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Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure

BACKGROUND: Chronic heart failure (CHF) leads to exercise intolerance. However, non-invasive ventilation is able to improve functional capacity of patients with CHF. OBJECTIVES: The aim of this study was to evaluate the effectiveness of continuous positive airway pressure (CPAP) on physical exercise...

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Autores principales: Reis, Hugo V., Borghi-Silva, Audrey, Catai, Aparecida M., Reis, Michel S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183494/
https://www.ncbi.nlm.nih.gov/pubmed/25003274
http://dx.doi.org/10.1590/bjpt-rbf.2014.0037
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author Reis, Hugo V.
Borghi-Silva, Audrey
Catai, Aparecida M.
Reis, Michel S.
author_facet Reis, Hugo V.
Borghi-Silva, Audrey
Catai, Aparecida M.
Reis, Michel S.
author_sort Reis, Hugo V.
collection PubMed
description BACKGROUND: Chronic heart failure (CHF) leads to exercise intolerance. However, non-invasive ventilation is able to improve functional capacity of patients with CHF. OBJECTIVES: The aim of this study was to evaluate the effectiveness of continuous positive airway pressure (CPAP) on physical exercise tolerance and heart rate variability (HRV) in patients with CHF. METHOD: : Seven men with CHF (62±8 years) and left ventricle ejection fraction of 41±8% were submitted to an incremental symptom-limited exercise test (IT) on the cicloergometer. On separate days, patients were randomized to perform four constant work rate exercise tests to maximal tolerance with and without CPAP (5 cmH(2)O) in the following conditions: i) at 50% of peak work rate of IT; and ii) at 75% of peak work rate of IT. At rest and during these conditions, instantaneous heart rate (HR) was recorded using a cardiofrequencimeter and HRV was analyzed in time domain (SDNN and RMSSD indexes). For statistical procedures, Wilcoxon test or Kruskall-Wallis test with Dunn's post-hoc were used accordingly. In addition, categorical variables were analysed through Fischer's test (p<0.05). RESULTS: There were significant improvements in exercise tolerance at 75% of peak work rate of IT with CPAP (405±52 vs. 438±58 s). RMSSD indexes were lower during exercise tests compared to CPAP at rest and with 50% of peak work rate of IT. CONCLUSION: These data suggest that CPAP appears to be a useful strategy to improve functional capacity in patients with CHF. However, the positive impact of CPAP did not generate significant changes in the HRV during physical exercises.
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spelling pubmed-41834942014-10-23 Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure Reis, Hugo V. Borghi-Silva, Audrey Catai, Aparecida M. Reis, Michel S. Braz J Phys Ther Original Articles BACKGROUND: Chronic heart failure (CHF) leads to exercise intolerance. However, non-invasive ventilation is able to improve functional capacity of patients with CHF. OBJECTIVES: The aim of this study was to evaluate the effectiveness of continuous positive airway pressure (CPAP) on physical exercise tolerance and heart rate variability (HRV) in patients with CHF. METHOD: : Seven men with CHF (62±8 years) and left ventricle ejection fraction of 41±8% were submitted to an incremental symptom-limited exercise test (IT) on the cicloergometer. On separate days, patients were randomized to perform four constant work rate exercise tests to maximal tolerance with and without CPAP (5 cmH(2)O) in the following conditions: i) at 50% of peak work rate of IT; and ii) at 75% of peak work rate of IT. At rest and during these conditions, instantaneous heart rate (HR) was recorded using a cardiofrequencimeter and HRV was analyzed in time domain (SDNN and RMSSD indexes). For statistical procedures, Wilcoxon test or Kruskall-Wallis test with Dunn's post-hoc were used accordingly. In addition, categorical variables were analysed through Fischer's test (p<0.05). RESULTS: There were significant improvements in exercise tolerance at 75% of peak work rate of IT with CPAP (405±52 vs. 438±58 s). RMSSD indexes were lower during exercise tests compared to CPAP at rest and with 50% of peak work rate of IT. CONCLUSION: These data suggest that CPAP appears to be a useful strategy to improve functional capacity in patients with CHF. However, the positive impact of CPAP did not generate significant changes in the HRV during physical exercises. Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia 2014 /pmc/articles/PMC4183494/ /pubmed/25003274 http://dx.doi.org/10.1590/bjpt-rbf.2014.0037 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Reis, Hugo V.
Borghi-Silva, Audrey
Catai, Aparecida M.
Reis, Michel S.
Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure
title Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure
title_full Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure
title_fullStr Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure
title_full_unstemmed Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure
title_short Impact of CPAP on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure
title_sort impact of cpap on physical exercise tolerance and sympathetic-vagal balance in patients with chronic heart failure
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183494/
https://www.ncbi.nlm.nih.gov/pubmed/25003274
http://dx.doi.org/10.1590/bjpt-rbf.2014.0037
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