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Sanatorium rehabilitation effects on vegetative test dynamics in myocardial infarction patients

Abstract

Aim. To study dynamics of vegetative reflex tests (VRT) during sanatorium rehabilitation in patients with noncomplicated myocardial infarction (MI).
Material and methods. In total, 106 men (mean age 48,6±1,0 years) were examined 44,3±3,2 days after MI, before
and after sanatorium6based rehabilitation. Heart rate variability (HRV) was assessed during 24-hour electrocardiography (ECG), ECG at rest, active orthostatic test (AOT) and controlled breath rate test (CBRT). Physical stress tolerability (PST) and echocardiography parameters were also assessed.
Results. After rehabilitation course, low frequency HRV component was increased in rest ECG (by 19 % for absolute values (p=0,06), by 5 % for normalized values (p=0,08)) and during AOT (by 27,3 % (р=0,015) and 6,2 % (р=0,011), respectively). CBRT results remained the same. Veloergometry PST increased by 10,1 %, end-systolic and end-diastolic left ventricular (LV) volumes decreased by 8,7 % and 6,6 %, respectively, asynergic area reduced by 6,0 %, and LV ejection fraction increased by 6,1 %. Rehabilitation adequacy was also confirmed by some decrease in mean HR and ventricular extrasystole rate during 246hour ECG monitoring.
Conclusion. The results obtained could facilitate HRV data use in physical rehabilitation effectiveness assessment,
optimizing and individual tailoring of rehabilitation programs.

About the Authors

A. N. Sumin
Scientific and Clinical Center of Miners’ Health, Leninsk-Kusnetsky
Russian Federation


V. L. Beresneva
Taraskul Rehabilitation Center, Tumen
Russian Federation


T. N. Enina
Taraskul Rehabilitation Center, Tumen
Russian Federation


N. N. Verkhoshapova
Taraskul Rehabilitation Center, Tumen
Russian Federation


E. A. Kabova
Taraskul Rehabilitation Center, Tumen
Russian Federation


V. I. Valeeva
Taraskul Rehabilitation Center, Tumen
Russian Federation


N. V. Shanaurina
Taraskul Rehabilitation Center, Tumen
Russian Federation


References

1. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use /Task Force of The European Society of Cardiologi and The North American Society of pacing and Electrophysiology. Eur Heart J 1996; 17: 354–81.

2. Явелов И.С., Грацианский Н.А., Зуйков Ю.А. Вариабельность ритма сердца при острых коронарных синдромах: значение для оценки прогноза заболевания (часть II). Кардиология 1997; 3: 74–81.

3. La Rovere MT, Bigger JTJr, Marcus FI, et al. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet 1998; 351: 478–84.

4. Жук В.С., Болдуева С.А., Леонова И.А. и др. Вариабельность сердечного ритма при вегетативных пробах у больных инфарктом миокарда и ее прогностическое значение для внезапной сердечной смерти. Ультразв функцион диагн 2002; 4: 102–6.

5. Абрамкин Д.В., Явелов И.С., Грацианский Н.А. Сравнение значения изменений ЧСС во время рефлекторных тестов и вариабельности ритма сердца для прогноза внезапной сердечной смерти у больных, перенесших инфаркт миокарда. Кардиология 2004; 9: 34–41.

6. Гизатулина Т.П., Шалаев С.В., Петрик С.В., Петрик Е.С. Уровень симпатовагального баланса при активной ортостатической пробе – независимый предиктор внезапной смерти у больных инфарктом миокарда. Кардиоваск тер профил 2004; 4: 57–62.

7. Lee CM, Wood RH, Welsch MA. Influence of short-term endurance exercise training on heart rate variability. Med Sci Sports Exerc 2003; 35(6): 961–9.

8. Сумин А.Н., Енина Т.Н., Верхошапова Н.Н. и др. Динамика вегетативного статуса при различных результатах реабилитации больных инфарктом миокарда. Вест аритмол 2004; 37: 32–9.

9. Швалев В.Н., Тарский Н.А. Феномен ранней возрастной инволюции симпатического отдела вегетативной нервной системы. Кардиология 2001; 2: 10–4.

10. Oya M, Itoh H, Kato K, et al. Effects of exercise training on the recovery of the autonomic nervous system and exercise capacity after acute myocardial infarction. Jpn Circ J 1999; 63(11): 843–8.

11. La Rovere MT, Bersano C, Gnemmi M, et al. Exercise6induced increase in baroreflex sensitivity predicts improved prognosis after myocardial infarction. Circulation 2002; 106(8): 945–9.

