Howorka K, Pumprla J, Haber P, Koller-Strametz J, Mondrzyk J, Schabmann A
Department of Biomedical Engineering and Physics, University of Vienna, Austria.
Cardiovasc Res. 1997 Apr;34(1):206-14. doi: 10.1016/s0008-6363(97)00040-0.
To investigate the effects of regularly performed endurance training on heart rate variability in diabetic patients with different degrees of cardiovascular autonomic neuropathy (CAN).
Bicycle ergometer training (12 weeks, 2 x 30 min/week, with 65% of maximal performance) was performed by 22 insulin-requiring diabetic patients (age 49.5 +/- 8.7 years; diabetes duration 18.6 +/- 10.6 years; BMI 25.1 +/- 3.4 kg/m2): i.e., by 8 subjects with no CAN, 8 with early CAN and by 6 patients with definite/severe CAN. A standard battery of cardiovascular reflex tests was used for grading of CAN, a short-term spectral analysis of heart rate variability for follow-up monitoring of training-induced effects.
While the training-free interval induced no changes in spectral indices, the 12-week training period increased the cumulative spectral power of the total frequency band (P = 0.04) but to a different extent (P = 0.039) in different degrees of neuropathy. In patients with no CAN the spectral power in the high-frequency (HF) band (0.15-0.50 Hz) increased from 6.2 +/- 0.3 to 6.6 +/- 0.4 In [ms2]; P = 0.016, and in the low-frequency (LF) band (0.06-0.13 Hz) from 7.1 +/- 0.1 to 7.6 +/- 0.3 in [ms2]; P = 0.08 which resulted in an increase of total spectral power (0.06-0.50 Hz) from 7.5 +/- 0.1 to 8.0 +/- 0.3 in [ms2] (P = 0.05). Patients with the early form of CAN showed an increase of spectral power in HF (5.1 +/- 0.2 to 5.8 +/- 0.1 in [ms2], P = 0.05) and LF bands (5.6 +/- 0.1 to 6.3 +/- 0.1 in [ms2], P = 0.008), resulting in an increase of total power from 6.1 +/- 0.1 to 6.6 +/- 0.1 in [ms2] (P = 0.04), whereas those with definite/severe CAN showed no changes after the training period. Training improved fitness in the whole patient cohort. The increased autonomic tone as assessed by spectral indices disappeared after a training withdrawal period of 6 weeks.
In diabetic patients with no or early CAN, regularly performed endurance training increased heart rate variability due to improved sympathetic and parasympathetic supply, whereas in subjects with definite/severe CAN no effect on heart rate variability could be demonstrated after this kind of training.
探讨定期进行耐力训练对不同程度心血管自主神经病变（CAN）的糖尿病患者心率变异性的影响。
22例需要胰岛素治疗的糖尿病患者（年龄49.5±8.7岁；糖尿病病程18.6±10.6年；体重指数25.1±3.4kg/m²）进行自行车测力计训练（12周，每周2次，每次30分钟，强度为最大运动能力的65%）：即8例无CAN患者、8例早期CAN患者和6例明确/重度CAN患者。采用一套标准的心血管反射测试对CAN进行分级，通过心率变异性的短期频谱分析对训练效果进行随访监测。
在无训练间期，频谱指标无变化，而12周训练期增加了总频段的累积频谱功率（P=0.04），但在不同程度的神经病变中增加程度不同（P=0.039）。无CAN患者高频（HF）频段（0.15 - 0.50Hz）的频谱功率从6.2±0.3增加到6.6±0.4In[ms²]；P=0.016，低频（LF）频段（0.06 - 0.13Hz）从7.1±0.1增加到
