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I 期心脏康复期间渐进运动对急性心肌梗死患者心率变异性的影响。

Effects of progressive exercise during phase I cardiac rehabilitation on the heart rate variability of patients with acute myocardial infarction.

机构信息

Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil.

出版信息

Disabil Rehabil. 2011;33(10):835-42. doi: 10.3109/09638288.2010.514016. Epub 2010 Sep 2.

Abstract

PURPOSE

Heart rate variability (HRV) decreases after an acute myocardial infarction (AMI) due to changes in cardiac autonomic balance. The purpose of the present study, therefore, was to evaluate the effects of a progressive exercise protocol used in phase I cardiac rehabilitation on the HRV of patients with post-AMI.

MATERIAL AND METHODS

Thirty-seven patients who had been admitted to hospital with their first non-complicated AMI were studied. The treated group (TG, n=21, age=52±12 years) performed a 5-day programme of progressive exercise during phase I cardiac rehabilitation, while the control group (CG, n=16, age=54±11 years) performed only respiratory exercises. Instantaneous heart rate (HR) and RR interval were acquired by a HR monitor (Polar®S810i). HRV was analysed by frequency domain methods. Power spectral density was expressed as normalised units (nu) at low (LF) and high (HF) frequencies, and as LF/HF.

RESULTS

After 5 days of progressive exercise, the TG showed an increase in HFnu (35.9±19.5 to 65.19±25.4) and a decrease in LFnu and LF/HF (58.9±21.4 to 32.5±24.1; 3.12±4.0 to 1.0±1.5, respectively) in the resting position (p<0.05). No changes were observed in the CG.

CONCLUSIONS

A progressive physiotherapeutic exercise programme carried out during phase I cardiac rehabilitation, as supplement to clinical treatment increased vagal and decreased sympathetic cardiac modulation in patients with post-AMI.

摘要

目的

急性心肌梗死(AMI)后,由于心脏自主平衡的变化,心率变异性(HRV)降低。因此,本研究的目的是评估在 I 期心脏康复中使用的渐进式运动方案对 AMI 后患者 HRV 的影响。

材料和方法

研究了 37 名因首次非复杂性 AMI 住院的患者。治疗组(TG,n=21,年龄=52±12 岁)在 I 期心脏康复期间进行了为期 5 天的渐进式运动方案,而对照组(CG,n=16,年龄=54±11 岁)仅进行呼吸运动。通过心率监测仪(Polar®S810i)获取即时心率(HR)和 RR 间期。通过频域方法分析 HRV。功率谱密度以低(LF)和高(HF)频率的归一化单位(nu)以及 LF/HF 表示。

结果

经过 5 天的渐进式运动,TG 在静息状态下的 HFnu 增加(35.9±19.5 至 65.19±25.4),LFnu 和 LF/HF 降低(58.9±21.4 至 32.5±24.1;3.12±4.0 至 1.0±1.5,分别)(p<0.05)。CG 没有观察到变化。

结论

在 I 期心脏康复期间进行的渐进式物理治疗运动方案,作为临床治疗的补充,增加了 AMI 后患者的迷走神经和降低了交感神经心脏调节。

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