Swanson Kimberly S, Gevirtz Richard N, Brown Milton, Spira James, Guarneri Ermina, Stoletniy Liset
The Everett Clinic, Everett, WA 98201, USA.
Appl Psychophysiol Biofeedback. 2009 Jun;34(2):71-91. doi: 10.1007/s10484-009-9077-2. Epub 2009 Feb 10.
Decreased HRV has been consistently associated with increased cardiac mortality and morbidity in HF patients. The aim of this study is to determine if a 6-week course of heart rate variability (HRV) biofeedback and breathing retraining could increase exercise tolerance, HRV, and quality of life in patients with New York Heart Association Class I-III heart failure (HF). Participants (N = 29) were randomly assigned to either the treatment group consisting of six sessions of breathing retraining, HRV biofeedback and daily practice, or the comparison group consisting of six sessions of quasi-false alpha-theta biofeedback and daily practice. Exercise tolerance, measured by the 6-min walk test (6MWT), HRV, measured by the standard deviation of normal of normal beats (SDNN), and quality of life, measured by the Minnesota Living with Congestive Heart Failure Questionnaire, were measured baseline (week 0), post (week 6), and follow-up (week 18). Cardiorespiratory biofeedback significantly increased exercise tolerance (p = .05) for the treatment group in the high (>or=31%) left ventricular ejection fraction (LVEF) category between baseline and follow-up. Neither a significant difference in SDNN (p = .09) nor quality of life (p = .08), was found between baseline and follow-up. A combination of HRV biofeedback and breathing retraining may improve exercise tolerance in patients with HF with an LVEF of 31% or higher. Because exercise tolerance is considered a strong prognostic indicator, cardiorespiratory biofeedback has the potential to improve cardiac mortality and morbidity in HF patients.
心率变异性降低一直与心力衰竭（HF）患者心脏死亡率和发病率的增加相关。本研究的目的是确定为期6周的心率变异性（HRV）生物反馈和呼吸再训练课程是否能提高纽约心脏协会I-III级心力衰竭（HF）患者的运动耐量、HRV和生活质量。参与者（N = 29）被随机分配到治疗组或对照组，治疗组包括六次呼吸再训练、HRV生物反馈和日常练习，对照组包括六次准假α-θ生物反馈和日常练习。通过6分钟步行试验（6MWT）测量运动耐量，通过正常心搏标准差（SDNN）测量HRV，通过明尼苏达充血性心力衰竭生活问卷测量生活质量，在基线（第0周）、治疗后（第6周）和随访（第18周）进行测量。在基线和随访之间，治疗组中左心室射血分数（LVEF）高（≥31%）的患者，心肺生物反馈显著提高了运动耐量（p = 0.05）。在基线和随访之间，未发现SDNN（p = 0.09）和生活质量（p = 0.08）有显著差异。HRV生物反馈和呼吸再训练相结合可能会改善LVEF为31%或更高的HF患者的运动耐量。由于运动耐量被认为是一个强有力的预后指标，心肺生物反馈有可能改善HF患者的心脏死亡率和发病率。
