Inspiratory muscle weakness contributes to exertional dyspnea in chronic thromboembolic pulmonary hypertension

Determination of potentially-reversible factors contributing to exertional dyspnea remains an unmet clinical need in chronic thromboembolic pulmonary hypertension (CTEPH). Therefore, we aimed to evaluate the influence of inspiratory muscle weakness (IMW) on exercise capacity and dyspnea during effor...

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Bibliographic Details
Published in:PloS one 2018-09, Vol.13 (9), p.e0204072-e0204072
Main Authors: Rolim, João Victor, Ota-Arakaki, Jaquelina Sonoe, Ferreira, Eloara V M, Figliolino, Gabriela A M, Ivanaga, Ivan, Vieira, Elaine Brito, Fonseca, Angelo X C, Messina, Carolina M S, Costa, Camila Melo, Neder, J Alberto, Nery, Luiz Eduardo, Ramos, Roberta Pulcheri
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Catheterization
Dyspnea
Ergometry
Exercise
Exercise physiology
Heart
Hypertension
Influence
Laboratories
Medical diagnosis
Medical prognosis
Medicine
Medicine and Health Sciences
Muscle weakness
Muscles
Patients
Pulmonary arteries
Pulmonary embolisms
Pulmonary hypertension
Regression analysis
Respiration
Respiratory diseases
Thromboembolism
Ventilation
Ventilators
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Summary:Determination of potentially-reversible factors contributing to exertional dyspnea remains an unmet clinical need in chronic thromboembolic pulmonary hypertension (CTEPH). Therefore, we aimed to evaluate the influence of inspiratory muscle weakness (IMW) on exercise capacity and dyspnea during effort in patients with CTEPH. We performed a prospective cross-sectional study that included thirty-nine consecutive patients with CTEPH (48 ± 15 yrs, 61% female) confirmed by right heart catheterization that underwent an incremental cardiopulmonary exercise test, 6-minute walk test and maximum inspiratory pressure (MIP) measurement. MIP < 70%pred was found in 46% of patients. On a multiple linear regression analysis, MIP was independently associated with 6MWD and [Formula: see text]. Patients with MIP < 70% presented greater [Formula: see text] than those with MIP ≥ 70%. Additionally, they also presented stronger sensations of dyspnea throughout exercise, even when adjusted for ventilation. At rest and at different levels of exercise, mean inspiratory flow (VT/TI) was significantly higher in patients with MIP < 70%. In conclusion, IMW is associated with a rapid increase of dyspnea, higher inspiratory load and poor exercise capacity in patients with CTEPH.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0204072