Abstract
Maximal inspiratory pressure (MIP) is an effective method for evaluating inspiratory muscle strength and can be obtained by standard (MIPsta) or unidirectional expiratory valve method (MIPuni). Handgrip strength (HS) has been an important indicator of peripheral muscle weakness. This study aimed at determining the prevalence of both inspiratory and peripheral muscle weakness in hospitalized patients with decompensated heart failure (HF). We also compared MIPsta and MIPuni values obtained in these patients. Twenty-eight patients (14 males), with a mean age of 75.3 ± 13.1 years and LVEF of 42.0 ± 17.5% were included. On the first day after stabilization, the patients underwent lung function, HS and quality of life measurements. On the next day, MIPsta and MIPuni were evaluated in a random order. A digital manometer was attached to a rigid mouthpiece to measure MIPsta and an oronasal mask was attached to a unidirectional expiratory valve for MIPuni measurement. The prevalence of inspiratory muscle weakness (MIP<70% of predicted) was 75% and all patients presented HS<70%. MIPuni showed higher values (−63.0 ± 26.6 cmH2O) compared with MIPsta (−52.9 ± 25.6 cmH2O) (p=0.01). HS was higher in NYHA functional class II (27.1 ± 10.6) compared with class III (20.7 ± 7.9) (p=0.02). There was a significant correlation of HSwith quality of life (r=-0.38; p=0.04), FEV1 % (r=0.38; p=0.04) and MIP % of predicted (r=0.59; p=0.01). We observed a high prevalence of both inspiratory and peripheral weakness in patients with decompensated HF. MIPuni is the better method for measuring MIP in individuals with decompensated HF without artificial airway.
- Copyright ©ERS 2015