Effect of Aerobic Training on Heart Rate Recovery in Patients with Established Heart Disease; a Systematic Review

Snoek, Johan A.; Berkel, Sietske van; Meeteren, Nico van; Backx, Frank; Daanen, H.A.M.

doi:10.1371/journal.pone.0083907

Cited by 30 publications

(23 citation statements)

References 33 publications

(36 reference statements)

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“…A comprehensive literature search of PubMed, Cochrane Library, and Web of Science for English‐language studies was performed through its inception to August 2016 with the use of search terms modified from published systematic review or meta‐analysis as follows: (“heart rate recovery”) and (risk or cox or hazard or “survival analysis” or odds) (Table ). Bibliographies of selected articles and related reviews were manually checked to identify additional studies.…”

Section: Methodsmentioning

confidence: 99%

Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies

Qiu

Cai

Sun

et al. 2017

JAHA

164

147

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BackgroundHeart rate recovery (HRR) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantify these associations in the general population.Methods and ResultsA literature search using 3 databases up to August 2016 was conducted for studies that reported hazard ratios with 95% CIs for the association between baseline HRR and outcomes of interest. The overall hazard ratios were calculated using a random‐effects model. There were 9 eligible studies in total, with 5 for cardiovascular events enrolling 1061 cases from 34 267 participants, and 9 for all‐cause mortality enrolling 2082 cases from 41 600 participants. The pooled hazard ratios associated with attenuated HRR versus fast HRR that served as the referent were 1.69 (95% CI 1.05–2.71) for cardiovascular events and 1.68 (95% CI 1.51–1.88) for all‐cause mortality. For every 10 beats per minute decrements in HRR, the hazard ratios were 1.13 (95% CI 1.05–1.21) and 1.09 (95% CI 1.01–1.19), respectively. Further analyses suggested that the associations observed between attenuated HRR and risk of fatal cardiovascular events and all‐cause mortality were independent of traditional metabolic factors for cardiovascular disease (all P<0.05).ConclusionsAttenuated HRR is associated with increased risk of cardiovascular events and all‐cause mortality, which supports the recommendation of recording HRR for risk assessment in clinical practice as a routine.

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Section: Methodsmentioning

confidence: 99%

Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies

Qiu

Cai

Sun

et al. 2017

JAHA

164

147

View full text Add to dashboard Cite

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“…Increased vagal activity associated with a faster HRR has been shown to be associated with a decrease in risk of death (34). In a systemic view it was found that HRR is considerably reduced after an aerobic exercise programme in patients with established heart disease (35). It was also demonstrated that HRR at 1-2 min recovery is a prognostic measurement (36).…”

Section: Fitness and Exercise Capacitymentioning

confidence: 99%

Preoperative high-intensity interval training is effective and safe in deconditioned patients with lung cancer: A randomized clinical trial

Bhatia¹,

Kayser²

2019

J Rehabil Med

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High-intensity interval training is used increasingly in patient care. Various training patterns are used. For patients diagnosed with lung cancer, the first choice intervention is surgery. There is a wait of approximately a mean of 3 weeks between the clinical decision to operate and the intervention. A high-intensity interval training protocol was designed, to be performed during this time-window, to improve the physical condition of these patients before surgery. Patients cycled 3 times per week under supervision, performing 2 × 10-min series of 15-s sprints at peak power, interspersed with 15-s pauses. Compared to usual care, just before surgery, after 8 sessions of high-intensity interval training, the patients' physical fitness was significantly improved while after surgery the outcome was improved. Background: The outcome of surgery in deconditioned patients can be improved through prehabilitation. This study examined the effect of prehabilitation in patients diagnosed with lung cancer. Methods: Candidates for lung cancer resection were assigned to high-intensity interval training (n = 74) or usual care (n = 77). Cardiopulmonary exercise testing and 6-min walk test were performed before and after training. High-intensity interval training consisted of 2-3-weekly, 2 × 10-min series of cycling at peak power, measured with cardiopulmonary exercise testing prior to training, with a 15-s on-off duty cycle, preceded by a 5-min warm-up and followed by a 5-min cool-down. Work-rate, heart-rate, saturation, dyspnoea and leg effort were monitored. Results: Waiting time (median 25 days) allowed a median of 8 high-intensity interval training sessions to be performed. Adherence to mean high-intensity interval training was 87% (18% standard deviation; SD). High-intensity interval training power increased (23 watt, 95% confidence interval (95% CI): 20-26 watt), as did heart rate (14 bpm, 95% CI 11-16 bpm). Resting heart rate (-6 bpm, 95% CI-4 to-7 bpm) and heart rate 1 min post-cool-down decreased (-5 bpm, 95% CI-4 to-7 bpm). Aerobic capacity increased after high-intensity interval training (14%, 95% CI 3-26%), as did peak power output (median 7%, 95% CI 2-13%), but not after usual care. Six-min walk test score increased after high-intensity interval training (median 20%, 95% CI 14-26%), but not after usual care. Conclusion: Short-term high-intensity interval training is feasible in deconditioned patients and increases cardio-respiratory fitness and walking capacity.

