6. Đánh giá hiệu quả bài tập cơ hít vào cường độ cao ở người bệnh suy tim có phân suất tống máu > 40%: Thử nghiệm lâm sàng ngẫu nhiên có đối chứng
Nội dung chính của bài viết
Tóm tắt
Yếu cơ hô hấp (IMW) có liên quan đến giảm khả năng gắng sức và tiên lượng xấu ở bệnh nhân suy tim phân suất tống máu bảo tồn (HF-pEF) và giảm nhẹ (HF-mrEF). Tập mạnh cơ hô hấp (IMT) được xem là một phương pháp đầy hứa hẹn, tuy nhiên bằng chứng về hiệu quả của IMT cường độ cao (HI-IMT) trong nhóm bệnh này còn hạn chế. Nghiên cứu lâm sàng ngẫu nhiên, mù đôi, có đối chứng được thực hiện trên 40 bệnh nhân tại Bệnh viện Vinmec Times City. Bệnh nhân được chia ngẫu nhiên vào nhóm HI-IMT hoặc nhóm đối chứng. Kết quả cho thấy nhóm HI-IMT có cải thiện đáng kể so với nhóm đối chứng về VO2peak, 6MWT, và MIP, chỉ số biến dạng nhĩ trái trong pha chứa. Hai lĩnh vực chất lượng cuộc sống cải thiện rõ rệt là Vai trò thể chất và Sức khỏe tâm thần. Không ghi nhận biến cố bất lợi. Như vậy, HI-IMT trong 8 tuần là phương pháp an toàn, hiệu quả, giúp cải thiện khả năng gắng sức, chức năng tim và chất lượng cuộc sống ở bệnh nhân HF-pEF và HF-mrEF.
Chi tiết bài viết
Từ khóa
Tập mạnh cơ hô hấp, suy tim, khả năng gắng sức
Tài liệu tham khảo
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2. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022; 145: e895-e1032. doi: 10.1161/CIR.0000000000001063.
3. Palau P, Domínguez E, Núñez E, Schmid JP, Vergara P, Ramón JM, Mascarell B, Sanchis J, Chorro FJ, Núñez J. Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. Eur J Prev Cardiol. 2014; 21: 1465-1473. doi: 10.1177/2047487313498832.
4. Pandey A, Parashar A, Kumbhani DJ, Agarwal S, Garg J, Kitzman D, Levine BD, Drazner M, Berry JD. Exercise Training in Patients With Heart Failure and Preserved Ejection Fraction. Circulation: Heart Failure. 2015; 8: 33-40. doi: doi:10.1161/CIRCHEARTFAILURE.114.001615.
5. Hamazaki N, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tanaka S, Nakamura T, Yamashita M, Maekawa E, Noda C, et al. Prevalence and prognosis of respiratory muscle weakness in heart failure patients with preserved ejection fraction. Respiratory Medicine. 2020; 161: 105834. doi: https://doi.org/10.1016/j.rmed.2019.105834.
6. Yamada K, Kinugasa Y, Sota T, Miyagi M, Sugihara S, Kato M, Yamamoto K. Inspiratory Muscle Weakness Is Associated With Exercise Intolerance in Patients With Heart Failure With Preserved Ejection Fraction: A Preliminary Study. Journal of Cardiac Failure. 2016; 22: 38-47. doi: https://doi.org/10.1016/j.cardfail.2015.10.010.
7. Li H, Tao L, Huang Y, Li Z, Zhao J. Inspiratory muscle training in patients with heart failure: A systematic review and meta-analysis. Front Cardiovasc Med. 2022; 9: 993846. doi: 10.3389/fcvm.2022.993846.
8. Baral N, Changezi HU, Khan MR, Adhikari G, Adhikari P, Khan HMW, Poudyal A, Abdelazeem B, Sigdel S, Champine A. Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-Analysis. Cureus. 2020; 12: e12260. doi: 10.7759/cureus.12260.
9. Piepoli MF, Spoletini I, Rosano G. Monitoring functional capacity in heart failure. Eur Heart J Suppl. 2019; 21: M9-m12. doi: 10.1093/eurheartj/suz216.
10. Antunes-Correa LM. Maximal oxygen uptake: New and more accurate predictive equation. European Journal of Preventive Cardiology. 2020; 25: 1075-1076. doi: 10.1177/2047487318780442.
11. Corrà U, Mezzani A, Bosimini E, Giannuzzi P. Prognostic value of time-related changes of cardiopulmonary exercise testing indices in stable chronic heart failure: a pragmatic and operative scheme. European journal of cardiovascular prevention and rehabilitation. 2006; 13: 186-192. doi: 10.1097/01.hjr.0000189807.22224.54.
