Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University; Tehran-Iran.
Anatol J Cardiol. 2022 Feb;26(2):80-89. doi: 10.5152/AnatolJCardiol.2021.215.
Autonomic imbalance in patients with chronic heart failure (CHF) and cardiovascular diseases (CVD) is characterized by reduced parasympathetic and enhanced sympathetic activity. Aerobic exercise improves autonomic function in patients with CHF and CVD. However, little is known about the effects of resistance training (RT) on cardiac autonomic function. Therefore, we aimed to investigate the effects of RT added on aerobic training on autonomic function in patients with CHF and CVD.
The relevant clinical trials were searched in PubMed, Physiotherapy evidence Database (PEDro, Science Direct and Google Scholar databases using the following keywords, "resistance or strength training", "chronic heart failure", "coronary artery disease", "myocardial infarction", "hypertension", "cardiovascular disease", "heart rate variability (HRV)", "heart rate recovery (HRR)", "muscle sympathetic nerve activity (MSNA)", and "autonomic function".
Twelve articles with 323 subjects were eligible to be evaluated. The outcome measures included HRV, HRR, and MSNA. There were seven studies on CHF, two on CAD, and three studies on hypertension. Meta-analysis of all the studies showed that combined RT and aerobic training decreased MSNA significantly in patients with CHF and CAD (mean difference: -3.796; CI: -6.779 to 0.813; p=0.013; I2 =93.5%). No study evaluated the effects of RT or combined training on HRR.
We could not find sufficient data about the effects of RT alone on HRV and HRR, but the results showed that combined RT and aerobic training improved MSNA in patients with CHF and CAD, significantly. Further studies with similar methodological principles on the same patient population are needed.
慢性心力衰竭（CHF）和心血管疾病（CVD）患者的自主神经失衡表现为副交感神经活性降低和交感神经活性增强。有氧运动可改善 CHF 和 CVD 患者的自主神经功能。然而，关于抗阻训练（RT）对心脏自主神经功能的影响知之甚少。因此，我们旨在研究在有氧运动的基础上增加 RT 对 CHF 和 CVD 患者自主神经功能的影响。
在 PubMed、Physiotherapy evidence Database（PEDro）、Science Direct 和 Google Scholar 数据库中，使用以下关键词搜索相关临床试验：“阻力或力量训练”、“慢性心力衰竭”、“冠状动脉疾病”、“心肌梗死”、“高血压”、“心血管疾病”、“心率变异性（HRV）”、“心率恢复（HRR）”、“肌肉交感神经活动（MSNA）”和“自主功能”。
符合条件的评估有 12 项研究，共 323 例患者。结果测量指标包括 HRV、HRR 和 MSNA。其中 7 项研究针对 CHF，2 项研究针对 CAD，3 项研究针对高血压。所有研究的荟萃分析显示，在 CHF 和 CAD 患者中，联合 RT 和有氧运动可显著降低 MSNA（平均差异：-3.796；CI：-6.779 至 0.813；p=0.013；I2=93.5%）。没有研究评估 RT 或联合训练对 HRR 的影响。
我们没有找到足够的数据来评估单独进行 RT 对 HRV 和 HRR 的影响，但结果表明，联合 RT 和有氧运动可显著改善 CHF 和 CAD 患者的 MSNA。需要在同一患者群体中进行具有类似方法学原则的进一步研究。
