Effects of exercise rehabilitation program on heart rate recovery in patients with chronic heart failure

Dimopoulos, Stavros; Anastasiou-Nana, Maria; Sakellariou, Dimitrios; Drakos, Stavros G.; Kapsimalakou, Smaragda; Maroulidis, George; Roditis, Petros; Papazachou, Ourania; Vogiatzis, Ioannis; Roussos, Charis; Nanas, Serafim

doi:10.1097/01.hjr.0000198449.20775.7c

Cited by 69 publications

(42 citation statements)

References 43 publications

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“…The ANS regulation of the heart is impaired in CHF. In our study, the values of HRV, HRR, and HRT were abnormal before the beginning of rehabilitation training, an observation concordant with prior studies 2–6 . In this study, the magnitude of changes in the indices of ANS function after PT was variable (Table I).…”

Section: Discussionsupporting

confidence: 92%

“…Few studies of patients suffering from CHF have reported improvements in HRR after PT. Streuber et al 7 observed improvements limited to patients with an HRR response <12 bpm, and Dimopoulos et al 6 found improvements in HRR by continuous, but not by intermittent, exercise training, suggesting that, despite effective training of patients presenting with CHF, HRR may not improve. Our study is the first to examine the effect of PT on HRT, and first to analyze simultaneously the effects of exercise training on HRV, HRT, and HRR.…”

Section: Discussionmentioning

confidence: 99%

“…Since physical training (PT) improves the prognosis of patients presenting with CHF, we hypothesized that it also improves the indices that reflect ANS activity 1,2 . Heart rate variability (HRV), heart rate turbulence (HRT), and heart rate recovery (HRR) have a significant prognostic value in CHF 2–8 . However, it is unclear whether they reflect the same components of ANS activity, or whether they respond differently to PT.…”

Section: Introductionmentioning

confidence: 99%

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Variable Effects of Physical Training of Heart Rate Variability, Heart Rate Recovery, and Heart Rate Turbulence in Chronic Heart Failure

Piotrowicz

Baranowski

Piotrowska

et al. 2009

Pacing Clinical Electrophis

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Background: Heart rate variability (HRV), heart rate turbulence (HRT), and heart rate recovery (HRR), indices that reflect autonomic nervous system (ANS) activity, are outcome predictors in patients with chronic heart failure (CHF). It is not clear, however, whether they reflect the same components of ANS activity. No study has examined the effects of physical training (PT) training on HRV, HRT, and HRR in CHF. Study Objective: To examine the responses of HRV, HRT, and HRR to a PT program in patients presenting with CHF. Methods: In 41 patients (mean age = 58.7 ± 10.2 years) in New York Heart Association CHF functional classes II or III, and with a left ventricular ejection fraction <40%, HRV, HRT, and HRR were measured before and after 8 weeks of PT. Results: The training was clinically effective in all patients. Before versus after PT, standard deviation of all normal RR intervals increased from 107 ± 30 to 114 ± 32 ms (P = 0.047), high frequency increased from 210 ± 227 to 414 ± 586 ms 2 /Hz (P = 0.02), and the low/high frequency ratio decreased from 1.8 ± 1.55 to 1.1 ± 1.2 (P = 0.002). HRT and HRR did not change significantly after PT.Conclusions: In patients with CHF, the positive effects of PT were limited to HRV indices, which reflect parasympathetic activity, without significantly changing HRR and HRT. These observations indicate that different mechanisms modulate HRV, HRR, and HRT, which provide complementary information regarding ANS activity. The 8-week PT program failed to completely normalize ANS function. (PACE 2009; 32:S113-S115) heart rate variability, heart rate turbulence, heart rate recovery, autonomic nervous system, heart failure, physical training

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Variable Effects of Physical Training of Heart Rate Variability, Heart Rate Recovery, and Heart Rate Turbulence in Chronic Heart Failure

Piotrowicz

Baranowski

Piotrowska

et al. 2009

Pacing Clinical Electrophis

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“…The HRR immediately after exercise is reflective of aerobic capacity, and a delayed HRR, defined as a reduction of the heart rate by <12 beats within the 1 st minute after peak exercise, is an independent predictor of mortality, especially in the older population [29–31]. The effect of cardiac rehabilitation on HRR has been demonstrated in both CAD and chronic heart failure populations [32,33]. In our study, the HRR improved from 13.9 ± 3.45 bpm to 16.62 ± 4.28 bpm after 12 weeks of exercise training, an improvement that was less than that reported in the abovementioned studies.…”

Section: Discussioncontrasting

confidence: 45%

Benefits of exercise training and the correlation between aerobic capacity and functional outcomes and quality of life in elderly patients with coronary artery disease

