Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos, Brazil.
J Rehabil Med. 2011 Jul;43(8):720-7. doi: 10.2340/16501977-0843.
Cardiac rehabilitation is associated with cardiac autonomic and physiological benefits. However, it is unclear whether baseline left ventricular function (LVF) impacts on training-induced cardiac autonomic adaptations. The aim of this study was to assess the cardiac autonomic adaptations in patients with varying left ventricular function profiles undergoing coronary artery bypass grafting and cardiac rehabilitation.
Assessor-blinded prospective trial.
Forty-four patients undergoing coronary artery bypass grafting, divided into normal LVFN (≥ 55%, n = 23) or reduced LVFR (35-54%, n = 21) were evaluated.
Cardiac autonomic function was evaluated by heart rate variability indexes obtained both pre- and post-cardiac rehabilitation. All patients participated in a short-term (approximately 5 days) supervised inpatient physiotherapy program.
There were differences in heart rate variability indexes, correlation dimension and SD2 according to time and group (e.g. interaction time (effect of cardiac rehabilitation) vs group (LVFN vs LVFR), p = 0.04). Simple main effects analysis showed that the LVFR group benefited to a greater degree from cardiac rehabilitation compared with the LVFN group. Heart rate variability indexes increased significantly in the former group compared with the latter.
Among post-coronary artery bypass grafting patients engaged in short-term inpatient rehabilitation, those with reduced left ventricular function are most likely to have better cardiac autonomic adaptations to exercise-based rehabilitation.
心脏康复与心脏自主神经和生理益处相关。然而，目前尚不清楚基线左心室功能（LVF）是否会影响训练引起的心脏自主神经适应性变化。本研究旨在评估接受冠状动脉旁路移植术和心脏康复治疗的不同左心室功能患者的心脏自主神经适应性变化。
评估者设盲前瞻性试验。
44 例行冠状动脉旁路移植术的患者，分为左心室功能正常组（≥55%，n=23）或左心室功能降低组（35-54%，n=21）。
通过心率变异性指数评估心脏自主神经功能，该指数在心脏康复前后均获得。所有患者均参加了短期（约 5 天）的住院物理治疗计划。
心率变异性指数、关联维数和 SD2 存在时间和组别的差异（例如，时间（心脏康复的效果）与组（LVFN 与 LVFR）之间的交互作用，p=0.04）。简单主效应分析表明，与 LVFN 组相比，LVFR 组从心脏康复中获益更大。与后者相比，前者的心率变异性指数显著增加。
在接受短期住院康复治疗的冠状动脉旁路移植术后患者中，左心室功能降低的患者最有可能对基于运动的康复产生更好的心脏自主神经适应性。
