Heart Rate Variability Biofeedback and Mental Stress Myocardial Flow Reserve: A Randomized Clinical Trial

Area of Science:

• Cardiology
• Autonomic Nervous System Research
• Psychophysiology

Background:

• Heart rate variability biofeedback (HRVB) is a self-regulation technique targeting autonomic nervous system activity.
• Investigating HRVB's impact on cardiovascular responses to psychological stress is crucial for patients with coronary artery disease (CAD).

Purpose of the Study:

• To examine the effects of HRVB on myocardial blood flow (MBF) changes during mental stress in individuals with CAD.

Main Methods:

• A pilot randomized clinical trial involving 21 participants with CAD.
• Intervention group received 6 weeks of HRVB training; control group received usual care.
• Myocardial blood flow (MBF) and mental stress myocardial flow reserve (MFR) were measured using rubidium-82 positron emission tomography at baseline and after 8 weeks.

Main Results:

• The HRVB group showed a significant increase in MFR with mental stress compared to the usual care group (0.10 units greater, P=.03).
• While within-group changes were not statistically significant, the between-group difference in MFR change was significant.
• Mean MFR in the HRVB group increased from 1.07 to 1.16; in the usual care group, it changed from 1.20 to 1.15.

Conclusions:

• HRVB intervention led to increased MFR with mental stress in CAD patients compared to usual care.
• These findings suggest potential benefits of HRVB for cardiovascular health during mental stress.
• Larger trials are warranted to confirm HRVB efficacy in cardiovascular disease prevention.