12. Lucini D, Milani RV, Costantino G, et al. Effects of cardiac rehabilitation and exercise training on autonomic regulation in patients with coronary artery disease. Am Heart J 2002; 143(6): 977–83.

13. Tegtbur U, Meyer H, Machold H, Busse MW. Exercise recommendation and catecholamines in patients with coronary artery disease. Z Kardiol 2002; 91(11): 927–36.

14. Pichot V, Busso T, Roche F, et al. Autonomic adaptations to intensive and overload training periods: a laboratory study. Med Sci Sports Exerc 2002; 34(10): 1660–6.

15. Cottin F, Medigue C, Lepretre PM, et al. Heart rate variability during exercise performed below and above ventilatory threshold. Med Sci Sports Exerc 2004; 36(4): 594–600.

16. Mourot L, Bouhaddi M, Perrey S, et al. Decrease in heart rate variability with overtraining: assessment by the Poincare plot analysis. Clin Physiol Funct Imag 2004; 24(1): 10–8.

17. Lind P, Hintze U, Moller M, Mickley H. Thrombolytic therapy preserves vagal activity early after acute myocardial infarction. Scand Cardiovasc J 2001; 35(2): 92–5.

18. Monmeneu JV, Chorro FJ, Bodi V, et al. Relationships between heart rate variability, functional capacity, and left ventricular function following myocardial infarction: an evaluation after one week and six months. Clin Cardiol 2001; 24(4): 313–20.

19. Lampert R, Ickovics JR, Viscoli CJ, et al. Effects of propranolol on recovery of heart rate variability following acute myocardial infarction and relation to outcome in the Beta6Blocker Heart Attack Trial. Am J Cardiol 2003; 91(2): 137–42.

20. Cooke WH, Reynolds BV, Yandl MG, et al. Effects of exercise training on cardiovagal and sympathetic responses to Valsalva’s maneuver. Med Sci Sports Exerc 2002; 34(6): 928–35.

21. Blumenthal JA, Sherwood A, Babyak MA, et al. Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: a randomized controlled trial. JAMA 2005; 293(13): 1626–34.

22. Михайлов В.М. Вариабельность ритма сердца: опыт практического применения метода. Изд. Второе, переработанное и доп. Иваново 2002; 290 с.

23. Конради Г.П. Рефлексы на сердце с аортально-каротидной зоны и рецепторов крупных артерий. В книге: Физиология кровообращения. Физиология сердца. Ленинград “Наука” 1980; 475–85.

24. Buchheit M, Simon C, Piquard F, et al. Effect of increased training load on vagal-related indexes of heart rate variability: a novel sleep approach. Am J Physiol Heart Circ Physiol 2004; 287(6): H2813–8.

25. Uusitalo AL, Uusitalo AJ, Rusko HK. Endurance training, overtraining and baroreflex sensitivity in female athletes. Clin Physiol 1998; 18(6): 510–20.

26. Чумакова Г.А., Киселева Е.В., Чурсина В.И., Лычев В.Г. Влияние физических тренировок различной интенсивности на постинфарктное моделирование и функцию левого желудочка. Кардиология 2003; 2: 71–2.

27. Kubo N, Ohmura N, Nakada I, et al. Exercise at ventilatory threshold aggravates left ventricular remodeling in patients with extensive anterior acute myocardial infarction. Am Heart J 2004; 147(1): 113–20.

28. Skinner JS, Wilmore KM, Krasnoff JB, et al. Adaptation to a standardized training program and changes in fitness in a large, heterogeneous population: the HERITAGE Family Study. Med Sci Sports Exerc 2000; 32(1): 157–61.

29. Иванов А.П., Эльгардт И.А., Сдобникова Н.С. Вегетативный баланс, вариабельность и нарушения ритма у больных, перенесших инфаркт миокарда. Тер архив 2001; 12: 49–52.

30. Jensen-Urstad K, Bouvier F, Saltin B, Jensen-Urstad M. High prevalence of arrhythmias in elderly male athletes with a lifelong history of regular strenuous exercise. Heart 1998; 79(2): 161–4.


Review

For citations:


Sumin A.N., Beresneva V.L., Enina T.N., Verkhoshapova N.N., Kabova E.A., Valeeva V.I., Shanaurina N.V. Sanatorium rehabilitation effects on vegetative test dynamics in myocardial infarction patients. Cardiovascular Therapy and Prevention. 2008;7(1):52-58. (In Russ.)

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