The Effect of Lifestyle-based Active Pursed-lip Diaphragmatic Breathing Training on the Prognosis of Patients with Chronic Heart Failure

Abstract Respiratory training benefits chronic heart failure (CHF) patients but is underused due to multiple barriers. Lifestyle-based active pursed-lip diaphragmatic breathing (PLDB) offers a feasible, device-independent alternative. This study aimed to evaluate its impact on CHF patients’ exercise tolerance, cardiac function, quality of life, and clinical outcomes. A prospective cohort study enrolled 58 hospitalized CHF patients (NYHA II-IV, Jan 2023-Feb 2024). All received standard therapy and PLDB instruction. Post-discharge, patients who self-administered PLDB were monitored via WeChat and grouped by adherence: the PLDB group (≥30 breaths/day, ≥3 days/week, n=20) and the Control group (non-compliant, n=38). Outcomes included 6-minute walk test (6MWT), grip strength, serum N-terminal pro-brain natriuretic peptide, left ventricular ejection fraction (LVEF), and quality of life indicators (Minnesota Living with Heart Failure Questionnaire [MLHFQ], Self-rating Somatic Symptom Scale-China [SSS-CN], Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 [GAD-7], Pittsburgh Sleep Quality Index). Clinical endpoints were rehospitalization and major adverse cardiovascular events (MACE). Over 6 months, the PLDB group showed significant improvements in 6MWT (333.75 ± 148.57 m to 407.9±153.29m, p=0.012), LVEF (46.67±13.86% to 51.81±14.89%, p=0.002), and quality of life (MLHFQ: 42.25±16.00 to 18.75±13.47, p