Exercise Training Improves Heart Rate Variability in Older Patients With Heart Failure: A Randomized, Controlled, Single‐Blinded Trial

Abstract

Background Reduced heart rate variability (HRV) in older patients with heart failure (HF) is common and indicates poor prognosis. Exercise training (ET) has been shown to improve HRV in younger patients with HF. However the effect of ET on HRV in older patients with HF is not known. Methods and Results Sixty-six participants (36% males), age 69±5 years, with HF and both preserved ejection fraction (HFPEF) and reduced ejection fraction (HFREF), were randomly assigned to 16 weeks of supervised ET (ET group) versus attention-control (AC group). Two HRV parameters (the standard deviation of all normal RR intervals (SDNN) and the root mean square of successive differences in normal RR intervals (RMSSD)) were measured at baseline and after completion of the study. When compared with the AC group, the ET group had a significantly greater increase in both SDNN (15.46 ± 5.02 ms in ET versus 2.37 ± 2.13 ms in AC, P = 0.016), and RMSSD (17.53 ± 7.83 ms in ET versus 1.69 ± 2.63 ms in AC, P = 0.003). This increase was seen in both genders and HF categories. Conclusion ET improves HRV in older patients with both HFREF and HFPEF.

Heart rate variability assessment with fingertip photoplethysmography and polar RS800cx as compared with electrocardiography in obese adolescents

“…HRV reflects beat-to-beat changes in heart rate (HR), expressing the sympathovagal interaction obtained by the variation of both instantaneous HR and R-R intervals within the cardiac cycle [4]. Lower variance in HRV might be explained by either lower parasympathetic or higher sympathetic activity, and has been associated with the development of pathological conditions such as metabolic syndrome [5], stroke [6], chronic fatigue [7,8], obesity [9,10], and especially hypertension [11,12].…”

“…As a consequence, obese adolescents may exhibit increased heart rate and cardiac output at rest, as well as decreased baroreflex sensitivity and higher blood pressure [14][15][16]. The assessment of autonomic activity in obese adolescents is therefore clinically relevant, and HRV indices are frequently used as markers of sympathetic and parasympathetic modulation [2,6]. Evidently, it is important that the results obtained from HRV are accurate and reliable, truly reflecting the modulation of autonomic nervous system activity to the heart.…”

Positive Effects of the Reversion of Depression on the Sympathovagal Balance after Telerehabilitation in Heart Failure Patients

“…22 Published data indicated that exercise training restores ANS function by increasing vagal tone and decreasing sympathetic activity which lead to parasympathetic-sympathetic balance improvement in CHF patients. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]…”

Detailed heart rate variability analysis in athletes

“…Several trials examined the influences of physical activity on HRV. The enhancing effect of training on HRV was observed in healthy participants as well as in coronary artery disease, heart failure, obesity, type-2 diabetes mellitus and following myocardial infarction [9,10]. In healthy participants, baseline autonomic status has been shown to be an important determinant of cardiac autonomic response to exercise [11].…”