An international prospective randomised multicenter study proposed by the European Association for Cardiovascular Prevention and Rehabilitation is about to be launched!
Consistent findings of respiratory muscle fatigue with reduced inspiratory pressure-generating capacity indicate a decrease in inspiratory muscle strength in patients with chronic heart failure (CHF). Recent studies support the use of inspiratory muscle training (IMT) in improving exercise capacity and in particular the symptom of dyspnoea in patients with CHF. VENT-HEFT is a multicenter trial aiming to investigate the additive effect of IMT on whole body endurance training standard cardiac rehabilitation programmes for CHF patients.
Simply randomize stable CHF patients (NYHA class II-IV, EF <35%) in either a group (preferably, at least, 10-12 per center) participating in an endurance (e.g. bike) training programme or in another group (preferably, at least, 10-12 per center) following exactly the same training programme (e.g. bike) plus IMT. Inspiratory muscle training will be performed by using an inspiratory incremental endurance testing device, a software with an electronic mouth pressure manometer interfaced to a computer. This device provides endurance training at a percentage of individual sustained maximal inspiratory pressure (SPimax). Inspiratory muscle training should be performed at least 3 times per week for 12 weeks in the hospital (supervised) while intensity of training is suggested at 60% of SPimax and length of training to respiratory fatigue.
Pre- and post-training, exercise capacity should be measured using ergospirometry (peakVO2) and/or the 6-min walk test while dyspnoea by the Borg scale at the end of exercise testing. Measurement of Quality of Life should be performed using the Minnesota Living with Heart Failure questionnaire. You can also evaluate ventricular function and structure using 2-dimensional echocardiography and lung function by spirometry. Finally, is very useful to keep records regarding morbidity and possibly mortality of patients participating in the programme. Apart from these basic measurements, each center may approach its own CHF patients by measuring some other parameters (i.e. blood samples, Holter monitoring) they consider important in clinical and research terms.
For centers wishing to participate in this interesting multicenter trial, please register asking for the protocol and conduct:
Principal investigator: Stamatis Adamopoulos (email@example.com)
Study co-ordinator: Ioannis Laoutaris (firstname.lastname@example.org)
Our mission: To reduce the burden of cardiovascular disease
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