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Deep Breathing Heart Rate Variability is Associated with Inspiratory Muscle Weakness in Chronic Heart Failure
Author(s) -
Reis Michel Silva,
Arena Ross,
Archiza Bruno,
Toledo Carlos Fischer,
Catai Aparecida Maria,
BorghiSilva Audrey
Publication year - 2014
Publication title -
physiotherapy research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 49
eISSN - 1471-2865
pISSN - 1358-2267
DOI - 10.1002/pri.1552
Subject(s) - medicine , cardiology , heart failure , heart rate variability , heart rate , ejection fraction , respiratory system , blood pressure
Background and Purpose There is a synchronism between the respiratory and cardiac cycles. However, the relationship of inspiratory muscle weakness in chronic heart failure (CHF) on cardiac autonomic modulation is unknown. The purpose of the present investigation was to evaluate the impact of inspiratory muscle strength on the magnitude of respiratory sinus arrhythmia. Methods Ten CHF (62 ± 7 years — left ventricle eject fraction of 40 ± 5% and New York Heart Association class I–III) and nine matched‐age healthy volunteers (64 ± 5 years) participated in this study. Heart rate variability (HRV) was obtained at rest and during deep breathing manoeuvre (DB‐M) by electrocardiograph. Results CHF patients demonstrated impaired cardiac autonomic modulation at rest and during DB‐M when compared with healthy subjects ( p < 0.05). Moreover, significant and positive correlations between maximal inspiratory pressure and inspiratory–expiratory differences ( r = 0.79), expiratory/inspiratory ratio ( r = 0.83), root mean square of the successive differences ( r = 0.77), standard deviation of NN intervals ( r = 0.77), low frequency ( r = 0.77), and high frequency ( r = 0.70) were found during DB‐M. At rest, significant correlations were found also. Conclusion Patients with CHF presented impaired cardiac autonomic modulation at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in CHF. Based on this evidence, recommendations for future research applications of respiratory muscle training can bring to light a potentially valuable target for rehabilitation. Copyright © 2013 John Wiley & Sons, Ltd.