Inspiratory muscle training in heart disease and heart failure: A review of the literature with a focus on method of training and outcomes

Lawrence P. Cahalin, Ross Arena, Marco Guazzi, Jonathan Myers, Gerson Cipriano, Gaspar Chiappa, Carl J. Lavie, Daniel E. Forman

Research output: Contribution to journalArticle

48 Scopus citations


Evidence to date strongly suggests that poor inspiratory muscle performance is associated with dyspnea, poor exercise tolerance and poor functional status in patients with heart failure (HF). A growing body of literature has examined the effects of inspiratory muscle training (IMT) in HF patients with the majority of studies reporting favorable effects on several of the above limitations and a substantial number of related deficiencies due to inadequate inspiration and inspiratory muscle strength and endurance. The domains and manifestations of HF, which were significantly improved by IMT in one or more of the 18 out of 19 studies of IMT, included dyspnea, quality of life, balance, peripheral muscle strength and blood flow, peripheral muscle sympathetic nervous activity, heart rate, respiratory rate, peak VO2, 6-min walk test distance, ventilation, VE/VCO2 slope, oxygen uptake efficiency, circulatory power, recovery oxygen kinetics and several indices of cardiac performance. This paper will also review the available IMT literature with a focus on methods of IMT and clinical outcomes. Key differences between available IMT methods will be highlighted with a goal to improve IMT efforts and decrease the pathophysiological manifestations of heart disease and HF.

Original languageEnglish (US)
Pages (from-to)161-177
Number of pages17
JournalExpert Review of Cardiovascular Therapy
Issue number2
StatePublished - Feb 1 2013



  • breathing
  • heart failure
  • inspiratory muscle training
  • maximal inspiratory pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

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