{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:27:06Z","timestamp":1790018826663,"version":"4.0.1"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Patients with a Fontan circulation have reduced exercise capacity and respiratory muscle strength. Inspiratory muscle training (\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      ) improves exercise capacity and quality of life in adults with heart failure. We assessed whether 6\u00a0weeks of a home\u2010based program of\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      improves inspiratory muscle strength and the ventilatory efficiency of exercise in adolescent patients with a Fontan circulation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Twenty\u2010three adolescent participants (aged 16\u00b12\u00a0years) with a Fontan circulation underwent 6\u00a0weeks of\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      for 30\u00a0minutes daily. Respiratory muscle strength (maximal inspiratory pressure and expiratory pressure), lung function, and exercise capacity (cardiopulmonary exercise testing) were assessed. Fourteen of 23 participants also underwent exercise cardiac magnetic resonance imaging to examine the effects of\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      on cardiac output and systemic and pulmonary blood flow. Six weeks of\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      improved maximal inspiratory pressure by 36\u00b124\u00a0cm H\n                      <jats:sub>2<\/jats:sub>\n                      O (61\u00b146%) with no change in maximal expiratory pressure. Ventilatory efficiency of exercise improved after 6\u00a0weeks of\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      (from 34.2\u00b17.8 to 32.2\u00b15.6,\n                      <jats:italic>P<\/jats:italic>\n                      =0.04). In those who underwent exercise cardiac magnetic resonance imaging,\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      increased resting cardiac output (from 4.2\u00b11.2 to 4.5\u00b11.0\u00a0L\/min,\n                      <jats:italic>P<\/jats:italic>\n                      =0.03) and ejection fraction (from 50.1\u00b14.3 to 52.8\u00b16.1%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Six weeks of\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      is associated with improved inspiratory muscle strength, ventilatory efficiency of exercise, and resting cardiac output in young Fontan patients.\n                      <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>\n                      may be a simple beneficial addition to the current management of Fontan patients, potentially reducing exercise intolerance and long\u2010term morbidity and mortality.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.117.005750","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T14:25:38Z","timestamp":1504275938000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":86,"title":["Inspiratory Muscle Training Is Associated With Improved Inspiratory Muscle Strength, Resting Cardiac Output, and the Ventilatory Efficiency of Exercise in Patients With a Fontan Circulation"],"prefix":"10.1161","volume":"6","author":[{"given":"Karina","family":"Laohachai","sequence":"first","affiliation":[{"name":"The Children's Hospital at Westmead, Sydney, NSW, 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