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Evidence to date strongly suggests that poor inspiratory muscle performance is associated with dyspnea, poor exercise tolerance and poor functional status in patients with heart failure (HF). A growing body of literature has examined the effects of inspiratory muscle training (IMT) in HF patients with the majority of studies reporting favorable effects on several of the above limitations and a substantial number of related deficiencies due to inadequate inspiration and inspiratory muscle strength and endurance. The domains and manifestations of HF, which were significantly improved by IMT in one or more of the 18 out of 19 studies of IMT, included dyspnea, quality of life, balance, peripheral muscle strength and blood flow, peripheral muscle sympathetic nervous activity, heart rate, respiratory rate, peak VO2, 6-min walk test distance, ventilation, VE/VCO2 slope, oxygen uptake efficiency, circulatory power, recovery oxygen kinetics and several indices of cardiac performance. This paper will also review the available IMT literature with a focus on methods of IMT and clinical outcomes. Key differences between available IMT methods will be highlighted with a goal to improve IMT efforts and decrease the pathophysiological manifestations of heart disease and HF.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Affiliations
• Lawrence P Cahalin
Department of Physical Therapy, Leonard M. Miller School of Medicine, University of Miami, 5915 Ponce de Leon Blvd. 5th Floor, Miami, Coral Gables, FL 33146-2435, USA
• Ross Arena
Division of Physical Therapy, Department of Orthopaedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, NM, USAandDivision of Cardiology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
• Marco Guazzi
Cardiology, I.R.C.C.S. Policlinico San Donato, University of Milano, San Donato Milanese, Italy
• Jonathan Myers
Division of Cardiology, VA Palo Alto Healthcare System, Stanford University, Palo Alto, CA, USA
• Gerson Cipriano
Department of Physical Therapy, University of Brasilia, Brasilia, Brazil
• Gaspar Chiappa
Exercise Pathophysiology Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
• Carl J Lavie
Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USAandPennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
• Daniel E Forman
Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA, USA