12. Palau P, Domínguez E, Núñez E, Schmid J-P, Vergara P, Ramón JM, Mascarell B, Sanchis J, Chorro FJ, Núñez J. Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. European Journal of Preventive Cardiology. 2014; 21: 1465-1473. doi: 10.1177/2047487313498832.
13. Laoutaris ID, Dritsas A, Brown MD, Manginas A, Kallistratos MS, Chaidaroglou A, Degiannis D, Alivizatos PA, Cokkinos DV. Effects of inspiratory muscle training on autonomic activity, endothelial vasodilator function, and N-terminal pro-brain natriuretic peptide levels in chronic heart failure. J Cardiopulm Rehabil Prev. 2008; 28: 99-106. doi: 10.1097/01.HCR.0000314203.09676.b9.
14. Weiner P, Waizman J, Magadle R, Berar-Yanay N, Pelled B. The effect of specific inspiratory muscle training on the sensation of dyspnea and exercise tolerance in patients with congestive heart failure. Clin Cardiol. 1999; 22: 727-732. doi: 10.1002/clc.4960221110.
15. Kinugasa Y, Sota T, Ishiga N, Nakamura K, Kamitani H, Hirai M, Yanagihara K, Kato M, Yamamoto K. Home-based Inspiratory Muscle Training in Patients With Heart Failure and Preserved Ejection Fraction: A Preliminary Study. Journal of Cardiac Failure. 2020; 26: 1022-1023. doi: https://doi.org/10.1016/j.cardfail.2020.08.006.
16. Jalili M, Nazem F, Sazvar A, Ranjbar K. Prediction of Maximal Oxygen Uptake by Six-Minute Walk Test and Body Mass Index in Healthy Boys. J Pediatr. 2018; 200: 155-159. doi: 10.1016/j.jpeds.2018.04.026.
17. Tanriverdi A, Savci S, Ozcan Kahraman B, Odaman H, Ozpelit E, Senturk B, Ozsoy I, Baran A, Akdeniz B, Acar S, et al. Effects of high intensity interval-based inspiratory muscle training in patients with heart failure: A single-blind randomized controlled trial. Heart & Lung. 2023; 62: 1-8. doi: https://doi.org/10.1016/j.hrtlng.2023.05.011.
18. Sadek Z, Salami A, Youness M, Awada C, Hamade M, Joumaa WH, Ramadan W, Ahmaidi S. A randomized controlled trial of high-intensity interval training and inspiratory muscle training for chronic heart failure patients with inspiratory muscle weakness. Chronic Illness. 2020; 18: 140-154. doi: 10.1177/1742395320920700.
19. Shoemaker MJ, Curtis AB, Vangsnes E, Dickinson MG. Clinically meaningful change estimates for the six-minute walk test and daily activity in individuals with chronic heart failure. Cardiopulm Phys Ther J. 2013; 24: 21-29.
20. Padula CA, Yeaw E, Mistry S. A home-based nurse-coached inspiratory muscle training intervention in heart failure. Applied Nursing Research. 2009; 22: 18-25. doi: https://doi.org/10.1016/j.apnr.2007.02.002.
2. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022; 145: e895-e1032. doi: 10.1161/CIR.0000000000001063.
3. Palau P, Domínguez E, Núñez E, Schmid JP, Vergara P, Ramón JM, Mascarell B, Sanchis J, Chorro FJ, Núñez J. Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. Eur J Prev Cardiol. 2014; 21: 1465-1473. doi: 10.1177/2047487313498832.
4. Pandey A, Parashar A, Kumbhani DJ, Agarwal S, Garg J, Kitzman D, Levine BD, Drazner M, Berry JD. Exercise Training in Patients With Heart Failure and Preserved Ejection Fraction. Circulation: Heart Failure. 2015; 8: 33-40. doi: doi:10.1161/CIRCHEARTFAILURE.114.001615.
5. Hamazaki N, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tanaka S, Nakamura T, Yamashita M, Maekawa E, Noda C, et al. Prevalence and prognosis of respiratory muscle weakness in heart failure patients with preserved ejection fraction. Respiratory Medicine. 2020; 161: 105834. doi: https://doi.org/10.1016/j.rmed.2019.105834.
6. Yamada K, Kinugasa Y, Sota T, Miyagi M, Sugihara S, Kato M, Yamamoto K. Inspiratory Muscle Weakness Is Associated With Exercise Intolerance in Patients With Heart Failure With Preserved Ejection Fraction: A Preliminary Study. Journal of Cardiac Failure. 2016; 22: 38-47. doi: https://doi.org/10.1016/j.cardfail.2015.10.010.
