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Published on: June 5, 2019
Bio-behavioral Interventions for Cardiovascular Diseases Rehabilitation: A Systematic Review on Heart Rate
Valeria Carola1, Valeria Gigli2, Filippo Cellucci3
1Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli, 1, 00185, Rome, Italy. valeria.carola@uniroma1.it.
Insights
Heart rate variability biofeedback (HRVBF) and cardioprotective diets show promise for cardiovascular disease (CVD) rehabilitation. However, more research is needed to establish their effectiveness in clinical settings for secondary prevention.
Area of Science:
- Cardiology
- Preventive Medicine
- Rehabilitation
Background:
- Cardiovascular diseases (CVD) are a major global health burden, necessitating effective secondary prevention and rehabilitation strategies.
- Noninvasive interventions like heart rate variability biofeedback (HRVBF) and cardioprotective diets are explored for their potential benefits.
- The established efficacy of these interventions within cardiac rehabilitation and secondary prevention contexts requires further systematic evaluation.
Purpose of the Study:
- To systematically review the evidence for HRVBF and heart-healthy dietary patterns in CVD relapse prevention and rehabilitation.
- To assess the potential role of these noninvasive strategies, particularly within hospital-based and postoperative settings.
- To identify gaps in current research and guide future clinical protocol development.
Main Methods:
- Systematic literature search conducted in Scopus and PubMed, adhering to PRISMA guidelines.
- Focus on studies evaluating heart rate variability biofeedback (HRVBF) and cardioprotective dietary patterns (e.g., Mediterranean, omega-3 fatty acids).
- Inclusion criteria prioritized evidence relevant to patients with established CVD or undergoing cardiac rehabilitation.
Main Results:
- Heart rate variability biofeedback (HRVBF) shows potential to improve autonomic regulation, reduce psychological distress, and decrease hospital stays.
- Dietary interventions, especially Mediterranean-style diets and omega-3 fatty acids, may reduce inflammation and modulate cardiovascular risk markers.
- Limited evidence currently supports the widespread integration of HRVBF and specific dietary patterns into established CVD rehabilitation protocols.
Conclusions:
- HRVBF and cardioprotective diets offer promising avenues for noninvasive cardiovascular rehabilitation and secondary prevention.
- Further research with structured protocols is essential to confirm their efficacy, particularly in immediate postoperative phases or post-acute cardiac events.
- Standardization of study designs is crucial for enhancing the generalizability of findings in clinical settings.
Abstract:
Cardiovascular diseases (CVD) are leading causes of premature mortality, disability, and reduced quality of life worldwide. While extensive literature has addressed cardiovascular risk and treatment, the role of noninvasive interventions in rehabilitation and secondary prevention remains less well defined. Among these, heart rate variability biofeedback (HRVBF) and cardioprotective dietary approaches have shown preventive benefits, yet their effectiveness in patients with established CVD or those undergoing cardiac rehabilitation is not fully established. This review systematically evaluates the evidence for HRVBF and heart-healthy dietary patterns in relapse prevention and rehabilitation, with particular attention to hospital-based contexts. Following PRISMA guidelines, systematic searches were conducted in Scopus and PubMed. Results suggest that HRVBF may enhance autonomic regulation, alleviate psychological distress, and shorten hospital stays. Dietary interventions, particularly those emphasizing omega-3 polyunsaturated fatty acids and Mediterranean-style patterns, demonstrate potential to reduce inflammation and modulate cardiovascular risk markers. Nevertheless, evidence supporting their integration into postoperative rehabilitation or treatment of established CVD remains limited. Heterogeneity in study designs and lack of standardization further constrain generalizability. Overall, the findings underscore the promise of early, noninvasive, and integrative rehabilitation strategies, highlighting the need for structured protocols in clinical settings, particularly during the immediate postoperative phase or after acute cardiac events.
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