Chen

et al. 2014

The Kaohsiung J of Med Scie

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Cardiopulmonary exercise training is beneficial to people with coronary artery disease (CAD). Nevertheless, the correlation between aerobic capacity, and functional mobility and quality of life in elderly CAD patients is less addressed. The purpose of the current study is to investigate the beneficial effects of exercise training in elderly people with CAD, integrating exercise stress testing, functional mobility, handgrip strength, and health-related quality of life. Elderly people with CAD were enrolled from the outpatient clinic of a cardiac rehabilitation unit in a medical center. Participants were assigned to the exercise training group (N = 21) or the usual care group (N = 15). A total of 36 sessions of exercise training, completed in 12 weeks, was prescribed. Echocardiography, exercise stress testing, the 6-minute walking test, Timed Up and Go test, and handgrip strength testing were performed, and the Short-Form 36 questionnaire (SF-36) was administered at baseline and at 12-week follow-up. Peak oxygen consumption improved significantly after training. The heart rate recovery improved from 13.90/minute to 16.62/minute after exercise training. Functional mobility and handgrip strength also improved after training. Significant improvements were found in SF-36 physical function, social function, role limitation due to emotional problems, and mental health domains. A significant correlation between dynamic cardiopulmonary exercise testing parameters, the 6-minute walking test, Timed Up and Go test, handgrip strength, and SF-36 physical function and general health domains was also detected. Twelve-week, 36-session exercise training, including moderate-intensity cardiopulmonary exercise training, strengthening exercise, and balance training, is beneficial to elderly patients with CAD, and cardiopulmonary exercise testing parameters correlate well with balance and quality of life.

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“…It is well known that exercise training, particularly endurance training, may attenuate dysautonomia in patients with CVD (9). Dimoupoulos et al (24) and Keteyian et al (25) demonstrated that a 3‐ and 6‐month endurance exercise training program, respectively, improved the CR and the ΔHRR in patients with chronic heart failure. Moreover, Adams et al (26) showed that 12‐week exercise training led to improvements in the CR and ΔHRR, which were associated with a 33% decrease in the Duke prognostic 5‐year predicted cardiovascular mortality rate in cardiovascular patients.…”

Section: Discussionmentioning

confidence: 99%

Using exercise training to counterbalance chronotropic incompetence and delayed heart rate recovery in systemic lupus erythematosus: A randomized trial

Miossi¹,

Benatti²,

Pinto³

et al. 2012

Arthritis Care & Research

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Objective. To evaluate the efficacy of a 3-month exercise training program in counteracting the chronotropic incompetence and delayed heart rate recovery in patients with systemic lupus erythematosus (SLE). Methods. A 12-week randomized trial was conducted. Twenty-four inactive SLE patients were randomly assigned into 2 groups: trained (T; n ‫؍‬ 15, 3-month exercise program) and nontrained (NT; n ‫؍‬ 13). A sex-, body mass index-, and age-matched healthy control (C) group (n ‫؍‬ 8) also underwent the exercise program. Subjects were assessed at baseline and at 12 weeks after training. Main measurements included the chronotropic reserve (CR) and the heart rate (HR) recovery (⌬HRR) as defined by the difference between HR at peak exercise and at both the first (⌬HRR1) and second (⌬HRR2) minutes after the exercise test. Results. Neither the NT SLE patients nor the C group presented any change in the CR or in ⌬HRR1 and ⌬HRR2 (P > 0.05). The exercise training program was effective in promoting significant increases in CR (P ‫؍‬ 0.007, effect size [ES] 1.15) and in ⌬HRR1 and ⌬HRR2 (P ‫؍‬ 0.009, ES 1.12 and P ‫؍‬ 0.002, ES 1.11, respectively) in the SLE T group when compared with the NT group. Moreover, the HR response in SLE patients after training achieved parameters comparable to the C group, as evidenced by the analysis of variance and by the Z score analysis (P > 0.05, T versus C). Systemic Lupus Erythematosus Disease Activity Index scores remained stable throughout the study. Conclusion. A 3-month exercise training program was safe and capable of reducing the chronotropic incompetence and the delayed ⌬HRR observed in physically inactive SLE patients.

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Effects of exercise rehabilitation program on heart rate recovery in patients with chronic heart failure

Abstract: Both continuous and interval exercise training program improves exercise capacity in CHF patients. However, continuous rather than interval exercise training improves early HRR1, a marker of parasympathetic activity, suggesting a greater contribution to the autonomic nervous system.

Cited by 69 publications

References 43 publications

Variable Effects of Physical Training of Heart Rate Variability, Heart Rate Recovery, and Heart Rate Turbulence in Chronic Heart Failure

Variable Effects of Physical Training of Heart Rate Variability, Heart Rate Recovery, and Heart Rate Turbulence in Chronic Heart Failure

Benefits of exercise training and the correlation between aerobic capacity and functional outcomes and quality of life in elderly patients with coronary artery disease

Using exercise training to counterbalance chronotropic incompetence and delayed heart rate recovery in systemic lupus erythematosus: A randomized trial

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