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Functional outcome in chronic heart failure after exercise training: Possible predictive value of heart rate variability / Roberto Ricca-Mallada in Annals of physical and rehabilitation medicine, Vol. 60 n° 2 (April 2017)
[article] Functional outcome in chronic heart failure after exercise training: Possible predictive value of heart rate variability [texte imprimé] / Roberto Ricca-Mallada, Auteur ; Eduardo Roberto Migliaro, Auteur ; Gabriela Silvera, Auteur . - 2017 . - p. 87-94.
Langues : Anglais (eng) Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 60 n° 2 (April 2017) . - p. 87-94
Catégories : PATHOLOGIE
Cardiopathie
VARIABLE ÉPIDÉMIOLOGIQUE
Variable épidémiologiqueTags : Exercise Heart failure Heart rate variability Parasympathetic indexes Clinical value Résumé : Background: Controlled exercise training (ET) is a valuable therapeutic addition to pharmacological treatment in most patients with chronic heart failure (CHF), reducing long-term mortality, preventing cardiac remodelling and improving functional capacity. Despite the fact that the mechanism underlying its benefits might be multifactorial, a sustained improvement in autonomic balance is usually attributed as a major effect. Nevertheless, not all eligible subjects show the same response to ET, probably due to several differences in the subpopulations enrolled. We hypothesize that some heart rate variability (HRV) indexes could be valid tools to optimize the selection and follow-up of CHF patients receiving ET intervention.
Methods: Forty patients with CHF and left ventricular ejection fraction (LVEF)≤40% under complete evidence-based pharmacological treatment were included; 20 were assigned to a program of controlled ET on a 3-times/week basis during 24 weeks, training group (TG) and 20 received a standard follow-up program, control group (CG). In each patient, full clinical assessments, echocardiography, HRV analysis and 6-minute-walk test were performed at the beginning and the end of the study.
Results: After 24 weeks, patients in the TG showed a significant improvement in LVEF, 6-minute walk test, functional class of symptoms and HRV parasympathetic related indices (HF and rMSSD). Patients in the CG did not exhibit any improvement in the aforementioned indices and experienced more adverse events. Moreover, an initial value of HF<150 ms2/Hz or rMSSD<20ms predicted better outcomes of the ET program, including improvements in systolic function, the distance walked in 6minutes, and the functional class of symptoms, along with a reduction in clinical events.
Conclusions: 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.En ligne : http://www.em-consulte.com/produit/rehab Permalink : https://ifm3r.centredoc.fr/index.php?lvl=notice_display&id=14811 [article]Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome / Tiffany Astolfi in Annals of physical and rehabilitation medicine, Vol. 61 n° 2 (March 2018)
[article] Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome [texte imprimé] / Tiffany Astolfi, Auteur ; Fabio Borrani, Auteur ; Milos Savcic, Auteur . - 2018 . - p. 65-71.
Langues : Anglais (eng) Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 61 n° 2 (March 2018) . - p. 65-71
Catégories : PATHOLOGIE
Cardiopathie coronaire
SPÉCIALITÉ
Rééducation fonctionnelleTags : Autonomic nervous system Heart rate recovery Heart rate variability Cardiac rehabilitation Acute coronary syndrome Résumé : Background: An efficient cardiac rehabilitation programme (CRP) can improve the functional ability of patients after acute coronary syndrome (ACS).
Objective: To examine the effect of a CRP on parasympathetic reactivation and heart rate recovery (HRR) measured after a 6-min walk test (6MWT), and correlation with 6MWT distance and well-being after ACS.
Methods: Eleven normoweight patients after ACS (BMI<25kg/m2; 10 males; mean [SD] age 61 [9] years) underwent an 8-week CRP. Before (pre-) and at weeks 4 (W4) and 8 (W8) during the CRP, they performed a 6MWT on a treadmill, followed by 10-min of seated passive recovery, with HRR and HR variability (HRV) recordings. HRR was measured at 1, 3, 5 and 10min after the 6MWT (HRR1, HRR3, HRR5, HRR10), then modelized by a mono-exponential function. Time-domain (square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals [RMSSD]) and frequency-domain (with high- and low-frequency band powers) were used to analyse HRV. Participants completed a mental and physical well-being questionnaire at pre- and W8. Exhaustion after tests was assessed by the Borg scale. Pearson correlation was used to assess correlations.
Results: HRR3, HRR5 and HRR10 increased by 37%, 36% and 28%, respectively, between pre- and W8 (P <0.05), and were positively correlated with change in 6MWT distance (r =0.58, 0.66 and 0.76; P <0.05). Percentage change in HRR3 was positively correlated with change in well-being (r =0.70; P =0.01). Parasympathic reactivation (RMSSD) was improved only during the first 30sec of recovery (P =0.04).
Conclusion: Among patients undergoing a CRP after ACS, increased HRR after a 6MWT, especially at 3min, was positively correlated with 6MWT distance and improved well-being. HRR raw data seem more sensitive than post-exercise HRV analysis for monitoring functional and autonomic improvement after ACS.En ligne : http://www.em-consulte.com/produit/rehab Permalink : https://ifm3r.centredoc.fr/index.php?lvl=notice_display&id=15736 [article]