Segovia Victoria, Manterola Carlos, González Marcelo, Rodríguez-Núñez Iván
Programa de Magíster en Kinesiología Cardiorrespiratoria, Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile; Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile.
Departamento de Cirugía y CEMyQ, Universidad de La Frontera, Temuco, Chile; Centro de investigaciones biomédicas, Universidad Autónoma de Chile, Temuco, Chile.
Arch Cardiol Mex. 2017 Oct-Dec;87(4):326-335. doi: 10.1016/j.acmx.2016.12.002. Epub 2017 Jan 5.
Cardiovascular diseases are a significant cause of morbidity and mortality in the general population. In this sense, the autonomic imbalance is the cornerstone of the pathophysiology underlying the development of these diseases. The aim of this study was to determine the efficacy of exercise training on heart rate variability (HRV) in adult patients with chronic heart failure.
A systematic literature review was conducted in electronic databases. The considered studies were randomised clinical trials, quasi-experimental studies with non-randomised control group, quasi-experimental studies with analysis of pre- and post- intervention, and crossover studies with randomly assigned training and non-training periods. The standardised mean differences were calculated between pre- and post-intervention in both the control and experimental group.
Within-subject analysis of the control group showed no statistical significance in the standardised mean differences of HRV. In the experimental group, the standardised mean differences were positive for the root mean square of successive difference (+0.468±0.215; P=.032), high frequency band (HF) (0.934±0.256; P < .001) and low frequency band (LF) (< 0.415±0.096; P=.001). Moreover, the standardised mean difference was negative for LF/HF (-0.747±0.369, P=<.044). On the other hand, only 3 studies entered the comparative meta-analysis. The effect of exercise training was favourable for the experimental group in LF/HF (-2.21±95% CI: -3.83 to -0.60), HF, and LF.
The exercise training was effective in increasing HRV and restoring the autonomic balance in patients with heart failure.
心血管疾病是普通人群发病和死亡的重要原因。从这个意义上讲,自主神经失衡是这些疾病发生发展的病理生理学基石。本研究的目的是确定运动训练对成年慢性心力衰竭患者心率变异性(HRV)的疗效。
在电子数据库中进行系统的文献综述。纳入的研究包括随机临床试验、有非随机对照组的准实验研究、有干预前后分析的准实验研究以及有随机分配训练期和非训练期的交叉研究。计算对照组和实验组干预前后的标准化平均差异。
对照组的组内分析显示HRV的标准化平均差异无统计学意义。在实验组中,连续差值的均方根(+0.468±0.215;P=0.032)、高频带(HF)(0.934±0.256;P<0.001)和低频带(LF)(<0.415±0.096;P=0.001)的标准化平均差异为正值。此外,LF/HF的标准化平均差异为负值(-0.747±0.369,P<0.044)。另一方面,只有3项研究纳入了比较荟萃分析。运动训练对实验组的LF/HF(-2.21±95%CI:-3.83至-0.60)、HF和LF有有利影响。
运动训练可有效提高心力衰竭患者的HRV并恢复自主神经平衡。