Effects of noninvasive ventilation with bilevel positive airway pressure on exercise tolerance and dyspnea in heart failure patients

Background: Heart failure (HF) is a syndrome that results in inadequate blood supply, leading to a number of structural and functional changes. Noninvasive ventilatory support (NIVS) is used as an adjuvant treatment to improve the functional capacity of these patients. Objective: To investigate the effect of NIVS with bilevel positive airway pressure ventilation (BiPAP) on exercise tolerance and dyspnea in HF patients. Methods: Forty patients with New York Heart Association class I/II/III HF were randomly assigned either to a NIVS group (n = 20) or control group (n = 20). All patients underwent two 6-min walk tests (6MWT), with a 30-min interval between them. In the NIVS group, the patients performed the BiPAP with an inspiratory positive airway pressure of 12 cmH(2)O and expiratory positive airway pressure of 6 cmH(2)O for 30 min. At baseline, and after the first and second 6MWT, the heart rate, systolic and diastolic blood pressure, peripheral oxygen saturation (SaO(2)), and dyspnea were evaluated. Results: Forty patients completed the study safely according to the randomization protocol, and no adverse events were reported during the tests. The NIVS group showed a significant improvement in the 6MWT distance (68.3 vs. 9.8 m) and dyspnea (1.3 vs. 3.1) compared with the control group. No serious adverse events were reported. Conclusions: NIVS/BiPAP showed beneficial effects on exercise tolerance and dyspnea. It was safe and well tolerated by HF patients and should be considered for inclusion in cardiac rehabilitation programs. (C) 2017 Hellenic Society of Cardiology. Publishing services by Elsevier B.V.