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Effect of Exercise Training on Heart Rate Variability in Patients with Heart Failure After Percutaneous Coronary
S Abolahrari-Shirazi1, J Kojuri2, Z Bagheri3
1PhD Candidate, Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Exercise training improved heart rate variability (HRV) in heart failure patients post-percutaneous coronary intervention. This intervention is safe and feasible, even for those with reduced ejection fraction.
Area of Science:
- Cardiology
- Exercise Physiology
- Rehabilitation Medicine
Background:
- Heart failure (HF) patients post-percutaneous coronary intervention (PCI) often have reduced ejection fraction (EF).
- Heart rate variability (HRV) is a key indicator of autonomic nervous system function and cardiovascular health.
- The impact of exercise training on HRV in this specific patient population requires further investigation.
Purpose of the Study:
- To evaluate the effect of a structured exercise training (ET) program on HRV parameters in patients with HF after PCI.
- To determine the correlation between HRV parameters and left ventricular ejection fraction (LVEF) in these patients.
Main Methods:
- Fifty patients with LVEF ≤ 40% post-PCI were randomized into an ET group or a control group.
- The ET group underwent 7 weeks of supervised exercise training (45 minutes, 3 times/week).
- 24-hour Holter monitoring assessed HRV parameters: standard deviation of normal R-R intervals (SDNN), RMSSD, and PNN50.
Main Results:
- The ET group showed a significant improvement in SDNN (P=0.002) compared to the control group (P=0.003).
- No significant changes were observed in RMSSD or PNN50 in either group.
- A weak, significant correlation was found between baseline EF and SDNN (r=0.279, P=0.047), but not with other HRV parameters.
Conclusions:
- Exercise training is safe and feasible for HF patients with reduced EF following PCI.
- A 7-week exercise program effectively improved HRV, specifically SDNN, in this patient cohort.
- Exercise training may be a valuable component of cardiac rehabilitation for post-PCI patients.
Background:
This study aims to evaluate the effect of exercise training on heart rate variability (HRV) and to determine the correlation between parameters of HRV and the ejection fraction in patients with heart failure after percutaneous coronary intervention.
Material And Methods:
Fifty patients with left ventricular ejection fraction ≤ 40% undergone percutaneous coronary intervention were randomly allocated in either an exercise training (ET) group or a control group. The ET group performed exercise training for 45 minutes, three times a week for seven weeks. Patients in both groups received a leaflet for daily exercising at home. HRV parameters comprising, the standard deviation of normal R-R intervals (SDNN), the square root of the mean of the squares of successive R-R intervals differences (RMSSD) ,the percentage of successive R-R intervals differing from more than 50 ms (PNN50), using 24-hour Holter electrocardiographic monitoring was measured.
Results:
After the intervention, the SDNN improved in the ET group (P=0.002), while changes in all remaining HRV indices were insignificant (P≥0.05). The control group showed no significant changes in any HRV parameters (P≥0.05). Changes in SDNN in the ET group were significantly different from the control group (P=0.003). At baseline, our results revealed a significant weak correlation between ejection fraction and SDNN (r =0.279, P=0.047). However, ejection fraction did not correlate significantly with RMSSD and PNN50.
Conclusion:
Exercise training is safe and feasible in post percutaneous coronary intervention patients, even in those with reduced ejection fraction. In a seven-week period, exercise training was effective in improving HRV in heart failure patients after percutaneous coronary intervention.
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