The Effects of the Inspiratory Muscle Plus Aerobic Training Compare to Aerobic Training Alone in Heart Failure Patients.
The Effects of the Inspiratory Muscle Plus Aerobic Training Compare to Aerobic Training Alone in Heart Failure Patients.
This study aims to compare effects of inspiratory muscle training added by aerobic training
 to aerobic training alone in heart failure patients with inspiratory muscle weakness. To do
 so, strength and endurance of inspiratory muscles, functional capacity, quality of life,
 heart rate variability and sleep apnea evaluations will be conducted in patients with heart
 failure.
A sample comprising at least 30 individuals is necessary. These subjects will be randomized
 in two groups, one consisting of inspiratory muscle training plus aerobic training, whereas
 the other will consist of the aerobic training alone.

 This prospective, randomized, controlled trial will include patients with the diagnosis of
 chronic heart failure attributable to left ventricular systolic dysfunction who will be
 recruited from the Heart Failure Clinic.

 Entry criteria for the study are a previous history of symptomatic heart failure caused by
 left ventricular systolic dysfunction, inspiratory muscle weakness (PImax < 70% of the
 predicted), and clinical stability, including no change in medications for the past three
 months.

 Exclusion criteria will be unstable angina, myocardial infarction, or cardiac surgery within
 the previous three months, chronic metabolic, orthopedic, or infectious diseases, treatments
 with steroids, hormones, or cancer chemotherapy, history of exercise-induced asthma, chronic
 obstructive pulmonary disease and smokers will be not recruited.

 The protocol was approved by the Committee for Ethics in Research of Hospital de Clinics de
 Porto Alegre and Ijuí University and all subjects are required to sign an informed consent
 form.

 Variables will be measured by strength and endurance (progressive and constant load), 6-min
 walk test, cardiopulmonary exercise testing, quality of life questionnaire, evaluation of the
 heart rate variability and sleep apnea.

 The inspiratory muscle training plus aerobic training will consist of cycle exercise (3
 sessions/week) and inspiratory exercise by using Threshold equipment for 30 min, 7 times per
 week, whereas aerobic training group will perform only cycle exercise. Both treatments will
 last 12 weeks.
Inclusion Criteria:

 -  previous history of symptomatic heart failure caused by left ventricular systolic
 dysfunction

 -  inspiratory muscle weakness (PImax < 70% of the predicted)

 -  clinical stability, including no change in medications for the past three months

 Exclusion Criteria:

 -  unstable angina

 -  myocardial infarction, or cardiac surgery within the previous three months

 -  chronic metabolic, orthopedic, or infectious diseases

 -  treatments with steroids, hormones, or cancer chemotherapy

 -  history of exercise-induced asthma, chronic obstructive pulmonary disease

 -  smokers