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Effect of exercise training on autonomic derangement and neurohumoral activation in chronic heart failure

Maaike G J Gademan1, Cees A Swenne, Harriette F Verwey

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Journal of Cardiac Failure
|May 23, 2007
PubMed

Insights

Exercise training improves autonomic function in chronic heart failure (CHF) by enhancing baroreflex sensitivity and reducing sympathetic nervous system activity. This approach offers a promising strategy for managing CHF patients.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Autonomic Neuroscience

Background:

  • Chronic heart failure (CHF) is characterized by autonomic dysfunction and neurohumoral imbalance, leading to organ damage and reduced quality of life.
  • Pharmacotherapy offers benefits but cannot fully normalize autonomic derangement in CHF.
  • Exercise training is increasingly recognized for its potential to mitigate these detrimental effects.

Purpose of the Study:

  • To evaluate the impact of exercise training on autonomic derangement and neurohumoral activation in patients with chronic heart failure.
  • To synthesize existing evidence on the mechanisms through which exercise training influences the autonomic nervous system in CHF.

Main Methods:

  • Systematic review and analysis of available evidence on exercise training in CHF.
  • Assessment of changes in baroreflex sensitivity, heart rate variability, and sympathetic outflow.
  • Evaluation of alterations in plasma levels of key neurohormones.

Main Results:

  • Exercise training was found to increase baroreflex sensitivity and heart rate variability.
  • Significant reductions were observed in sympathetic outflow and plasma levels of catecholamines, angiotensin II, vasopressin, and brain natriuretic peptides at rest.
  • These findings indicate a sympathoinhibitory effect of exercise training in CHF.

Conclusions:

  • Exercise training exerts direct and reflex sympathoinhibitory effects, offering significant benefits in CHF management.
  • Further research is needed to fully elucidate the mechanisms underlying exercise-induced autonomic normalization.
  • Optimizing CHF-related training programs requires a deeper understanding of these mechanisms to maximize efficacy and minimize patient workload.
Abstract

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