Laurino Maria Júlia Lopez, da Silva Anne Kastelianne França, Santos Lorena Altafin, Vanderlei Luiz Carlos Marques
Laboratory of Stress Physiology, Department of Physiotherapy, São Paulo State University (UNESP), Faculty of Science and Technology, Presidente Prudente, Brazil.
Front Neurosci. 2023 Jun 22;17:1147299. doi: 10.3389/fnins.2023.1147299. eCollection 2023.
The post-exercise recovery is a period of vulnerability of the cardiovascular system in which autonomic nervous system plays a key role in cardiovascular deceleration. It is already known that individuals with coronary artery disease (CAD) are at greater risk due to delayed vagal reactivation in this period. Water ingestion has been studied as a strategy to improve autonomic recovery and mitigate the risks during recovery. However, the results are preliminary and need further confirmation. Therefore, our aim was to investigate the influence of individualized water drinking on the non-linear dynamics of heart rate during and after aerobic exercise in CAD subjects.
30 males with CAD were submitted to a control protocol composed of initial rest, warming up, treadmill exercise, and passive recovery (60 min). After 48 hours they performed the hydration protocol, composed of the same activities, however, with individualized water drinking proportional to the body mass lost in the control protocol. The non-linear dynamics of heart rate were assessed by indices of heart rate variability extracted from the recurrence plot, detrended fluctuation analysis, and symbolic analysis.
During exercise, the responses were physiological and similar in both protocols, indicating high sympathetic activity and reduced complexity. During recovery, the responses were also physiological, indicating the rise of parasympathetic activity and the return to a more complex state. However, during hydration protocol, the return to a more complex physiologic state occurred sooner and non-linear HRV indices returned to resting values between the 5th and 20th minutes of recovery. In contrast, during the control protocol, only a few indices returned to resting values within 60 minutes. Despite that, differences between protocols were not found. We conclude that the water drinking strategy accelerated the recovery of non-linear dynamics of heart rate in CAD subjects but did not influence responses during exercise. This is the first study to characterize the non-linear responses during and after exercise in CAD subjects.
运动后恢复是心血管系统的一个脆弱时期，在此期间自主神经系统在心血管减速中起关键作用。已知冠心病（CAD）患者由于在此期间迷走神经重新激活延迟而面临更大风险。饮水已被作为一种改善自主神经恢复并降低恢复期间风险的策略进行研究。然而，结果是初步的，需要进一步证实。因此，我们的目的是研究个性化饮水对CAD患者有氧运动期间及之后心率非线性动力学的影响。
30名CAD男性患者接受了一个对照方案，包括初始休息、热身、跑步机运动和被动恢复（60分钟）。48小时后，他们进行了补水方案，包括相同的活动，但根据对照方案中体重减轻情况进行个性化饮水。通过从递归图、去趋势波动分析和符号分析中提取的心率变异性指标来评估心率的非线性动力学。
在运动期间，两种方案中的反应都是生理性的且相似，表明交感神经活动增强且复杂性降低。在恢复期间，反应也是生理性的，表明副交感神经活动增强并恢复到更复杂的状态。然而，在补水方案期间，恢复到更复杂的生理状态发生得更快，并且非线性心率变异性指标在恢复的第5至20分钟之间恢复到静息值。相比之下，在对照方案中，只有少数指标在60分钟内恢复到静息值。尽管如此，未发现两种方案之间存在差异差异。我们得出结论，饮水策略加速了CAD患者心率非线性动力学的恢复，但不影响运动期间的反应。这是第一项描述CAD患者运动期间及之后非线性反应的研究。
