Heart Failure Clinical Trial
Official title:
Impact of a Structural Phonation Training on Respiratory Muscle Function in Patients With Structural Heart Disease - HeartChoir
Most patients with complex congenital heart disease and cardiomyopathy from acquired heart disease have reduced exercise capacity. Exercise capacity is associated with respiratory muscle strength and function. If structured respiratory muscle training positively influences respiratory muscle function in patients with structural heart disease is not well known. The aim of this study is to investigate whether regular singing lessons and breathing exercises improve respiratory muscle strength in patients with congenital or acquired structural heart disease.
Most patients with complex congenital heart disease and cardiomyopathy from acquired heart
disease have reduced exercise capacity (VO2 max). Furthermore, exercise capacity is
associated with respiratory muscle strength and function (maximal inspiratory (MIP) and
maximal respiratory (MEP) pressures. If structured respiratory muscle training positively
influences respiratory muscle function in patients with complex congenital heart disease or
cardiomyopathy from acquired heart disease is not well known.
Aim: The aim of this study is to investigate the influence of a structured phonation and
respiratory training with regular singing lessons on respiratory muscle strength and function
(MIP and MEP), exercise capacity (VO2 max), NT-proBNP and quality of life.
This is an interventional, single-centre, randomized study. Patients will be recruited from
the heart failure and congenital heart disease clinic of the University hospital Basel.
Patients will be asked to participate in a structured phonation and respiratory muscle
training for 12 weeks. The structured phonation and respiratory muscle training includes
weekly singing lessons in a choir, held by a professional instructor, with additional
instructions for daily respiratory muscle strength training at home. Respiratory muscle
function (MIP and MEP), exercise capacity (VO2max) and quality of life will be measured at
the beginning of the intervention and after 12 weeks of interventional training. In parallel,
respiratory muscle function, exercise capacity, NT-proBNP and quality of life will be
measured in a gender and age matched group of patients without performing the intervention
and in a healthy control group who co-participate the choir lessons and the respiratory
muscle training. Primary endpoint is the change of maximal inspiratory pressures (MIP)
between patients with and without a structured phonation and respiratory muscle training.
Secondary endpoints are changes of MEP, VO2max, NT-proBNP and quality of life between
patients with and without the intervention; changes of all measured variables between
patients and the healthy control group, and changes of all measured variables before and
after the intervention in patients. Inclusion criteria: Patients >18 years with known
cardiomyopathy from acquired heart disease (ischemic or dilated) or complex forms of
congenital heart disease. Exclusion criteria: Acute coronary syndrome ≤6 months or heart
failure hospitalization ≤12 months.
Structural singing lesions and respiratory muscle function training may improve respiratory
muscle strength, exercise capacity and quality of life in patients with heart failure or
complex congenital heart disease. The intervention comes at low costs, can be applied by most
of the patients and is feasible even for disabled patients who are not able to participate in
regular exercise training. Furthermore, singing may improve respiratory muscle strength and
exercise capacity even in the healthy population.
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