Piotrowicz Ewa, Baranowski Rafał, Piotrowska Małgorzata, Zieliński Tomasz, Piotrowicz Ryszard
National Institute of Cardiology, Warsaw, Poland.
Pacing Clin Electrophysiol. 2009 Mar;32 Suppl 1:S113-5. doi: 10.1111/j.1540-8159.2008.02266.x.
Heart rate variability (HRV), heart rate turbulence (HRT), and heart rate recovery (HRR), indices that reflect autonomic nervous system (ANS) activity, are outcome predictors in patients with chronic heart failure (CHF). It is not clear, however, whether they reflect the same components of ANS activity. No study has examined the effects of physical training (PT) training on HRV, HRT, and HRR in CHF.
To examine the responses of HRV, HRT, and HRR to a PT program in patients presenting with CHF.
In 41 patients (mean age = 58.7 +/- 10.2 years) in New York Heart Association CHF functional classes II or III, and with a left ventricular ejection fraction <40%, HRV, HRT, and HRR were measured before and after 8 weeks of PT.
The training was clinically effective in all patients. Before versus after PT, standard deviation of all normal RR intervals increased from 107 +/- 30 to 114 +/- 32 ms (P = 0.047), high frequency increased from 210 +/- 227 to 414 +/- 586 ms(2)/Hz (P = 0.02), and the low/high frequency ratio decreased from 1.8 +/- 1.55 to 1.1 +/- 1.2 (P = 0.002). HRT and HRR did not change significantly after PT.
In patients with CHF, the positive effects of PT were limited to HRV indices, which reflect parasympathetic activity, without significantly changing HRR and HRT. These observations indicate that different mechanisms modulate HRV, HRR, and HRT, which provide complementary information regarding ANS activity. The 8-week PT program failed to completely normalize ANS function.
心率变异性（HRV）、心率震荡（HRT）和心率恢复（HRR）是反映自主神经系统（ANS）活动的指标，是慢性心力衰竭（CHF）患者的预后预测指标。然而，它们是否反映ANS活动的相同组成部分尚不清楚。尚无研究探讨体育锻炼（PT）对CHF患者HRV、HRT和HRR的影响。
探讨CHF患者HRV、HRT和HRR对PT方案的反应。
对41例纽约心脏协会CHF功能分级为II或III级、左心室射血分数<40%的患者（平均年龄=58.7±10.2岁），在PT 8周前后测量HRV、HRT和HRR。
该训练对所有患者均有临床疗效。PT前后，所有正常RR间期的标准差从107±30增加到114±32毫秒（P=0.047），高频从210±227增加到414±586毫秒(2)/赫兹（P=0.02），低频/高频比值从1.8±1.55降低到1.1±1.2（P=0.002）。PT后HRT和HRR无显著变化。
在CHF患者中，PT的积极作用仅限于反映副交感神经活动的HRV指标，而HRR和HRT无显著变化。这些观察结果表明，不同的机制调节HRV、HRR和HRT，它们提供了关于ANS活动的补充信息。8周的PT方案未能使ANS功能完全正常化。
