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 cmH2O and expiratory positive airway pressure of 6 cmH2O for 30 min. At baseline, and after the first and second 6MWT, the heart rate, systolic and diastolic blood pressure, peripheral oxygen saturation (SaO2), 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. Keywords: Exercise, Heart failure, Ventilatio