Abstract
Objectives. Cardiac autonomic imbalance accompanies the progression of chronic heart failure (CHF). It is unclear whether exercise training could modulate autonomic control in CHF. This study aimed to review systematically the effects of exercise training on heart rate recovery (HRR) and heart rate variability (HRV) in patients with CHF. Methods. Literatures were systematically searched in electronic databases and relevant references. Only published randomized controlled trials (RCTs) focusing on exercise training for CHF were eligible for inclusion. Outcome measurements included HRR and HRV parameters. Results. Eight RCTs were eligible for inclusion and provided data on 280 participants (186 men). The participants were 52–70 years of age with New York Heart Association functional class II-III of CHF. Each study examined either aerobic or resistance exercise. Two trials addressed outcome of HRR and six HRV among these studies. Two RCTs showed that moderate aerobic exercise could improve HRR at 2 minutes after exercise training in CHF. Five of six RCTs demonstrated positive effects of exercise training on HRV which revealed the increments in high frequency (HF) and decrements in LF (low frequency)/HF ratio after training. Conclusion. Participation in an exercise training program has positive effects on cardiac autonomic balance in patients with CHF.
Highlights
Chronic heart failure (CHF), the common final stage of all heart diseases with negative impact on prognosis, is increasingly prevalent worldwide and is associated with significant morbidity and mortality [1, 2]
The heterogeneity of heart rate variability (HRV) parameters restricted the direct pooled analysis, the results derived from fair to good quality evidence indicated that participation in exercise training programs which consisted of moderate intensity aerobic exercise had beneficial effects on autonomic function, as indicated by increases in Heart rate recovery (HRR) as well as HRV parameters
The results of this review revealed that exercise training has considerable effects on HRV in patients with CHF, including increase in vagal tone and modulation of sympathovagal balance activity
Summary
Chronic heart failure (CHF), the common final stage of all heart diseases with negative impact on prognosis, is increasingly prevalent worldwide and is associated with significant morbidity and mortality [1, 2]. Autonomic imbalance includes increase in sympathetic tone, decrease in parasympathetic activity, and depressed heart rate variability (HRV) [5], which is a common clinical predictor of poor survival in CHF [6, 7]. Heart rate recovery (HRR) after exercise termination is mediated by a combination of sympathetic withdrawal and parasympathetic reactivation, primarily by vagal reactivation [9]. HRR at 1 minute after exercise termination (HRR1) was used as a simple measure indicative of decreased autonomic nervous system activity [12]. HRV and HRR do not directly measure autonomic nervous activity, both are considered significant prognostic indicators of mortality in CHF by evidence [14,15,16]. A variety of drugs as well as numerous invasive procedures have been
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