Heart Failure Awareness Week 2018

What does heart failure feel like?

According to the British Heart Foundation, there are over half a million people in the UK living with heart failure (HF). They say they experience:

  1. Shortness of breath, not only during an activity but also at rest.
  2. Swollen feet, ankles and legs.
  3. Feeling unusually weak and tired most of the time, and feeling exhausted after an activity or exercise.

What causes heart failure?

It usually occurs if the heart is too weak, or ‘stiff’, to pump blood around the body as well as it used to. Consequently, the heart needs some support to help it work better again. Although HF is more common in the elderly, it can also occur at any age.

One of the most common reasons for the heart weakening is heart muscle damage. This may occur following a heart attack. But there are other conditions that can also lead to heart failure, including:

  • High blood pressure
  • Heart rhythm problems (also known as arrhythmias)
  • Coronary heart disease
  • Cardiomyopathy
  • Congenital heart disease

What can you do to prevent heart failure?

According to NHS Choices, there are a few things you can do yourself to help reduce your risk of HF. The aim of these prevention strategies is to lower blood pressure and reduce levels of bad cholesterol in the blood.

  • Tip 1: Eat a healthy, balanced diet with low-fat, high-fibre and five portions of fruit and vegetables.
  • Tip 2: Stay active with regular exercise to make the heart and circulatory system more efficient, helping to regulate blood pressure.
  • Tip 3: Maintain a healthy weight – you can find your body mass index using a BMI calculator, or ask your GP.
  • Tip 4: Give up smoking to reduce the risk of developing furring of the arteries.
  • Tip 5: Cut back on the consumption of alcohol.

What is heart failure treatment?

A cure for this condition is only a possibility when there is a treatable cause, such as replacing damaged heart valves. Otherwise, treatment focuses on controlling the symptoms. By controlling the symptoms people are able to live full and active lives.

Sometimes implantable devices, such as a pacemaker, or other surgery will be needed. However, for the majority of people, a combination of medication and lifestyle changes will be sufficient to control and stabilise symptoms.

How heart failure affects daily living

Because the heart isn’t able to pump blood around the body as well as it used to, the load on the breathing muscles, mainly the diaphragm, increases. This results in a significant contribution to the feeling of breathlessness. Consequently, this affects a person’s everyday life. In fact, something like simple everyday tasks feel tiring. As a result, quality of life diminishes.

Did you know?

During February 11- 17, the Heart Failure Society of America (HFSA) will increase national awareness about the severity of heart failure. In Europe, Heart Failure Awareness Week will fall in May.

These awareness days take place because the number of people with heart failure is increasing. In fact, projections show it will rise by 46% (2030), according to the American Heart Association’s 2017 Heart Disease and Stroke Statistics Update.

Heart failure (HF) is a long-term condition. There is currently no cure and symptoms will get worse over time. Sadly HF also has a poor prognosis, with 30-40% of patients dying within a year. However, if diagnosed early enough, symptoms can be controlled for many years.

Improving quality of life

There are many research studies showing that Inspiratory Muscle Training (IMT) successfully increases both inspiratory strength and endurance. They also show that stronger breathing muscles will alleviate breathlessness and improve functional status in chronic heart failure.

In one particular study, findings reveal that in patients with HF and inspiratory muscle weakness, IMT results in:

  • Marked improvement in inspiratory muscle strength
  • Improvement in functional capacity
  • Improvement in ventilatory response to exercise
  • Improvement in recovery oxygen uptake kinetics
  • Improvement in quality of life

Training the inspiratory muscles

POWERbreathe IMT is a hand-held breathing muscle training device. It is drug-free with no known side effects and no interactions with existing treatments. There are also no reports of any adverse events. It is easy to use as you only need to breathe forcefully IN through the device for 30 breaths, twice a day.

Because the cardiovascular strain of POWERbreathe training is very low, it is suitable for even the most physically compromised patients and is particularly helpful in patients who are too ill for rehabilitation.

POWERbreathe training is completely safe for the vast majority of patients. However there may be small theoretical risks for some patients. For instance, IMT will not be a recommendation for patients with a history of spontaneous pneumothorax.

The POWERbreathe Medic is approved by the NHS’s PPA and is available on prescription in the UK.

Always check with your doctor first before undertaking anything new for the treatment of any medical condition.


IMT associated with Improved Inspiratory Muscle Strength in Fontan Circulation patients

Like other forms of heart failure, low cardiac output and raised central venous pressure is what characterises the Fontan Circulation. However unlike other forms of heart failure, in Fontan circulation patients the primary limitation is absence of a subpulmonary ventricle.

Affects of Fontan circulation

Patients will experience reduced exercise capacity and respiratory muscle strength. Fortunately Inspiratory Muscle Training (IMT) improves exercise capacity and quality of life in adults with heart failure. This is evident from previous studies.

Purpose and method of study

The purpose of this study is to assess whether a home-based IMT program improves inspiratory muscle strength and the ventilatory efficiency of exercise in adolescent patients with a Fontan circulation.