7. Li H, Tao L, Huang Y, Li Z, Zhao J. Inspiratory muscle training in patients with heart failure: A systematic review and meta-analysis. Front Cardiovasc Med. 2022; 9: 993846. doi: 10.3389/fcvm.2022.993846.
8. Baral N, Changezi HU, Khan MR, Adhikari G, Adhikari P, Khan HMW, Poudyal A, Abdelazeem B, Sigdel S, Champine A. Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-Analysis. Cureus. 2020; 12: e12260. doi: 10.7759/cureus.12260.
9. Piepoli MF, Spoletini I, Rosano G. Monitoring functional capacity in heart failure. Eur Heart J Suppl. 2019; 21: M9-m12. doi: 10.1093/eurheartj/suz216.
10. Antunes-Correa LM. Maximal oxygen uptake: New and more accurate predictive equation. European Journal of Preventive Cardiology. 2020; 25: 1075-1076. doi: 10.1177/2047487318780442.
11. Corrà U, Mezzani A, Bosimini E, Giannuzzi P. Prognostic value of time-related changes of cardiopulmonary exercise testing indices in stable chronic heart failure: a pragmatic and operative scheme. European journal of cardiovascular prevention and rehabilitation. 2006; 13: 186-192. doi: 10.1097/01.hjr.0000189807.22224.54.
12. Palau P, Domínguez E, Núñez E, Schmid J-P, Vergara P, Ramón JM, Mascarell B, Sanchis J, Chorro FJ, Núñez J. Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction. European Journal of Preventive Cardiology. 2014; 21: 1465-1473. doi: 10.1177/2047487313498832.
13. Laoutaris ID, Dritsas A, Brown MD, Manginas A, Kallistratos MS, Chaidaroglou A, Degiannis D, Alivizatos PA, Cokkinos DV. Effects of inspiratory muscle training on autonomic activity, endothelial vasodilator function, and N-terminal pro-brain natriuretic peptide levels in chronic heart failure. J Cardiopulm Rehabil Prev. 2008; 28: 99-106. doi: 10.1097/01.HCR.0000314203.09676.b9.
14. Weiner P, Waizman J, Magadle R, Berar-Yanay N, Pelled B. The effect of specific inspiratory muscle training on the sensation of dyspnea and exercise tolerance in patients with congestive heart failure. Clin Cardiol. 1999; 22: 727-732. doi: 10.1002/clc.4960221110.
15. Kinugasa Y, Sota T, Ishiga N, Nakamura K, Kamitani H, Hirai M, Yanagihara K, Kato M, Yamamoto K. Home-based Inspiratory Muscle Training in Patients With Heart Failure and Preserved Ejection Fraction: A Preliminary Study. Journal of Cardiac Failure. 2020; 26: 1022-1023. doi: https://doi.org/10.1016/j.cardfail.2020.08.006.
16. Jalili M, Nazem F, Sazvar A, Ranjbar K. Prediction of Maximal Oxygen Uptake by Six-Minute Walk Test and Body Mass Index in Healthy Boys. J Pediatr. 2018; 200: 155-159. doi: 10.1016/j.jpeds.2018.04.026.
17. Tanriverdi A, Savci S, Ozcan Kahraman B, Odaman H, Ozpelit E, Senturk B, Ozsoy I, Baran A, Akdeniz B, Acar S, et al. Effects of high intensity interval-based inspiratory muscle training in patients with heart failure: A single-blind randomized controlled trial. Heart & Lung. 2023; 62: 1-8. doi: https://doi.org/10.1016/j.hrtlng.2023.05.011.
18. Sadek Z, Salami A, Youness M, Awada C, Hamade M, Joumaa WH, Ramadan W, Ahmaidi S. A randomized controlled trial of high-intensity interval training and inspiratory muscle training for chronic heart failure patients with inspiratory muscle weakness. Chronic Illness. 2020; 18: 140-154. doi: 10.1177/1742395320920700.
19. Shoemaker MJ, Curtis AB, Vangsnes E, Dickinson MG. Clinically meaningful change estimates for the six-minute walk test and daily activity in individuals with chronic heart failure. Cardiopulm Phys Ther J. 2013; 24: 21-29.
20. Padula CA, Yeaw E, Mistry S. A home-based nurse-coached inspiratory muscle training intervention in heart failure. Applied Nursing Research. 2009; 22: 18-25. doi: https://doi.org/10.1016/j.apnr.2007.02.002.