Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial

Patricia Palau; Eloy Domínguez; Laura López; José María Ramón; Raquel Heredia; Jessika González; Enrique Santas; Vicent Bodí; Gema Miñana; Ernesto Valero; Anna Mollar; Vicente Bertomeu González; Francisco J. Chorro; Juan Sanchis; Josep Lupón; Antoni Bayés-Genís; Julio Núñez

doi:10.1016/j.recesp.2018.01.024

Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial

Patricia Palau, Eloy Domínguez, Laura López, José María Ramón, Raquel Heredia, Jessika González, Enrique Santas, Vicent Bodí, Gema Miñana, Ernesto Valero, Anna Mollar, Vicente Bertomeu González, Francisco J. Chorro, Juan Sanchis, Josep Lupón, Antoni Bayés-Genís, Julio Núñez

Department of Medicine

Research output: Contribution to journal › Article › Research

5 Citations (Scopus)

Abstract

© 2018 Sociedad Española de Cardiología Introduction and objectives: Despite the prevalence of heart failure with preserved ejection fraction (HFpEF), there is currently no evidence-based effective therapy for this disease. This study sought to evaluate whether inspiratory muscle training (IMT), functional electrical stimulation (FES), or a combination of both (IMT + FES) improves 12- and 24-week exercise capacity as well as left ventricular diastolic function, biomarker profile, and quality of life in HFpEF. Methods: A total of 61 stable symptomatic patients (New York Heart Association functional class II-III) with HFpEF were randomized (1:1:1:1) to receive a 12-week program of IMT, FES, or IMT + FES vs usual care. The primary endpoint of the study was to evaluate change in peak exercise oxygen uptake at 12 and 24 weeks. Secondary endpoints were changes in quality of life, echocardiogram parameters, and prognostic biomarkers. We used a mixed-effects model for repeated-measures to compare endpoints changes. Results: Mean age and peak exercise oxygen uptake were 74 ± 9 years and 9.9 ± 2.5 mL/min/kg, respectively. The proportion of women was 58%. At 12 weeks, the mean increase in peak exercise oxygen uptake (mL/kg/min) compared with usual care was 2.98, 2.93, and 2.47 for IMT, FES, and IMT + FES, respectively (P <.001) and this beneficial effect persisted after 24 weeks (1.95, 2.08, and 1.56; P <.001). Significant increases in quality of life scores were found at 12 weeks (P <.001). No other changes were found. Conclusions: In HFpEF patients with low aerobic capacity, IMT and FES were associated with a significant improvement in exercise capacity and quality of life. This trial was registered at ClinicalTrials.gov (Identifier: NCT02638961). Full English text available from: www.revespcardiol.org/en

Original language	English
Pages (from-to)	288-297
Journal	Revista Espanola de Cardiologia
Volume	72
DOIs	https://doi.org/10.1016/j.recesp.2018.01.024
Publication status	Published - 1 Apr 2019

Keywords

Exercise capacity
Heart failure with preserved ejection fraction
Physical therapy
Quality of life

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Palau, P., Domínguez, E., López, L., Ramón, J. M., Heredia, R., González, J., Santas, E., Bodí, V., Miñana, G., Valero, E., Mollar, A., Bertomeu González, V., Chorro, F. J., Sanchis, J., Lupón, J., Bayés-Genís, A., & Núñez, J. (2019). Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial. Revista Espanola de Cardiologia, 72, 288-297. https://doi.org/10.1016/j.recesp.2018.01.024

Palau, Patricia ; Domínguez, Eloy ; López, Laura ; Ramón, José María ; Heredia, Raquel ; González, Jessika ; Santas, Enrique ; Bodí, Vicent ; Miñana, Gema ; Valero, Ernesto ; Mollar, Anna ; Bertomeu González, Vicente ; Chorro, Francisco J. ; Sanchis, Juan ; Lupón, Josep ; Bayés-Genís, Antoni ; Núñez, Julio. / Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial. In: Revista Espanola de Cardiologia. 2019 ; Vol. 72. pp. 288-297.

