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Beneficial impacts of physical activity on heart rate variability: A systematic review and meta-analysis
Ouahiba El-Malahi1, Darya Mohajeri1, Raluca Mincu1
1Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany.
Insights
Physical activity positively impacts heart rate variability (HRV), a key indicator of autonomic nervous system function. This benefit is particularly notable in patients with congestive heart failure (CHF), suggesting tailored exercise programs improve cardiovascular disease (CVD) prognosis.
Area of Science:
- Cardiology
- Exercise Physiology
- Autonomic Neuroscience
Background:
- Cardiovascular diseases (CVD) are primary causes of death globally.
- Heart rate variability (HRV) reflects autonomic nervous system modulation and impacts mortality.
- Physical activity's influence on HRV in various cardiac conditions warrants investigation.
Purpose of the Study:
- To meta-analyze the impact of physical activity interventions on HRV in adults with cardiovascular diseases.
- To assess HRV changes in patients with coronary artery disease, congestive heart failure, peripheral arterial disease, or post-acute coronary syndrome.
- To identify specific HRV parameters affected by physical activity.
Main Methods:
- Systematic search of randomized and non-randomized controlled trials.
- Inclusion of adult patients with specific cardiovascular conditions.
- Meta-analysis of time-domain and frequency-domain HRV parameters using a random effects model.
- Subgroup and sensitivity analyses based on intervention type, study design, and cardiac condition.
Main Results:
- Significant improvements in RR-Interval and standard deviation of Normal-to-Normal intervals (SDNN) for short-term HRV.
- Significant changes in the low-frequency to high-frequency power ratio (LF/HF) for 24-hour HRV.
- Significant positive effects on root-mean-square difference of successive normal R-R intervals (RMSSD), SDNN, and high-frequency power (HF) in congestive heart failure (CHF) patients.
Conclusions:
- Physical activity demonstrates a beneficial effect on HRV across various cardiovascular conditions.
- The positive impact of physical activity on HRV is particularly pronounced in patients with CHF.
- Individualized cardiac rehabilitation exercise programs are crucial for optimizing patient prognosis in CVD.
Background:
Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous nervous system and influences mortality. By surveying this meta-analysis, we investigated the impact of physical activity on HRV.
Methods:
Databases, online journal libraries and clinical trial registries were searched for publications of randomized controlled and non-randomized controlled trials concerning adults with coronary artery disease (CAD)/ischemic heart disease (IHD), congestive heart failure (CHF), peripheral arterial disease (PAD) or after acute coronary syndrome (ACS) joining an intervention group with physical activity or a control group with usual care or no intervention. Extracted time-domain and frequency-domain parameter of HRV were analyzed in a meta-analysis using a random effect model. Subgroup analyses concerning intervention type, study design and type of heart disease and sensitivity analysis were performed.
Results:
Significant results were obtained for RR-Interval (p = 0.05) and standard deviation of Normal-to-Normal intervals (SDNN) (p = 0.01) for short-term assessment and for the ratio of low-frequency power (LF) to high-frequency power (HF) (p = 0.05) for 24-hour assessment. Subgroup analyses also resulted significant: root-mean-square difference of successive normal R-R intervals (RMSSD) (p = 0.01), SDNN (p = 0.02) and HF (p < 0.01) concerning CHF.
Conclusion:
We were able to demonstrate the positive impact of physical activity on HRV, especially in patients with CHF. Cardiac rehabilitation exercise programs need to be individualized to identify the most beneficial method of training for improving the prognosis of patients with CVD.
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