Patients with post-Covid-19 syndrome are at high risk of developing cardiovascular diseases 12 months after acute infection of COVID-19. We recently revealed that these patients have elevated muscular sympathetic nerve activity (MSNA), vascular dysfunction, impaired cardiac diastolic function, and reduced functional capacity. Considering that these outcomes are independent predictors of cardiovascular mortality, it is urgent to restore the cardiovascular health of these patients. High resistance inspiratory muscle strength training (IMST) at 75% of pressure inspiratory (PImax) performed at home (5 min/session, 5-7 times/week per 6 weeks) reduces the MSNA, improves the endothelial function and lowers blood pressure in different populations. Based on these findings, IMST (75% PImax) is an excellent therapeutic option for patients with post-COVID-19 syndrome. Therefore, the aim of the present proposal is to test whether IMST (75% PImax) reduces sympathetic activity, improves vascular function, and restores cardiac function, evoking an increase in functional capacity in patients with post-COVID-19 syndrome. To test these hypotheses we will conduct a randomized, double-blind, sham-controlled clinical trial to test these hypotheses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
Using a handheld device, participants will perform 30 breaths per day at 75% of maximal inspiratory pressure, six days a week, during 6 weeks.
D'Or Institute of Research and Education
São Paulo, Brazil
RECRUITINGMuscle sympathetic nerve activity
Microneurography
Time frame: Baseline and 6 weeks after ISMT and Sham
Endothelial function
Doppler Ultrasound
Time frame: Baseline and 6 weeks after ISMT and Sham
Arterial stiffness
Applanation tonometry
Time frame: Baseline and 6 weeks after ISMT and Sham
Blood pressure
Sphygmomanometry
Time frame: Baseline and 6 weeks after ISMT and Sham
Exercise Capacity
Cardiopulmonary exercise testing
Time frame: Baseline and 6 weeks after ISMT and Sham
Maximum inspiratory pressure
Manovacuometry
Time frame: Baseline and 6 weeks after ISMT and Sham
Oxidative stress
Blood samples
Time frame: Baseline and 6 weeks after ISMT and Sham
Nitric oxide
Blood samples
Time frame: Baseline and 6 weeks after ISMT and Sham
Inflammatory profile
Blood samples
Time frame: Baseline and 6 weeks after ISMT and Sham
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