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Mazzoli-Rocha F, Diniz CP, de Rezende DPR, Mendes FDSNS, Hasslocher-Moreno AM, de Sousa AS, Saraiva RM, Borghi-Silva A, Mediano MFF, Alexandre DJDA. Inspiratory Muscle Strength in Chagas Cardiomyopathy: A Systematic Scoping Review. Rev Soc Bras Med Trop 2023; 56:0389. [PMID: 38088665 PMCID: PMC10706025 DOI: 10.1590/0037-8682-0389-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
The increase in inflammatory markers associated with persistent chronic fibrosing myocarditis, a characteristic of chronic Chagas disease, can result in a reduction in inspiratory muscle strength (IMS) in Chagas cardiomyopathy (CC). However, literature in this field is still scarce. This review aimed to map and summarize the evidence regarding IMS in patients with CC. The inclusion criteria included reports with adult participants with a CC diagnosis, with or without heart failure (HF). The core concept examined was the maximum inspiratory pressure evaluated in the untrained and trained groups in the pre-training period. The context was open, including but not limited to hospitals and health centers. Two authors independently identified eligible studies and extracted the data. Descriptive synthesis was used as the primary strategy for analyzing the results. Nine studies (five clinical trials, three cross-sectional, and one cohort) were included. The CC classification differed among the studies, with no mention of HF in five and no CC staging specification in six. IMS was assessed using a manovacuometer, and only six studies analyzed and interpreted the data concerning the predicted values. The CC population with HF appeared to have impaired IMS. All studies involved only Brazilian volunteers. In conclusion, randomized clinical trials evaluating IMS and the effects of inspiratory muscle training need to be conducted to better understand the prevalence and risk of inspiratory muscle weakness in the CC population, as well as the effects of training. Such studies should be conducted at different stages of CC in different populations and countries.
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Affiliation(s)
- Flavia Mazzoli-Rocha
- Laboratório de Pesquisa Clínica em Doença de Chagas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Clara Pinto Diniz
- Laboratório de Pesquisa Clínica em Doença de Chagas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | | | - Alejandro Marcel Hasslocher-Moreno
- Laboratório de Pesquisa Clínica em Doença de Chagas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Andréa Silvestre de Sousa
- Laboratório de Pesquisa Clínica em Doença de Chagas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Roberto Magalhães Saraiva
- Laboratório de Pesquisa Clínica em Doença de Chagas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Audrey Borghi-Silva
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - Mauro Felippe Felix Mediano
- Laboratório de Pesquisa Clínica em Doença de Chagas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
- Departamento de Ensino e Pesquisa, Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brasil
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