Open AccessEffects of 6 Months of Exercise‐Based Cardiac Rehabilitation on Autonomic Function and Neuro‐Cardiovascular Stress Reactivity in Coronary Artery Disease Patients
Author(s) -
Badrov Mark B.,
Wood Katelyn N.,
Lalande Sophie,
Sawicki Carolyn P.,
Borrell Lindsay J.,
Barron Carly C.,
Vording Jennifer L.,
Fleischhauer Arlene,
Suskin Neville,
McGowan Cheri L.,
Shoemaker J. Kevin
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.119.012257
Subject(s) - medicine , baroreflex , cardiology , blood pressure , coronary artery disease , heart rate , supine position , autonomic nervous system , sympathetic nervous system
Background Autonomic dysregulation represents a hallmark of coronary artery disease ( CAD ). Therefore, we investigated the effects of exercise‐based cardiac rehabilitation ( CR ) on autonomic function and neuro‐cardiovascular stress reactivity in CAD patients. Methods and Results Twenty‐two CAD patients (4 women; 62±8 years) were studied before and following 6 months of aerobic‐ and resistance‐training–based CR . Twenty‐two similarly aged, healthy individuals ( CTRL ; 7 women; 62±11 years) served as controls. We measured blood pressure, muscle sympathetic nerve activity, heart rate, heart rate variability (linear and nonlinear), and cardiovagal (sequence method) and sympathetic (linear relationship between burst incidence and diastolic blood pressure) baroreflex sensitivity during supine rest. Furthermore, neuro‐cardiovascular reactivity during short‐duration static handgrip (20s) at 40% maximal effort was evaluated. Six months of CR lowered resting blood pressure ( P <0.05), as well as muscle sympathetic nerve activity burst frequency (48±8 to 39±11 bursts/min; P <0.001) and burst incidence (81±7 to 66±17 bursts/100 heartbeats; P <0.001), to levels that matched CTRL and improved sympathetic baroreflex sensitivity in CAD patients ( P <0.01). Heart rate variability (all P >0.05) and cardiovagal baroreflex sensitivity ( P =0.11) were unchanged following CR , yet values were not different pre‐ CR from CTRL (all P >0.05). Furthermore, before CR , CAD patients displayed greater blood pressure and muscle sympathetic nerve activity reactivity to static handgrip versus CTRL (all P <0.05); yet, responses were reduced following CR (all P <0.05) to levels observed in CTRL . Conclusions Six months of exercise‐based CR was associated with marked improvement in baseline autonomic function and neuro‐cardiovascular stress reactivity in CAD patients, which may play a role in the reduced cardiac risk and improved survival observed in patients following exercise training.