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title = "Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial",

abstract = "{\textcopyright} 2018 Sociedad Espa{\~n}ola de Cardiolog{\'i}a Introduction and objectives: Despite the prevalence of heart failure with preserved ejection fraction (HFpEF), there is currently no evidence-based effective therapy for this disease. This study sought to evaluate whether inspiratory muscle training (IMT), functional electrical stimulation (FES), or a combination of both (IMT + FES) improves 12- and 24-week exercise capacity as well as left ventricular diastolic function, biomarker profile, and quality of life in HFpEF. Methods: A total of 61 stable symptomatic patients (New York Heart Association functional class II-III) with HFpEF were randomized (1:1:1:1) to receive a 12-week program of IMT, FES, or IMT + FES vs usual care. The primary endpoint of the study was to evaluate change in peak exercise oxygen uptake at 12 and 24 weeks. Secondary endpoints were changes in quality of life, echocardiogram parameters, and prognostic biomarkers. We used a mixed-effects model for repeated-measures to compare endpoints changes. Results: Mean age and peak exercise oxygen uptake were 74 ± 9 years and 9.9 ± 2.5 mL/min/kg, respectively. The proportion of women was 58%. At 12 weeks, the mean increase in peak exercise oxygen uptake (mL/kg/min) compared with usual care was 2.98, 2.93, and 2.47 for IMT, FES, and IMT + FES, respectively (P <.001) and this beneficial effect persisted after 24 weeks (1.95, 2.08, and 1.56; P <.001). Significant increases in quality of life scores were found at 12 weeks (P <.001). No other changes were found. Conclusions: In HFpEF patients with low aerobic capacity, IMT and FES were associated with a significant improvement in exercise capacity and quality of life. This trial was registered at ClinicalTrials.gov (Identifier: NCT02638961). Full English text available from: www.revespcardiol.org/en",

keywords = "Exercise capacity, Heart failure with preserved ejection fraction, Physical therapy, Quality of life",

author = "Patricia Palau and Eloy Dom{\'i}nguez and Laura L{\'o}pez and Ram{\'o}n, {Jos{\'e} Mar{\'i}a} and Raquel Heredia and Jessika Gonz{\'a}lez and Enrique Santas and Vicent Bod{\'i} and Gema Mi{\~n}ana and Ernesto Valero and Anna Mollar and {Bertomeu Gonz{\'a}lez}, Vicente and Chorro, {Francisco J.} and Juan Sanchis and Josep Lup{\'o}n and Antoni Bay{\'e}s-Gen{\'i}s and Julio N{\'u}{\~n}ez",

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doi = "10.1016/j.recesp.2018.01.024",

language = "English",

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Palau, P, Domínguez, E, López, L, Ramón, JM, Heredia, R, González, J, Santas, E, Bodí, V, Miñana, G, Valero, E, Mollar, A, Bertomeu González, V, Chorro, FJ, Sanchis, J, Lupón, J, Bayés-Genís, A & Núñez, J 2019, 'Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial', Revista Espanola de Cardiologia, vol. 72, pp. 288-297. https://doi.org/10.1016/j.recesp.2018.01.024

Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial. / Palau, Patricia; Domínguez, Eloy; López, Laura; Ramón, José María; Heredia, Raquel; González, Jessika; Santas, Enrique; Bodí, Vicent; Miñana, Gema; Valero, Ernesto; Mollar, Anna; Bertomeu González, Vicente; Chorro, Francisco J.; Sanchis, Juan; Lupón, Josep; Bayés-Genís, Antoni; Núñez, Julio.

In: Revista Espanola de Cardiologia, Vol. 72, 01.04.2019, p. 288-297.

Research output: Contribution to journal › Article › Research

TY - JOUR

T1 - Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: The TRAINING-HF Trial

AU - Palau, Patricia

AU - Domínguez, Eloy

AU - López, Laura

AU - Ramón, José María

AU - Heredia, Raquel

AU - González, Jessika

AU - Santas, Enrique

AU - Bodí, Vicent

AU - Miñana, Gema

AU - Valero, Ernesto

AU - Mollar, Anna

AU - Bertomeu González, Vicente

AU - Chorro, Francisco J.

