Heart Rate Variability-Guided Exercise Training Compared With Standard Exercise Training in Patients With Coronary...

Area of Science:

• Cardiology
• Exercise Physiology
• Rehabilitation

Background:

• Acute coronary syndrome (ACS) necessitates tailored exercise rehabilitation.
• Peak oxygen uptake (V̇O₂peak) is a key metric for cardiovascular health and exercise capacity.
• Standard exercise training (SET) is established, but personalized approaches may offer benefits.

Purpose of the Study:

• To compare the efficacy of heart rate variability-guided (HRV-G) exercise training against standard exercise training (SET).
• To evaluate the impact on peak oxygen uptake (V̇O₂peak) in patients post-ACS.
• To assess secondary outcomes including responder rates and ventilatory thresholds.

Main Methods:

• A randomized controlled trial involving 48 ACS patients.
• Intervention groups: HRV-guided exercise (HRV-G) and standard exercise training (SET).
• Both groups underwent 3 aerobic sessions weekly for 3 months, with HRV-G adapting intensity based on daily RMSSD measurements.

Main Results:

• Both HRV-G and SET significantly increased V̇O₂peak, with no significant difference between groups.
• A higher proportion of responders (ΔV̇O₂peak >5%) was observed in the HRV-G group (75%) versus SET (50%), though not statistically significant (P = .111).
• HRV-G demonstrated a significantly greater improvement in V̇O2 at the first ventilatory threshold compared to SET (P = .043), with a lower overall training load.

Conclusions:

• HRV-guided exercise training provides comparable V̇O₂peak improvements to SET in ACS patients.
• HRV-G may enhance submaximal exercise capacity, indicated by improved V̇O2 at the first ventilatory threshold.
• Personalized, HRV-based training is a viable alternative to SET, potentially optimizing rehabilitation outcomes with reduced training intensity.