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    Comparison of functional and maximal exercise capacity, respiratory and peripheral muscle strength, dyspnea, and fatigue in patients with heart failure with pacemakers and healthy controls: a cross-sectional study
    (Taylor & Francis Inc, 2021) Guclu, Meral Bosnak; Bargi, Gulsah; Katayifci, Nihan; Sen, Fatih
    Background: Despite major breakthroughs that have recently been made in pacemakers implanted in patients with heart failure (HF), it is clear that functional impairments and symptoms often remain. However, only limited studies have investigated exercise capacity, muscle strength, pulmonary function, dyspnea, and fatigue in these patients. Therefore, we aimed to compare aforementioned outcomes in patients and healthy controls. Methods: A cross-sectional study. Fifty patients with HF with pacemakers (58.90 +/- 10.69 years, NYHA II-III, LVEF: 30.79 +/- 8.78%) and 40 controls (56.33 +/- 5.82 years) were compared. Functional (6-Minute Walking test (6-MWT)) and maximal exercise capacity (Incremental Shuttle Walk test (ISWT)), respiratory (Mouth pressure device) and peripheral muscle strength (Dynamometer), pulmonary function (Spirometry), dyspnea (Modified Medical Research Council Dyspnea scale), and fatigue (Fatigue Severity scale) were evaluated. ClinicalTrial number: NCT03701854. Results: 6-MWT (412.62 +/- 96.51 m versus 610.16 +/- 59.48 m) and ISWT (279.97 m versus 655 m) distances (p < 0.001), pulmonary function (p<0.001), respiratory and peripheral muscle strength (p < 0.001) were significantly lower; dyspnea (p < 0.001) and fatigue (p = .030) scores were higher in patients compared with controls. Conclusion: Maximal and functional exercise capacity is impaired in the majority of patients with HF with pacemakers, respiratory and peripheral muscles are weakened, dyspnea and fatigue perceptions are increased. Patients with pacemakers have to be included in cardiac rehabilitation programs to improve impairments.
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    Öğe
    A comparison of the effects of inspiratory muscle strength and endurance training on exercise capacity, respiratory muscle strength and endurance, and quality of life in pacemaker patients with heart failure: A randomized study
    (Mosby-Elsevier, 2022) Katayifci, Nihan; Guclu, Meral Bosnak; Sen, Fatih
    Background: Studies have widely investigated the effects of inspiratory muscle strength training in patients with heart failure (HF). The effects of inspiratory muscle strength or endurance training on outcomes in patients with pacemakers have not been adequately studied. Objectives: The aim was to compare the effects of inspiratory muscle strength and endurance training on exercise capacity, quality of life (QoL), peripheral and respiratory muscle strength, respiratory muscle endurance, pulmonary function, dyspnea, fatigue, and physical activity levels in pacemaker patients with HF. Methods: A randomized, controlled, double-blind study was conducted. Fourteen pacemaker patients with HF received inspiratory muscle strength training (IMST) at 50% of maximal inspiratory pressure (MIP), and 18 patients received endurance training (IMET) at 30% of MIP 7 days/8 weeks. Exercise capacity [6 min. walking test (6MWT) and the Incremental Shuttle Walking Test (ISWT)], pulmonary function, respiratory muscle strength [MIP, maximal expiratory pressure (MEP)], endurance, peripheral muscle strength, dyspnea, fatigue, QoL, and physical activity level were evaluated before and after. Results: Demographic characteristics were similar in IMST (3F/11M, 56.92 +/- 7.61y, EF: 25%, ICD/CRT: 11/3) and IMET (4F/14M, 56 +/- 10.77y, EF: 30%, ICD/CRT:16/2) groups (p > 0.05). Significant improvements were present in MIP, MEP, respiratory muscle endurance, peripheral muscle strength, 6MWT and ISWT walking distances, dyspnea, QoL, physical activity level, fatigue scores within groups (p <= 0.05). However, there were no significant differences between the groups (p > 0.05). There were no significant improvements in FEV1%, FVC%, FEV1/FVC%, and FEF25-75 within and between the groups (p > 0.05). Conclusions: Inspiratory muscle strength and endurance training similarly improves respiratory and peripheral muscle strength, exercise capacity, QoL, physical activity level, and decreases dyspnea and fatigue and are safe and effective in pacemaker patients with HF. (C) 2022 Elsevier Inc. All rights reserved.