International Journal of Therapies and Rehabilitation Research 2017; 6 (2): 195-200 Original Research Article doi: 10.5455/ijtrr.000000263 International Journal of Therapies & Rehabilitation Research http://www.scopemed.org/?jid=12 E-ISSN 2278-0343 EFFICACY OF INSPIRATORY TRAINING ON BLOOD GASES AND BRAIN NATRUIRETIC PEPTIDE AMONG PATIENTS WITH HEART FAILURE Dina Reda 1 , Farag A. Aly 2 , Heba A Abdeen 3 , Bassem S Ibrahim 4 1 Stuff physical therapist at National Heart Institute 2 Prof. of physical therapy for Cardiovascular/Respiratory disorder and Geriatrics Faculty of Physical Therapy Cairo University, 3 Lecturer of Physical Therapy for Cardiovascular/ Respiratory Disorder and Geriatrics faculty of Physical Therapy Cairo University 4 Consultant cardiologist & physician At National Heart Institute FRCP (EDIN.) American college of cardiology ,Member oh HFA of ESC, ABSTRACT Purpose: To determine the efficacy of Inspiratory muscle trainer on arterial blood gases and the Brain Natriuretic Peptide in patients with decompensated heart failure. Methods: forty men presented with decompensated heart failure were selected from the heart failure intensive care unit at National Heart Institute with age ranged from 45-55years old. Patients were selected into two groups Study Group who received the inspiratory muscle trainer, traditional physical therapy program, in addition to medical treatment twice daily for 10 days only. Control Group received a traditional physical therapy program only, in addition to medical treatment twice daily for 10 days . Results: there was a significant statistical improvement in post treatment values of BNP with 29.84% , PaO2 with 53% and a non-significant statistical improvement in post treatment PaCO2 with 7.22% in the study group who uses IMT with their optimum medical treatment and traditional physical therapy sessions for a 10 days twice daily. Conclusion: inspiratory muscle training is effective in improving the brain natruiretic peptide and the arterial blood gases profile. Key words: inspiratory muscle trainer (IMT) / heart failure HF/ brain natruiretic peptide BNP/ dyspnea INTRODUCTION Heart failure (HF) means that the heart failed to meet the body's metabolic demands which results in dyspnea, fatigue and cough. These symptoms may be due to systolic dysfunction originating from the right or left side of the heart, or may occur with preserved systolic function with abnormal diastolic function symptoms. 1 Recently, heart failure has gradually become one of the most prevalent cardiovascular disorders, especially in the elderly. Heart failure is the main cause of hospitalization in our cardiac departments and is the main cause of hospital admission in elderly patients. It is expected that the prevalence of heart failure will almost be duplicated over the next 40 years 2 . Criteria for the Diagnosis of Chronic Heart Failure *Diagnosis of chronic heart failure (CHF) requires two of the major criteria or one of the major plus two of the minor criteria. Major Criteria: Neck-vein distention, Orthopnea or paroxysmal nocturnal dyspnea ,Crackles ( 10 cm above base of lung) ,Cardiomegaly on chest radiograph S3 gallop ,Central venous pressure 12 mm Hg ,Left ventricular dysfunction on echocardiogram, Weight loss 4.5 kg in response to CHF treatment ,Acute pulmonary edema .Minor Criteria: Bilateral ankle edema ,Night cough ,Dyspnea on exertion, Hepatomegaly ,Pleural effusion ,Tachycardia (120 beats/min) . 3 Arterial blood gases (ABG) are measured to determine the amount of oxygen dissolved in the blood (PaO2) the percentage of hemoglobin saturated with oxygen (S4O2). The amount of carbon dioxide dissolved in the blood (PaCO2). And the amount of acid in the blood PH . The oxygen measure may be used to determine if a patient needs oxygen therapy. The carbon dioxide measure gives some idea of lung function and is especially important to know when to start oxygen therapy. 4 Brain natriuretic peptide (BNP) level increases markedly in left ventricular dysfunction and the level in