Key result
Short-term inpatient cardiac rehabilitation resulted in significantly greater improvements in cardiac autonomic adaptations (correlation dimension and SD2) in post-CABG patients with reduced left ventricular function compared to those with normal left ventricular function.
Why the study?
Does baseline left ventricular function impact training-induced cardiac autonomic adaptations in patients undergoing CABG and short-term inpatient cardiac rehabilitation?
Cohort (n=44)
Single-blind
No
Does baseline left ventricular function impact training-induced cardiac autonomic adaptations in patients undergoing CABG and short-term inpatient cardiac rehabilitation?
Short-term inpatient cardiac rehabilitation post-CABG yields greater cardiac autonomic adaptations in patients with reduced left ventricular function compared to those with normal function.
Supports differential autonomic gains from inpatient CR by baseline LVEF post-CABG; hypothesis-generating, needs RCTs before practice change.
OBJECTIVE: Cardiac rehabilitation is associated with cardiac autonomic and physiological benefits. However, it is unclear whether baseline left ventricular function (LVF) impacts on training-induced cardiac autonomic adaptations. The aim of this study was to assess the cardiac autonomic adaptations in patients with varying left ventricular function profiles undergoing coronary artery bypass grafting and cardiac rehabilitation. DESIGN: Assessor-blinded prospective trial. PATIENTS: Forty-four patients undergoing coronary artery bypass grafting, divided into normal LVFN (≥ 55%, n = 23) or reduced LVFR (35-54%, n = 21) were evaluated. METHOD: Cardiac autonomic function was evaluated by heart rate variability indexes obtained both pre- and post-cardiac rehabilitation. All patients participated in a short-term (approximately 5 days) supervised inpatient physiotherapy program. RESULTS: There were differences in heart rate variability indexes, correlation dimension and SD2 according to time and group (e.g. interaction time (effect of cardiac rehabilitation) vs group (LVFN vs LVFR), p = 0.04). Simple main effects analysis showed that the LVFR group benefited to a greater degree from cardiac rehabilitation compared with the LVFN group. Heart rate variability indexes increased significantly in the former group compared with the latter. CONCLUSION: Among post-coronary artery bypass grafting patients engaged in short-term inpatient rehabilitation, those with reduced left ventricular function are most likely to have better cardiac autonomic adaptations to exercise-based rehabilitation.
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Borghi-Silva et al. (2011) conducted a cohort in Post-coronary artery bypass grafting (n=44). Short-term supervised inpatient physiotherapy exercise protocol vs. Normal left ventricular function (LVEF ≥ 55%) group was evaluated on Non-linear heart rate variability indexes (correlation dimension and SD2) (Cohen's d 0.92, 95% CI -0.47 to -0.07, p=0.04). Short-term inpatient cardiac rehabilitation resulted in significantly greater improvements in cardiac autonomic adaptations (correlation dimension and SD2) in post-CABG patients with reduced left ventricular function compared to those with normal left ventricular function.
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