Exercise-based cardiac rehabilitation and parasympathetic function in patients with coronary artery disease: a systematic review and meta-analysis

Manresa-Rocamora, Agustín, Ribeiro, Fernando, Sarabia, José Manuel, Íbias, Javier, Oliveira, Nórton Luís, Vera-García, Francisco José y Moya-Ramón, Manuel . (2020) Exercise-based cardiac rehabilitation and parasympathetic function in patients with coronary artery disease: a systematic review and meta-analysis. Clinical Autonomic Research


Título Exercise-based cardiac rehabilitation and parasympathetic function in patients with coronary artery disease: a systematic review and meta-analysis
Autor(es) Manresa-Rocamora, Agustín
Ribeiro, Fernando
Sarabia, José Manuel
Íbias, Javier
Oliveira, Nórton Luís
Vera-García, Francisco José
Moya-Ramón, Manuel
Materia(s) Psicología
Abstract Purpose The effects of exercise-based cardiac rehabilitation (CR) on parasympathetic modulation are controversial. This systematic review and meta-analysis aims to (a) determine the effect of exercise-based CR on heart-rate-derived indices associated with cardiac parasympathetic modulation in resting and post-exercise conditions in coronary artery disease (CAD) patients and (b) identify the possible moderator variables of the effect of exercise-based CR on parasympathetic modulation. Methods We searched CENTRAL and Web of Science up to November 2018 for the following terms: adult CAD patients, controlled exercise-based CR interventions and parasympathetic modulation measured in resting (vagal-related heart rate variability [HRV] indices of the root mean square of the differences in successive in RR interval [RMSSD] and high frequency [HF]) and post-exercise (heart rate recovery [HRR]) pre- and post-intervention. We estimated a random-effects model of standardised mean difference (SMD) and mean difference (MD) for vagal-related HRV indices and HRR, respectively. We assessed the influence of categorical and continuous variables. Results The overall effect size showed significant differences in RMSSD (SMD+ = 0.30; 95% confidence interval [CI] = 0.12–0.49) and HRR (MD+ = 5.35; 95% CI = 4.08–6.61 bpm) in favour of the exercise-based CR group. The overall effect size showed no differences in HF between groups (SMD+ = 0.14; 95% CI,  −0.12–0.40). Heterogeneity analyses reached statistical significance, with high heterogeneity for HF (p < 0.001; I2 = 70%) and HRR (p < 0.001; I2 = 85%). Analysis of the moderator variables showed that the effect on HRR is greater in young patients (p = 0.008) and patients treated with percutaneous intervention (p = 0.020). Conclusions Exercise-based CR improves the post-exercise parasympathetic function, with greater effects in younger CAD patients and in those who were revascularised with percutaneous intervention. The effects on resting parasympathetic function are more controversial due to methodological inconsistencies in measuring HRV, with the use of RMSSD recommended instead of HF because its results show higher consistency. Future studies involving women, focusing on methodological issues, and performing other training methods are needed to increase our knowledge about this topic.
Palabras clave Autonomic nervous system
Aerobic training
Resistance training
Acute myocardial infarction
Coronary heart disease
Editor(es) Springer Nature
Fecha 2020-04-08
Formato application/pdf
Identificador bibliuned:DptoMCC-FPSI-Articulos-Jibias-0007
http://e-spacio.uned.es/fez/view/bibliuned:DptoMCC-FPSI-Articulos-Jibias-0007
DOI - identifier 10.1007/s10286-020-00687-0
ISSN - identifier 619-1560
Nombre de la revista Clinical Autonomic Research
Número de Volumen 31
Página inicial 187
Página final 203
Publicado en la Revista Clinical Autonomic Research
Idioma eng
Versión de la publicación acceptedVersion
Tipo de recurso Article
Derechos de acceso y licencia http://creativecommons.org/licenses/by-nc-nd/4.0
info:eu-repo/semantics/openAccess
Tipo de acceso Acceso abierto
Notas adicionales This is an Accepted Manuscript of an article published by Springer Nature in Clinical Autonomic Research, available at: https://doi.org/10.1007/s10286-020-00687-0
Notas adicionales Este es el manuscrito aceptado del artículo publicado por Springer Nature en Clinical Autonomic Research, disponible en línea: https://doi.org/10.1007/s10286-020-00687-0

 
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Creado: Wed, 07 Feb 2024, 02:31:03 CET