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. 2022 Oct 19:9:993846.
doi: 10.3389/fcvm.2022.993846. eCollection 2022.

Inspiratory muscle training in patients with heart failure: A systematic review and meta-analysis

Hui Li  1 , Lingling Tao  2 , Yuewi Huang  1 , Ziyang Li  1 , Jianrong Zhao  1
Affiliations

Inspiratory muscle training in patients with heart failure: A systematic review and meta-analysis

Hui Li et al. Front Cardiovasc Med. .

Abstract

Objective: To explore the effect of inspiratory muscle training (IMT) on patients with heart failure and further explore the impact of IMT on patients with heart failure with preserved ejection fraction.

Methods: PubMed, EMBASE, Cochrane Library, CNKI, Wanfang and VIP databases were systematically searched. Randomized controlled trials of inspiratory muscle training in patients with heart failure were included. Revman 5.3 software was used to calculate the weighted mean difference (MD) of the combined effect size. The effects of IMT on the maximum oxygen uptake (peakVO2), maximum inspiratory pressure (PI max), ventilation efficiency (V E /VCO 2), six-minute walking distance (6MWD), forced expiratory volume (FEV1), forced vital capacity (FVC) and quality of life in patients with heart failure were compared and analyzed.

Results: After systematic retrieval and screening, 17 studies were included in this study, and the quality of the included studies was good. The results showed that IMT could increase peakVO2 (MD 2.53; 95% CI 1. 54, 3. 51; P < 0.0001) and PI max (MD 17.25; 95% CI 13. 75, 20. 75; P < 0.00001); improve the VE/VCO2 (MD -4.22; 95% CI -6.78, -1.66; P = 0.001) and significantly improve the quality of life in patients with heart failure (MD -13.34; 95% CI -20.42, -6.26; P = 0.0002). However, the effect of IMT on 6MWD in patients with heart failure was not statistically significant (MD 74.45; 95% CI -12.88,161.79; P = 0.09), and the effect on lung function (FEV1 and FVC) was also not statistically significant (P = 0.08; P = 0.86). IMT had a more significant positive effect on peakVO2 (MD 2.98; 95% CI 1.63, 4.34; P < 0.0001) and quality of life (MD -14.52; 95% CI -18.53, -10.52; P < 0.00001) in patients with heart failure with preserved ejection fraction. Descriptive analysis suggested that IMT may positively affect dyspnoea in patients with heart failure. In addition, the choice of evaluation scale may affect the evaluation results of quality of life and dyspnoea.

Conclusion: IMT has a significant positive effect on respiratory status in patients with heart failure, but different dyspnoea and quality of life evaluation scales can affect the final evaluation results.

Keywords: heart failure; inspiratory muscle training; peakVO2; preserved ejection fraction; quality of life.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of literature selection.
Figure 2
Figure 2
Quality evaluation results of included studies.
Figure 3
Figure 3
The effect of IMT on PeakVO2 (ml/min/kg) in patients with HF.
Figure 4
Figure 4
Meta-analysis of the effect of IMT on PImax in HF patients.
Figure 5
Figure 5
Subgroup analysis results of IMT on VE/VCO2 in patients with HF.
Figure 6
Figure 6
Subgroup analysis results of the effect of IMT on 6MWD (m) in patients with HF.
Figure 7
Figure 7
(A) Meta-analysis results of the effect of IMT on FEV1 in patients with HF; (B) Meta-analysis results of the effect of IMT on FVC in patients with HF.
Figure 8
Figure 8
Subgroup analysis results of the effect of IMT on the quality of life of patients with HF.
See this image and copyright information in PMC

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