Respiratory Muscle Training Clinical Trial
Official title:
Inspiratory Muscle Training During Right-heart Catheterization
The purpose of this study is to assess hemodynamic effects of inspiratory muscle training during routinely performed right-heart catheterization.
During the last years, respiratory muscle training (RMT) in patients with impaired
respiratory muscle function, e.g. in chronic obstructive pulmonary disease (COPD), is
increasingly applied. RMT can be done by applying increased respiratory effort for several
minutes via an apparatus providing an inspiratory stenosis. Threshold IMT® (Philips
Respironics) for example is such a training device, which is in the market for several years
now and which has been used to conduct studies applying RMT. For example, it has been shown
that training with the Threshold IMT® in patients with COPD increases inspiratory muscle
strength, endurance and functional capacity and ameliorates dyspnea and quality of life.
Furthermore, patients suffering from cardiac illness can also be affected by respiratory
muscle impairment, which can add to their cardiogenic dyspnea. RMT can help improve dyspnea
and physical exercise capacity in those patients as well.
To date, no studies have been performed addressing acute hemodynamic effects of inspiratory
muscle training. However, this is of special interest: COPD as well as heart failure patients
show an increased prevalence of pulmonary hypertension.
In case of suspected pulmonary hypertension, patients usually are subjected to right-heart
catheterization (RHC) to arrive at a definitive diagnosis and assess severity and etiology of
potentially present pulmonary hypertension. RHC is also a sensitive method to exclude an
intracardial shunt in COPD patients.
In this study, patients who are routinely subjected to RHC for the above mentioned reasons
will be instructed to do RMT using the Threshold IMT® during RHC. Two days in advance they
will begin a guided training to get familiar with the Threshold IMT®. The device's
inspiratory resistance can be set between 9 and 41 cm H2O. A single training session consists
of 7 cycles with 2 min inspiratory training each, followed by a 1 min break (total duration
21 min). RMT will be conducted with 20-30% of individual inspiratory muscle strength, which
will be measured beforehand.
During the RHC procedure the patients will again conduct RMT as instructed while the
suspected hemodynamic effects will be documented.
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