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“…Physiological measures that are readily available may help identify at-risk individuals, monitor their health changes, and evaluate the effectiveness of health interventions. HRR and HRV from 10-s ECGs are relatively easy to obtain, have been demonstrated to be responsive to exercise training (Bellenger et al, 2016;Snoek et al, 2013), and therefore may have such utility in lung cancer patients. Unlike HRR, HRV can be obtained at rest and therefore is not subjected to variations in patient effort associated with exercise testing.…”

Section: Discussionmentioning

confidence: 99%

Heart rate variability and heart rate recovery in lung cancer survivors eligible for long-term cure

Malhotra

Ries

et al. 2019

Respiratory Physiology & Neurobiology

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A B S T R A C TLung cancer survivors are at risk for physical fitness and autonomic function impairments. In a cross-sectional study of consecutive lung cancer survivors post-curative intent therapy, we assessed and identified predictors of resting heart rate variability (HRV) and heart rate recovery (HRR), defined as standard deviation of normal-tonormal-R-to-R intervals (SDNN) and root-mean-square-of-successive-differences (rMSSD) from routine outpatient single 10-s electrocardiographs (ECGs) and difference in heart rate (HR) at 1-minute following and the end of the six-minute-walk-test (6MWT), respectively. In 69 participants, the mean (SD) HRR was -10.6 (6.7) beats. Significant independent predictors of HRR were age and HR change associated with the 6MWT. In a subset of 41 participants with available ECGs, the mean (SD) SDNN and rMSSD were 19.1 (15.6) and rMSSD 18.2 (14.6) ms, respectively. Significant independent predictors of HRV were supine HR, HRR, and total lung capacity. HRV/ HRR may be useful physiological measures in studies aimed at improving physical fitness and/or autonomic function in lung cancer survivors.Abbreviations: 6MWD, six-minute walk distance; 6MWT, six-minute walk test; ATS, American Thoracic Society; CAD, coronary artery disease; CI, confidence interval; COPD, chronic obstructive pulmonary disease; DL CO , diffusion capacity of the lung for carbon monoxide; DM, diabetes mellitus; ECG, electrocardiograph; FEV 1 , forced expiratory volume in 1 second; HR, heart rate; HRR, heart rate recovery; HRV, heart rate variability; MVA, multivariable linear regression analysis; NSCLC, non-small cell lung cancer; O 2 , oxygen; PAC, premature atrial contraction; PVC, premature ventricular contraction; QoL, quality of life; rMSSD, root mean square of successive differences; RPE, ratings of perceived exertion; SDNN, standard deviation of normal-to-normal R-R intervals; TLC, total lung capacity; UVA, univariable linear regression analysis; VASDHS, VA San Diego Healthcare System ⁎

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Effect of Aerobic Training on Heart Rate Recovery in Patients with Established Heart Disease; a Systematic Review

Cited by 30 publications

References 33 publications

Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies

Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies

Preoperative high-intensity interval training is effective and safe in deconditioned patients with lung cancer: A randomized clinical trial

Heart rate variability and heart rate recovery in lung cancer survivors eligible for long-term cure

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