Wong, Eric, Selig, Steve E and Hare, David L (2011) Respiratory muscle dysfunction and training in chronic heart failure. Heart Lung and Circulation, 20 (5). pp. 289-294. ISSN 1443-9506

Abstract

Patients with chronic heart failure exhibit significantly reduced respiratory muscle strength and endurance. These impairments are associated with numerous alterations in respiratory muscle structure and function, including a shift in muscle fibre phenotype, reduced oxidative capacity, and altered intracellular calcium regulation. There is now substantial evidence that selective respiratory muscle training in patients withCHFincreases respiratory muscle strength and overall aerobic capacity. The majority of studies have used a regimen of inspiratory muscle training against either a fixed or incremental inspiratory load, expressed as a percentage of MIP. The benefit of whole body aerobic and strength exercise in CHF patients has been well documented and is now implemented in many rehabilitation programes for these patients.The recent trial ofWinkelmann et al. [46], demonstrating that inspiratory muscle training in combination with whole-body aerobic training was more beneficial than aerobic training alone, should be repeated in a separate CHF cohort. If the results are concordant, inspiratory muscle training should be incorporated into existing rehabilitation programes for patients with CHF.

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