Effects of 6 Months of Exercise-Based Cardiac Rehabilitation on Autonomic Function and Neuro-Cardiovascular Stress Reactivity in Coronary Artery Disease Patients.

Content Provider	Europe PMC
Author	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
Abstract	BackgroundAutonomic 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 ResultsTwenty‐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.ConclusionsSix 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.
Page Count	10
Journal	Journal of the American Heart Association
Volume Number	8
PubMed Central reference number	PMC6755845
Issue Number	17
PubMed reference number	31438760
e-ISSN	20479980
DOI	10.1161/jaha.119.012257
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2019-08-23
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Subject Keyword	autonomic nervous system coronary artery disease exercise training myocardial infarction sympathetic nerve activity Autonomic Nervous System Cardiovascular Disease Chronic Ischemic Heart Disease Myocardial Infarction Exercise
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine