Key result
Six months of exercise-based cardiac rehabilitation in CAD patients significantly reduced muscle sympathetic nerve activity burst frequency from 48 to 39 bursts/min (P<0.001), matching healthy controls.
Why the study?
Autonomic dysregulation is a hallmark of CAD, motivating investigation into the effects of exercise-based cardiac rehabilitation on autonomic function and neuro-cardiovascular stress reactivity.
Does 6 months of exercise-based cardiac rehabilitation improve autonomic function and neuro-cardiovascular stress reactivity in patients with coronary artery disease?
Observational (n=44)
Does 6 months of exercise-based cardiac rehabilitation improve autonomic function and neuro-cardiovascular stress reactivity in patients with coronary artery disease?
Absolute Event Rate: 39% vs 48%
p-value: p=<0.001
Six months of exercise-based cardiac rehabilitation significantly improves baseline autonomic function and neuro-cardiovascular stress reactivity in patients with coronary artery disease, restoring them to levels comparable to healthy controls.
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.
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Badrov et al. (2019) conducted an observational in Coronary artery disease (n=44). Exercise-based cardiac rehabilitation vs. Pre-rehabilitation baseline and healthy controls was evaluated on Muscle sympathetic nerve activity burst frequency (p=<0.001). Six months of exercise-based cardiac rehabilitation in CAD patients significantly reduced muscle sympathetic nerve activity burst frequency from 48 to 39 bursts/min (P<0.001), matching healthy controls.
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