To assess this, Fontan circulation patients underwent 30 minutes of IMT daily for six weeks. Exercise capacity (cardiopulmonary exercise testing), lung function and respiratory muscle strength (maximal inspiratory pressure and expiratory pressure) are all assessed.

Study findings

Findings from the study show that IMT is a simple and beneficial addition to the management of Fontan patients. It shows that IMT potentially reduces exercise intolerance and long-term morbidity and mortality.


The study shows that six weeks of IMT is associated with improving inspiratory muscle strength, ventilatory efficiency of exercise, and resting cardiac output in young Fontan patients.

The study

Inspiratory Muscle Training Is Associated With Improved Inspiratory Muscle Strength, Resting Cardiac Output, and the Ventilatory Efficiency of Exercise in Patients With a Fontan Circulation >

Heart Failure and Heart Disease

A study concluded that Inspiratory Muscle Training (IMT) using an incremental endurance test, successfully increases both inspiratory strength and endurance, alleviates dyspnea and improves functional status in chronic heart failure1.

Another study concluded that in patients with chronic heart failure and inspiratory muscle weakness, Inspiratory Muscle Training (IMT) results in marked improvement in inspiratory muscle strength, as well as improvement in functional capacity, ventilatory response to exercise, recovery oxygen uptake kinetics, and quality of life2.

Inspiratory muscle training using an incremental endurance test alleviates dyspnea and improves functional status in patients with chronic heart failure

Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial

Breathing Effort in other Medical Conditions 

Any condition that prevents normal physical activity can lead to inspiratory muscle weakness, and in addition to asthma and Chronic Obstructive Pulmonary Disease (COPD), Inspiratory Muscle Training (IMT), such as with POWERbreathe, has been found to be helpful for managing other medical conditions, including chronic heart failure, postoperative pulmonary complications and inspiratory stridor.

Specific Inspiratory Muscle Training (IMT) of the muscles we use to breathe, such as with POWERbreathe, has been demonstrated to increase their strength, resistance to fatigue and reduce breathlessness, as well as being helpful in managing medical conditions including:

POWERbreathe, Exercise Training & Long Term Management of Heart Failure Patients

On 19th September POWERbreathe friend and distributor in Switzerland, Health MG, attended this 3-day training workshop on Rehabilitation and Long Term Management of Heart Failure Patients, at University Hospital, Switzerland.

Regular physical exercise for patients with heart failure is recommended in the guidelines of the European Society of Cardiology as it could ultimately lead to positive changes in myocardial function, symptoms, functional capacity and probably survival. But physical activity is poorly implemented in daily clinical practice.

The aim of the course was to demonstrate the art of exercise training and secondary prevention as well as the interplay between key elements of long term management of heart failure patients.

The workshop was aimed at cardiac rehab physicians, heart failure specialists, cardiologists and GP’s, physiotherapists, sports scientists and nurses and included many aspects of exercise training and testing, including POWERbreathe respiratory muscle training.

The workshop summarised the most current evidence of the benefits of exercise training in patients with heart failure, with practical advice for long-term management, assessment of exercise capacity and the application of different exercise modalities.

POWERbreathe respiratory muscle training has been used as a stand-alone therapy and in cardiac rehabilitation in patients with heart failure and heart disease. Because patients with chronic heart failure (CHF) experience a restrictive pattern of lung function due to pulmonary hypertension, their lung ‘stiffness’ increases the load on their respiratory muscles and makes a significant contribution to their breathlessness. Respiratory muscle training has been shown to successfully increase inspiratory strength and endurance, alleviate breathlessness (dyspnea) and improve functional status in chronic heart failure. POWERbreathe training will only provide a very low cardiovascular strain, making it suitable for the most physically compromised patients and those who’re too ill for rehabilitation.

Read more about POWERbreathe respiratory muscle training for medical conditions, or if you’re already using POWERbreathe to help reduce breathlessness due to breathing problems , then please leave a comment here or on the POWERbreathe Forum, Facebook or Twitter as we’d love to hear from you. You can also read more about POWERbreathe for medical conditions in our POWERbreathe blog.

Effects of IMT in patients with heart failure with preserved ejection fraction

The European Journal of Preventative Cardiology has just published the Abstract of a study that looked to evaluate whether inspiratory muscle training (IMT) would improve exercise capacity, as well as left ventricular diastolic function, biomarker profile and quality of life in patients with advanced heart failure with preserved ejection fraction (HFpEF) and nonreduced maximal inspiratory pressure (MIP).

The results revealed that the IMT group significantly improved their MIP, peak VO2, exercise oxygen uptake at anaerobic threshold, ventilator efficiency, metabolic equivalents and quality of life compared to the control group.

The study concluded therefore, “In HFpEF patients with low aerobic capacity and non-reduced MIP, IMT was associated with marked improvement in exercise capacity and QoL (quality of life).”

Read the full Abstract:

Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction

Patricia Palau, Eloy Domínguez, Eduardo Núñez et al

Patricia Palau, Cardiology Department, Hospital Clínico Universitario, Blasco Ibáñez 17, 46010 Valencia, Spain

Read more about Inspiratory Muscle Training with POWERbreathe for Chronic Heart Failure as a standalone therapy and for cardiac rehabilitation.