title: Device-guided paced breathing in the home setting: effects on exercise capacity, pulmonary and ventricular function in patients with chronic heart failure: a pilot study.
abstract: BACKGROUND
  Regular slow breathing is known to improve autonomic cardiac regulation and reduce chemoreflex sensitivity in heart failure. We explored the acceptability and usefulness of a device for paced slow breathing at the home setting.
  
  
  RESULTS
  In this open pilot study, 24 patients with chronic heart failure (61% males, mean age, 64+/-9 years; New York Heart Association class, 2.81+/-0.01) were randomized to a control group receiving conventional treatment (n=12) or to a group receiving conventional treatment and device-guided paced breathing (n=12). Groups were comparable for age, therapies, and clinical characteristics. They were evaluated at baseline and again after 10 weeks by Doppler echocardiography, pulmonary function, cardiopulmonary stress test, and quality of life (Minnesota Quality of Life questionnaire). The treatment group was instructed to use the equipment for 18 minutes twice daily. The device is a computerized box connected to a belt-type respiration sensor and to headphones; it generates musical tones (based on the user's breathing rate and inspiration ratio), which guide the user to progressively and effortlessly slow his or her breathing rate <10 breaths/min. The treatment group showed high compliance to the device (90% of the prescribed sessions were completed). Blinded analysis of data demonstrated increased ejection fraction and decreased estimated pulmonary pressure in the echocardiograms of the treated group versus controls and favorable changes in New York Heart Association class, Ve/Vco(2), FEV(1), and a quality of life measure, as well (all P<0.05).
  
  
  CONCLUSIONS
  This pilot investigation demonstrates that device-guided paced breathing at home is feasible and results in an improvement in clinically relevant parameters for patients with heart failure and systolic dysfunction.
authors.affiliation: Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy. gianfranco.parati@unimib.it
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.forename: Gabriella
authors.initials: G
authors.lastname: Malfatto
authors.forename: Simona
authors.initials: S
authors.lastname: Boarin
authors.forename: Giovanna
authors.initials: G
authors.lastname: Branzi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Caldara
authors.forename: Alessia
authors.initials: A
authors.lastname: Giglio
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Bilo
authors.forename: Guido
authors.initials: G
authors.lastname: Ongaro
authors.forename: Ariela
authors.initials: A
authors.lastname: Alter
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gavish
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000368:Aged; D015150:Echocardiography, Doppler; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D012138:Respiratory Therapy / Q000295:instrumentation*; D016896:Treatment Outcome; D016276:Ventricular Function / Q000502:physiology*