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Effects of device-guided slow breathing training on exercise capacity, cardiac function, and respiratory patterns during sleep in male and female patients with chronic heart failure
Kawecka-Jaszcz K, Bilo G, Drozdz T, Debicka-Dabrowska D, Kielbasa G, Malfatto G, Styczkiewicz K, Lombardi C, Bednarek A, Salerno S, Czarnecka D, Parati G
Polskie Archiwum Medycyny Wewnetrznej [Polish Archives of Internal Medicine] 2017 Jan;127(1):8-15
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Slow breathing training (SBT) has been proposed as a new nonpharmacologic treatment in patients with chronic heart failure (CHF). OBJECTIVES: The aim of this study was to assess the effects of SBT on exercise capacity, hemodynamic parameters, and sleep respiratory patterns in a relatively large sample of CHF patients. PATIENTS AND METHODS: A crossover open study was conducted. Patients completed, in a random order, 10- to 12-week SBT, with 2 15-minute sessions of device-guided SBT each day, reaching 6 breaths/min, and a 10- to 12-week follow-up under standard care. Clinical data collection, polysomnography, echocardiography, 6-minute walk test (6MWT), and laboratory tests were performed. RESULTS: A total of 96 patients (74 men, 22 women) in New York Heart Association classes I to III, with an average age of 65 years and an ejection fraction (EF) of 31%, completed the study. Home-based SBT was safe. After training, EF and 6MWT distance improved (EF 31.3% +/- 7.3% versus 32.3% +/- 7.7%; p = 0.030; 6MWT: 449.9 +/- 122.7 m versus 468.3 +/- 121.9 m; p < 0.001), and the apnea-hypopnea index decreased (5.6 (interquartile range (IQR) 2.1 to 12.8) versus 5.4 (IQR 2.0 to 10.8); p = 0.043). CONCLUSIONS: SBT improved physical capacity and systolic heart function; it also diminished sleep disturbances. The results support the benefits of SBT as a novel component of cardiorespiratory rehabilitation programs in patients with CHF.

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