Effects of exercise-based cardiac rehabilitation on heart rate variability and turbulence in patients with ST elevation myocardial infarction

Yıl 2020, Cilt: 6 Sayı: 1, 26 - 35, 04.01.2020

İsmet Zengin Selma Arı Hasan Arı Mehmet Melek

https://doi.org/10.18621/eurj.447020

Öz

Objectives: The
objective of this study was to evaluate the effect of the exercise-based cardiac
rehabilitation (CR) on the heart rate variability (HRV) and turbulence (HRT) in
patients with ST elevation myocardial infarction (STEMI) treated with the
primary percutaneous coronary intervention (PCI).

Methods: One hundred
one patients with STEMI, who underwent primary PCI were included in our study. Sixty-eight
of these patients were randomized to the CR group and the remaining 33 patients
to the control group. One month after the primary PCI, cardiac rehabilitation
was performed in CR group with a cycle ergometer for 8 weeks (30 sessions). One
month after STEMI, rhythm Holter monitorization was carried out in both groups
for 48 hours. The rhythm Holter monitorization was repeated in cardiac
rehabilitation group (CR group) after the cardiac rehabilitation again for 48
hours. HRV was evaluated according to time and frequency domains; HRT was
evaluated with the turbulence onset and turbulence slope parameters obtained
from the Holter recordings.

Results: Baseline
characteristics and baseline HRV and HRT parameters were comparable between CR
group and control group. In CR group, there was no statistically significant
difference between the HRV and HRT parameters, which were obtained before and
after the cardiac rehabilitation. The subgroup analyses (left ventricular
ejection fraction lower or higher than 40%) showed that turbulence onset
improved with the cardiac rehabilitation in the group with an ejection fraction
lower than 40%.

Conclusions: Our
results showed that exercise-based cardiac rehabilitation did not affect HRV
and HRT in patients whose left ventricular ejection fraction was mildly
affected (> 40%) after the treatment with primary PCI. However, the cardiac
rehabilitation provided an improvement of turbulence onset in patients with the
low left ventricular ejection fraction.

Anahtar Kelimeler

Cardiac rehabilitation, ST elevation myocardial infarction, heart rate variability, heart rate turbulence

Kaynakça

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