Blood Flow Reserve: Effects After Training With Heavy Inspiratory Exercises

The goal of this single-site, parallel-group, double-blind, sham-controlled randomized control trial is to examine the effect of high-intensity inspiratory muscle strength training (IMST) on coronary blood flow assessed using positron emission tomography coronary perfusion imaging in patients with coronary artery disease (CAD).The main question it aims to answer are:• if high-intensity IMST will improve coronary blood flow in patients with CAD, which could be assessed using positron emission tomography coronary perfusion imaging.Participants will be asked to complete the 8-week high-intensity or low-intensity IMST. Researchers will compare high and low-intensity IMST groups to see if coronary blood flow increases after IMST.

Inclusion criteria:≥18 years of age;Patients referred to PET at the University of Ottawa Heart Institute;able to perform a respiratory exercise testing; and,Patients with clinical stability, including no change in medications for the past one month.Exclusion criteria:unstable angina or established diagnosis of severe valvular heart disease, hypertrophic obstructive cardiomyopathy, chronic obstructive pulmonary disease;unable to follow training/breathing instructions;unable to return for follow-up visit;presence of any major non-cardiac problem that would adversely affect survival during the study in the opinion of the investigator; or,unable to provide informed consent.