Inspiratory Muscle Strength in Chagas Cardiomyopathy: A Systematic Scoping Review

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Flavia Mazzoli-Rocha, Clara Pinto Diniz, Daniel Pereira Redes de Rezende, Fernanda de Souza Nogueira Sardinha Mendes, Alejandro Marcel Hasslocher-Moreno, Andréa Silvestre de Sousa, Roberto Magalhães Saraiva, Audrey Borghi-Silva, Mauro Felippe Felix Mediano, Dângelo José de Andrade Alexandre
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2023
• Subjects: Chagas cardiomyopathy; Maximum inspiratory pressure; Inspiratory muscle strength; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0389-2023; https://doaj.org/article/8c59c52336f4436ba43207cafb4e190d

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.