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Effects of Neuromuscular Electrical Stimulation and Aerobic Exercise Training on Arterial Stiffness and Autonomic Functions in Patients With Chronic Heart Failure
Author(s) -
Dobšák Petr,
Tomandl Josef,
Spinarova Lenka,
Vitovec Jiri,
Dusek Ladislav,
Novakova Marie,
Jarkovsky Jiri,
Krejci Jan,
Hude Petr,
Honek Tomáš,
Siegelova Jarmila,
Homolka Pavel
Publication year - 2012
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2012.01474.x
Subject(s) - medicine , heart failure , ejection fraction , arterial stiffness , cardiology , heart rate variability , rehabilitation , stimulation , heart rate , aerobic exercise , ankle , physical therapy , surgery , blood pressure
Neuromuscular electrical stimulation (NMES) of leg muscles has been introduced in clinical practice as a rehabilitation (RHB) method in patients with chronic heart failure (CHF); however, the role of NMES on the reduction of arterial stiffness and autonomic disbalance in these patients has not yet been studied. Sixty‐one patients with stable CHF (mean age 58.9 [2.1] years; mean ejection fraction 31 [4.2]%, New York Heart Association II–III) were randomly assigned into two groups. Patients in (i) exercise training group (ET; n = 30) underwent 12 weeks of bicycle ET (3 × 40 min/week); (ii) group NMES ( n = 31) performed 12 weeks of NMES of quadriceps and calf muscles (frequency 10 Hz, mode “20 s on–20 s off,” intensity 60 mA), 2 × 60 min/day. Noninvasive assessment of arterial stiffness was done using the cardio‐ankle vascular index (CAVI). CAVI and heart rate variability (HRV) and were evaluated before and after RHB program. Both types of RHB reduced significantly CAVI (ET from 9.6 [0.2] to 8.9 [0.2], P < 0.012; NMES from 9.3 [0.2] to 8.7 [0.2], P < 0.013), increased high frequency (HF) component of HRV (+65.6%; P = 0.001) and decreased ratio of low frequency (LF) component with HF component (LF/HF ratio) in group ET (−39.8%; P < 0.001). Changes of HRV parameters in group NMES were not significant; however, a marked tendency to autonomic stabilization was present. Both types of RHB led also to significant increase of (ET from 18.7 [0.7] to 20.8 [0.7] mL/kg/min, P < 0.004; NMES from 17.3 [0.7] to 19.0 [0.7] mL/kg/min, P < 0.001). ET or NMES has been shown to improve significantly arterial stiffness and to stabilize autonomic balance.