title: Addition of non-invasive ventilatory support to combined aerobic and resistance training improves dyspnea and quality of life in heart failure patients: a randomized controlled trial.
abstract: To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients.
  
  
  
  A randomized, single-blind, controlled study.
  
  
  
  Cardiac rehabilitation center.
  
  
  
  A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support ( n = 23) or combined aerobic and resistance training alone ( n = 23).
  
  
  
  Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire.
  
  
  
  Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change: 4.8 vs. 1.3, p = 0.004), and quality of life (mean change: 19.3 vs. 6.8, p = 0.017 ). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 vs. 44.1, p = 0.924), but without a statistically significant difference.
  
  
  
  Non-invasive ventilatory support combined with combined aerobic and resistance training provides additional benefits for dyspnea and quality of life in moderate heart failure patients.
  
  
  
  ClinicalTrials.gov identifier: NCT02384798. Registered 03 April 2015.
authors.affiliation: 1 Hospital Ana Nery, Salvador, Brazil.
authors.forename: Hugo Souza
authors.initials: HS
authors.lastname: Bittencourt
authors.affiliation: 1 Hospital Ana Nery, Salvador, Brazil.
authors.forename: Cristiano Gonçalves
authors.initials: CG
authors.lastname: Cruz
authors.affiliation: 2 Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Bruno Costa
authors.initials: BC
authors.lastname: David
authors.affiliation: 2 Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Erenaldo
authors.initials: E
authors.lastname: Rodrigues
authors.affiliation: 2 Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Camille Magalhães
authors.initials: CM
authors.lastname: Abade
authors.affiliation: 2 Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Roque Aras
authors.initials: RA
authors.lastname: Junior
authors.affiliation: 3 Universidade Federal de Sergipe, Aracaju, Brazil.
authors.forename: Vitor Oliveira
authors.initials: VO
authors.lastname: Carvalho
authors.affiliation: 1 Hospital Ana Nery, Salvador, Brazil.
authors.forename: Francisco Borges Faria
authors.initials: FBF
authors.lastname: Dos Reis
authors.affiliation: 2 Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Mansueto
authors.initials: M
authors.lastname: Gomes Neto
mesh_terms: D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005260:Female; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation; D011788:Quality of Life; D055070:Resistance Training; D016037:Single-Blind Method; D000070857:Walk Test
keywords: Heart failure; exercise tolerance; non-invasive ventilation