title: Combined aerobic/inspiratory muscle training vs. aerobic training in patients with chronic heart failure: The Vent-HeFT trial: a European prospective multicentre randomized trial.
abstract: OBJECTIVE
  Vent-HeFT is a multicentre randomized trial designed to investigate the potential additive benefits of inspiratory muscle training (IMT) on aerobic training (AT) in patients with chronic heart failure (CHF).
  
  
  RESULTS
  Forty-three CHF patients with a mean age of 58 ± 12 years, peak oxygen consumption (peak VO2 ) 17.9 ± 5 mL/kg/min, and LVEF 29.5 ± 5% were randomized to an AT/IMT group (n = 21) or to an AT/SHAM group (n = 22) in a 12-week exercise programme. AT involved 45 min of ergometer training at 70-80% of maximum heart rate, three times a week for both groups. In the AT/IMT group, IMT was performed at 60% of sustained maximal inspiratory pressure (SPImax ) while in the AT/SHAM group it was performed at 10% of SPImax , using a computer biofeedback trainer for 30 min, three times a week. At baseline and at 3 months, patients were evaluated for exercise capacity, lung function, inspiratory muscle strength (PImax ) and work capacity (SPImax ), quality of life (QoL), LVEF and LV diameter, dyspnoea, C-reactive protein (CRP), and NT-proBNP. IMT resulted in a significantly higher benefit in SPImax (P = 0.02), QoL (P = 0.002), dyspnoea (P = 0.004), CRP (P = 0.03), and NT-proBNP (P = 0.004). In both AT/IMT and AT/SHAM groups PImax (P < 0.001, P = 0.02), peak VO2 (P = 0.008, P = 0.04), and LVEF (P = 0.005, P = 0.002) improved significantly; however, without an additional benefit for either of the groups.
  
  
  CONCLUSIONS
  This randomized multicentre study demonstrates that IMT combined with aerobic training provides additional benefits in functional and serum biomarkers in patients with moderate CHF. These findings advocate for application of IMT in cardiac rehabilitation programmes.
authors.affiliation: Heart Failure Unit, Stress Testing & Rehabilitation, Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: Stamatis
authors.initials: S
authors.lastname: Adamopoulos
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
authors.forename: Paul
authors.initials: P
authors.lastname: Dendale
authors.forename: Daniel
authors.initials: D
authors.lastname: Poerschke
authors.forename: Dominique
authors.initials: D
authors.lastname: Hansen
authors.forename: Athanasios
authors.initials: A
authors.lastname: Dritsas
authors.forename: Alexandros
authors.initials: A
authors.lastname: Kouloubinis
authors.forename: Toon
authors.initials: T
authors.lastname: Alders
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Gkouziouta
authors.forename: Ilse
authors.initials: I
authors.lastname: Reyckers
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Vartela
authors.forename: Nikos
authors.initials: N
authors.lastname: Plessas
authors.forename: Costas
authors.initials: C
authors.lastname: Doulaptsis
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Laoutaris
mesh_terms: D000368:Aged; D001945:Breathing Exercises / Q000379:methods / Q000523:psychology; D002097:C-Reactive Protein / Q000032:analysis; D015444:Exercise / Q000502:physiology / Q000523:psychology; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation; D006334:Heart Function Tests / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption; D010446:Peptide Fragments / Q000097:blood; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000379:methods; D016896:Treatment Outcome
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: Aerobic training; Chronic heart failure; Exercise; Inspiratory muscle training; Quality of life; Rehabilitation; Vent-HeFT trial