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J Am Coll Cardiol, 2008; 51:1663-1671, doi:10.1016/j.jacc.2007.12.045
© 2008 by the American College of Cardiology Foundation
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Inspiratory Muscle Training Improves Blood Flow to Resting and Exercising Limbs in Patients With Chronic Heart Failure

Gaspar R. Chiappa, PT, ScD*, Bruno T. Roseguini, PT, MSc*, Paulo J.C. Vieira, PT*, Cristiano N. Alves, PT*, Angela Tavares, MSc*, Eliane R. Winkelmann, PT, MSc*, Elton L. Ferlin, BsEE{dagger}, Ricardo Stein, MD, ScD*,{ddagger} and Jorge P. Ribeiro, MD, ScD*,{ddagger},§,*

* Exercise Pathophysiology Research Laboratory, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
{dagger} Biomedical Engineering, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
{ddagger} Cardiology Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
§ Department of Medicine, Faculty of Medicine, Federal University of Rio Grande Sul, Porto Alegre, Brazil.


Figure 1
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  		Figure 1 Hemodynamic Responses of the Resting Calf to Inspiratory Loading

Mean (±SD) responses mean arterial pressure (MAP) (upper panels), calf blood flow (CBF) (middle panels), and calf vascular resistance (CVR) (lower panels) obtained at rest, 1 min, 2 min, and at the end of inspiratory loading protocol, with "placebo loading" (left panels with 2% of maximal inspiratory pressure) and with inspiratory muscle loading (right panels with 60% of maximal inspiratory pressure). Results of 2-way analysis of variance for repeated measures (p < 0.05): *time effect; {dagger}group effect control versus CHF pre; {ddagger}training status effect CHF pre versus CHF post; §interaction control versus CHF pre; ||interaction CHF pre versus CHF post. CHF pre = chronic heart failure patients with inspiratory muscle weakness before inspiratory muscle training; CHF post = chronic heart failure patients with inspiratory muscle weakness after inspiratory muscle training; Control = healthy individuals.

 

Figure 2
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  		Figure 2 Hemodynamic Responses to Forearm Exercise After Inspiratory Loading

Mean (±SD) responses MAP (upper panels), FBF (middle panels), and FVR (lower panels) obtained at rest, minute 1, minute 2, and at the end of handgrip exercise after inspiratory loading protocol, with "placebo loading" (left panels with 2% of maximal inspiratory pressure) and with inspiratory muscle loading (right panels with 60% of maximal inspiratory pressure). Results of 2-way analysis of variance for repeated measures (p < 0.05): *time effect; {dagger}group effect control versus CHF pre; {ddagger}training status effect CHF pre versus CHF post; §interaction control versus CHF pre; ||interaction CHF pre versus CHF post. Abbreviations as in Figure 1.

 
 
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