cardiología, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain
López L:
Facultad de Fisioterapia, Departamento de Fisioterapia, Universitat de València, Valencia, Spain
Ramón JM:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Heredia R:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
González J:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Santas E:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Bodí V:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Miñana G:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Valero E:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Mollar A:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
:
Servicio de Cardiología, Hospital Universitario de San Juan, Universidad Miguel Hernández, CIBERCV, San Juan de Alicante, Alicante, Spain
Chorro FJ:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Sanchis J:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
Lupón J:
Servicio de Cardiología, Unidad de Insuficiencia Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
Department of Medicine, Autonomous University of Barcelona, CIBERCV, Barcelona, Spain
Bayés-Genís A:
Servicio de Cardiología, Unidad de Insuficiencia Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
Department of Medicine, Autonomous University of Barcelona, CIBERCV, Barcelona, Spain
Núñez J:
Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain
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