AU - Sanchis, Juan

AU - Lupón, Josep

AU - Bayés-Genís, Antoni

AU - Núñez, Julio

PY - 2019/4/1

Y1 - 2019/4/1

N2 - © 2018 Sociedad Española de Cardiología Introduction and objectives: Despite the prevalence of heart failure with preserved ejection fraction (HFpEF), there is currently no evidence-based effective therapy for this disease. This study sought to evaluate whether inspiratory muscle training (IMT), functional electrical stimulation (FES), or a combination of both (IMT + FES) improves 12- and 24-week exercise capacity as well as left ventricular diastolic function, biomarker profile, and quality of life in HFpEF. Methods: A total of 61 stable symptomatic patients (New York Heart Association functional class II-III) with HFpEF were randomized (1:1:1:1) to receive a 12-week program of IMT, FES, or IMT + FES vs usual care. The primary endpoint of the study was to evaluate change in peak exercise oxygen uptake at 12 and 24 weeks. Secondary endpoints were changes in quality of life, echocardiogram parameters, and prognostic biomarkers. We used a mixed-effects model for repeated-measures to compare endpoints changes. Results: Mean age and peak exercise oxygen uptake were 74 ± 9 years and 9.9 ± 2.5 mL/min/kg, respectively. The proportion of women was 58%. At 12 weeks, the mean increase in peak exercise oxygen uptake (mL/kg/min) compared with usual care was 2.98, 2.93, and 2.47 for IMT, FES, and IMT + FES, respectively (P <.001) and this beneficial effect persisted after 24 weeks (1.95, 2.08, and 1.56; P <.001). Significant increases in quality of life scores were found at 12 weeks (P <.001). No other changes were found. Conclusions: In HFpEF patients with low aerobic capacity, IMT and FES were associated with a significant improvement in exercise capacity and quality of life. This trial was registered at ClinicalTrials.gov (Identifier: NCT02638961). Full English text available from: www.revespcardiol.org/en

AB - © 2018 Sociedad Española de Cardiología Introduction and objectives: Despite the prevalence of heart failure with preserved ejection fraction (HFpEF), there is currently no evidence-based effective therapy for this disease. This study sought to evaluate whether inspiratory muscle training (IMT), functional electrical stimulation (FES), or a combination of both (IMT + FES) improves 12- and 24-week exercise capacity as well as left ventricular diastolic function, biomarker profile, and quality of life in HFpEF. Methods: A total of 61 stable symptomatic patients (New York Heart Association functional class II-III) with HFpEF were randomized (1:1:1:1) to receive a 12-week program of IMT, FES, or IMT + FES vs usual care. The primary endpoint of the study was to evaluate change in peak exercise oxygen uptake at 12 and 24 weeks. Secondary endpoints were changes in quality of life, echocardiogram parameters, and prognostic biomarkers. We used a mixed-effects model for repeated-measures to compare endpoints changes. Results: Mean age and peak exercise oxygen uptake were 74 ± 9 years and 9.9 ± 2.5 mL/min/kg, respectively. The proportion of women was 58%. At 12 weeks, the mean increase in peak exercise oxygen uptake (mL/kg/min) compared with usual care was 2.98, 2.93, and 2.47 for IMT, FES, and IMT + FES, respectively (P <.001) and this beneficial effect persisted after 24 weeks (1.95, 2.08, and 1.56; P <.001). Significant increases in quality of life scores were found at 12 weeks (P <.001). No other changes were found. Conclusions: In HFpEF patients with low aerobic capacity, IMT and FES were associated with a significant improvement in exercise capacity and quality of life. This trial was registered at ClinicalTrials.gov (Identifier: NCT02638961). Full English text available from: www.revespcardiol.org/en

KW - Exercise capacity

KW - Heart failure with preserved ejection fraction

KW - Physical therapy

KW - Quality of life

U2 - 10.1016/j.recesp.2018.01.024

DO - 10.1016/j.recesp.2018.01.024

M3 - Article

VL - 72

SP - 288

EP - 297

ER -