Functional outcome in chronic heart failure after exercise training: Possible predictive value of heart rate variability

Ricca-Mallada, Roberto; Migliaro, Edurado R.; Silvera, Gabriela; Chiappella, Lilián; Frattini, Rossana; Ferrando-Castagnetto, Federico

doi:10.1016/j.rehab.2016.12.003

Cited by 19 publications

(25 citation statements)

References 30 publications

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“…An increase in heart rate variability has been seen with pharmaceutical treatments that lower mean heart rate (e.g., ␤-blockers and ivabradine), but it has not been possible to distinguish if the improved heart rate variability has any additional benefit over the reduction in its mean rate (64). Physical conditioning, aerobic training, and strength and inspiratory muscle training have positive therapeutic benefits in patients with heart failure increase heart rate variability, including the high-frequency (RSA) oscillations (73,75,89). While increased respiratoryassociated heart rate variability is a beneficial outcome of physical conditioning in heart failure, these studies cannot inform whether RSA itself is of further benefit in cardiac health.…”

Section: Clinical Impact Of Cardiorespiratory Interactionsmentioning

confidence: 99%

Cardiorespiratory interactions in humans and animals: rhythms for life

Elstad

O’Callaghan

Smith

et al. 2018

American Journal of Physiology-Heart and Circulatory Physiology

117

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The cardiorespiratory system exhibits oscillations from a range of sources. One of the most studied oscillations is heart rate variability, which is thought to be beneficial and can serve as an index of a healthy cardiovascular system. Heart rate variability is dampened in many diseases including depression, autoimmune diseases, hypertension, and heart failure. Thus, understanding the interactions that lead to heart rate variability, and its physiological role, could help with prevention, diagnosis, and treatment of cardiovascular diseases. In this review, we consider three types of cardiorespiratory interactions: respiratory sinus arrhythmia (variability in heart rate at the frequency of breathing), cardioventilatory coupling (synchronization between the heart beat and the onset of inspiration), and respiratory stroke volume synchronization (the constant phase difference between the right and the left stroke volumes over one respiratory cycle). While the exact physiological role of these oscillations continues to be debated, the redundancies in the mechanisms responsible for its generation and its strong evolutionary conservation point to the importance of cardiorespiratory interactions. The putative mechanisms driving cardiorespiratory oscillations as well as the physiological significance of these oscillations will be reviewed. We suggest that cardiorespiratory interactions have the capacity to both dampen the variability in systemic blood flow as well as improve the efficiency of work done by the heart while maintaining physiological levels of arterial CO. Given that reduction in variability is a prognostic indicator of disease, we argue that restoration of this variability via pharmaceutical or device-based approaches may be beneficial in prolonging life.

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Section: Clinical Impact Of Cardiorespiratory Interactionsmentioning

confidence: 99%

Cardiorespiratory interactions in humans and animals: rhythms for life

Elstad

O’Callaghan

Smith

et al. 2018

American Journal of Physiology-Heart and Circulatory Physiology

117

View full text Add to dashboard Cite

show abstract

“…This can be prevented by exercise training in survivors, as suggested in chronic heart failure patients. 31,32 These findings constitute a hope for female survivors to regain good cardiorespiratory fitness. However, it is the responsibility of health care professionals and parents to consider the importance of physical activity in the care of children with cancer.…”

Section: Physical Activity In Oncology Needs To Be Strengthened In Fementioning

confidence: 89%

Sex and Gender Considerations After Surviving Acute Lymphoblastic Leukemia: An Exercise Oncology Context

Caru

Curnier

2020

Journal of Adolescent and Young Adult Oncology

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Childhood acute lymphoblastic leukemia (ALL) is the most common pediatric cancer in children worldwide. The distinction between sex (i.e., biological parameters) and gender (i.e., sociocultural and behavior) is not always taken into consideration in an exercise oncology context, despite its importance for the patient's care. A recent study showed that female survivors were more affected than males by low cardiorespiratory fitness several years after the end of their cancer treatments. This is all the more worrying considering that for a clinically equivalent level of moderate to vigorous physical activities, cardiorespiratory fitness is significantly lower in female survivors, compared with healthy females. Thus, the need for studies that help to better understand the physical deconditioning of female survivors after ALL is an essential aspect of exercise and oncology research. Because female survivors' cardiorespiratory fitness is directly impacted for many years, this article aims at discussing these aspects in an exercise and oncology context with sex and gender consideration.

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“…Exercise can improve the ANS balance. In patients with chronic heart failure, exercise training significantly elevated HRV parasympathetic indices (HF and RMSSD) compared with nonexercise training (87). ANS dysfunction in parallel with cognitive impairment is common in patients post stroke.…”

Section: Exercisementioning

confidence: 92%

The Association of Autonomic Nervous System Function With Ischemic Stroke, and Treatment Strategies

2020

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Acute ischemic stroke, especially minor stroke, and transient ischemic attack have high risks of recurrence and exacerbation into severe ischemic strokes. It remains challenging to perform risk stratification and screen high-risk groups for initiation of early treatment in these patients. Moreover, with the growing population of patients with chronic small vessel disease, the mechanisms and clinical implications require further investigation. Traditional tools such as the ABCD2 score (age, blood pressure, clinical features, duration of symptoms, diabetes) have only moderate predictive value in patients with transient ischemic attack or minor stroke. By contrast, measurement of changes in heart rate variability (HRV) is an important and novel tool for risk stratification and outcome prediction in patients with cardiovascular diseases, as it reflects the overall level of autonomic nervous system dysfunction. Thus, abnormal HRV may be useful for prognosis and improve stratification of stroke patients with diverse risks. HRV may also partially explain autonomic nervous dysfunction and other manifestations during the process of chronic cerebral small vessel disease. In summary, measurement of HRV may contribute to early initiation of interventions in acute or chronic stroke patients using novel treatments involving rebalancing of autonomic nervous system function.

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Functional outcome in chronic heart failure after exercise training: Possible predictive value of heart rate variability

Abstract: In CHF patients, HRV indexes related to parasympathetic function are valid and clinically useful tools to select and follow-up those candidates that could experience superior functional improvement after ET.

Cited by 19 publications

References 30 publications

Cardiorespiratory interactions in humans and animals: rhythms for life

Cardiorespiratory interactions in humans and animals: rhythms for life

Sex and Gender Considerations After Surviving Acute Lymphoblastic Leukemia: An Exercise Oncology Context

The Association of Autonomic Nervous System Function With Ischemic Stroke, and Treatment Strategies

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