Related Experiment Video
Updated: Nov 9, 2025
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Reduced inspiratory muscle strength increases pneumonia in patients with acute myocardial infarction
YiNing Dai1, Zhi Liu1, HuiMin Zhan1
1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China.
Background:
Inspiratory muscle strength is associated with pneumonia in patients after surgery or those with subacute stroke. However, inspiratory muscle strength in patients with acute myocardial infarction (AMI) has not been studied.
Objective:
To evaluate the predictive value of inspiratory muscle strength for pneumonia in patients with AMI.
Methods:
Patients with AMI were consecutively enrolled from March 2019 to September 2019. Measurements of maximal inspiratory pressure (MIP) were used to estimate inspiratory muscle strength and mostly were taken within 24 hr after culprit-vessel revascularization. Patients were divided into 3 groups by MIP tertile (T1: <56.1cm H2O, n=88; T2: 56.1-84.9cm H2O, n=88; T3: >84.9cm H2O, n=89). The primary endpoint was in-hospital pneumonia.
Results:
Among 265 enrolled patients, pneumonia developed in 26 (10%). The rates of pneumonia were decreased from MIP T1 to T3 (T1: 17%, T2: 10%, T3: 2%, P=0.004). In-hospital all-cause mortality and major adverse cardiovascular events (MACEs) did not differ between groups. Multivariate logistic regression confirmed increased MIP associated with reduced risk of pneumonia (odds ratio 0.78, 95% confidence interval 0.65-0.94, P=0.008). Receiver operating characteristic curve analysis indicated that MIP had good performance for predicting in-hospital pneumonia, with an area under the curve of 0.72 (95% confidence interval 0.64-0.81, P<0.001).
Conclusions:
The risk of pneumonia but not in-hospital mortality and MACEs was increased in AMI patients with inspiratory muscle weakness. Future study focused on training inspiratory muscle may be helpful.
Insights
Inspiratory muscle weakness increases pneumonia risk in acute myocardial infarction (AMI) patients. Assessing maximal inspiratory pressure (MIP) can predict this risk, guiding potential interventions.
Area of Science:
- Cardiology
- Pulmonology
- Critical Care Medicine
Background:
- Inspiratory muscle strength is linked to pneumonia post-surgery and in stroke patients.
- Its association with pneumonia in acute myocardial infarction (AMI) patients remains unstudied.
Purpose of the Study:
- To determine if inspiratory muscle strength predicts pneumonia in AMI patients.
- Evaluate the diagnostic accuracy of maximal inspiratory pressure (MIP) for pneumonia risk.
Main Methods:
- 265 AMI patients were enrolled and categorized into three groups based on MIP tertiles.
- Maximal inspiratory pressure (MIP) was measured within 24 hours post-revascularization.
- In-hospital pneumonia incidence was the primary outcome measure.
Main Results:
- Pneumonia occurred in 10% of patients, with rates decreasing significantly across MIP tertiles (17% to 2%).
- Reduced MIP was independently associated with a higher risk of pneumonia (OR 0.78).
- MIP demonstrated good predictive performance for pneumonia (AUC 0.72).
Conclusions:
- Inspiratory muscle weakness is a significant risk factor for pneumonia in AMI patients.
- MIP is a valuable predictor of pneumonia, independent of mortality and MACEs.
- Targeted inspiratory muscle training may benefit AMI patients at risk for pneumonia.
Related Concept Videos
01:29Pneumonia II: Pathophysiology
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: