Exercise training and cardiac autonomic function following coronary artery bypass grafting: a systematic review and meta-analysis

Abstract

Background Exercise training improves cardiac autonomic function is still debatable in patients with coronary artery bypass grafting (CABG). The aim of the present review is to assess the effect of exercise on CABG patient’s heart rate variability (HRV) and heart rate recovery (HRR) parameters. Main body Databases (PubMed, Web of Science and PEDro) were accessed for systematic search from inception till May 2022. Eleven potential studies were qualitatively analyzed by using PEDro and eight studies were included in the quantitative synthesis. Meta-analysis was conducted by using a random-effect model, inverse-variance approach through which standardized mean differences (SMDs) were estimated. The analysis of pooled data showed that exercise training improved HRV indices of standard deviation of the R–R intervals (SDNN) [SMD 0.44, 95% CI 0.17, 0.71, p = 0.002], square root of the mean squared differences between adjacent R–R intervals (RMSSD) [SMD 0.68, 95% CI 0.28, 1.08, p = 0.0008], high frequency (HF) [SMD 0.58, 95% CI 0.18, 0.98, p = 0.005] and low frequency-to-high frequency (LF/HF) ratio [SMD − 0.34, 95% CI − 0.65, − 0.02, p = 0.03]. Conclusions Exercise training enhances cardiac autonomic function in CABG patients. Owing to the methodological inconsistencies in assessing HRV, the precise effect on autonomic function still remains conflicted. Future high-quality trials are needed focusing on precise methodological approach and incorporation of various types of exercise training interventions will give clarity regarding autonomic adaptations post-exercise training in CABG. Trial registrationCRD42021230270, February 19, 2021.

Rehabilitation management of patients with COVID-19: lessons learned from the first experience in China

“…Regarding exercise prescription, 5 of the 6 exercise types were assessed for their impact on long-term clinical outcomes, such as total or cardiovascular mortality. Although limited evidence supports HIIT’s effectiveness in improving cardiovascular function, 42 , 55 , 79 no evidence supports its impact on long-term outcomes for CHD patients. In the case of mind-body exercise, only yoga showed non-significant long-term outcomes.…”

“…Several factors were found to influence the effects of exercise interventions. Population characteristics, such as age, sex, comorbidities, CHD diagnosis, the initial level of fitness, and serum level of HDL, 18 , 39 , 42 , 59 , 79 have been identified as influential factors. Additionally, exercise-related factors, such as exercise duration, exercise intensity, and workout frequency, 48 can impact intervention outcomes.…”

Heart Rate Variability and Coronary Artery Bypass Grafting: A Systematic Review

“…A meta-analysis conducted by Kushwaha et al . [ 85 ] confirmed and reinforced the finding that exercise training improved selected HRV indices, e.g., rMSSD, SDNN, HF power, and LF/HF ratio. Studies (N = 8) describing use of HRV to assess effects of post-CABG interventions are shown in Table 8 (Ref.…”

The effect of cardiac rehabilitation on cardiopulmonary function after coronary artery bypass grafting: A systematic review and meta-analysis

“…2 Sympathetic nerve activation may occur after CABG due to myocardial damage or surgical stimulation, which negatively impacts patient rehabilitation after CABG. 3 It is now believed that postoperative cardiac rehabilitation (CR) may reduce the risk of mortality by modulating functions of the autonomic nervous system. 4 , 5 …”