Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome

Tiffany Astolfi; Fabio Borrani; Milos Savcic; Vincent Gremeaux; Grégoire P Millet

doi:10.1016/j.rehab.2017.10.005

Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome

Ann Phys Rehabil Med. 2018 Mar;61(2):65-71. doi: 10.1016/j.rehab.2017.10.005. Epub 2017 Dec 6.

Authors

Tiffany Astolfi¹, Fabio Borrani¹, Milos Savcic², Vincent Gremeaux³, Grégoire P Millet¹

Affiliations

¹ Institute of Sport Sciences of University of Lausanne (ISSUL), Lausanne, Switzerland.
² Actif+ Center, clinic Bois-Cerf, Lausanne, Switzerland.
³ Institute of Sport Sciences of University of Lausanne (ISSUL), Lausanne, Switzerland; Swiss Olympic Medical Center, Sport Medicine Unit, Locomotor Apparatus Department, Lausanne University Hospital, Lausanne, Switzerland; Rehabilitation Department, University Hospital Dijon, 21000 Dijon, France. Electronic address: vincent.gremeaux@chu-dijon.fr.

PMID: 29223653
DOI: 10.1016/j.rehab.2017.10.005

Abstract

Background: An efficient cardiac rehabilitation programme (CRP) can improve the functional ability of patients after acute coronary syndrome (ACS).

Objective: To examine the effect of a CRP on parasympathetic reactivation and heart rate recovery (HRR) measured after a 6-min walk test (6MWT), and correlation with 6MWT distance and well-being after ACS.

Methods: Eleven normoweight patients after ACS (BMI<25kg/m²; 10 males; mean [SD] age 61 [9] years) underwent an 8-week CRP. Before (pre-) and at weeks 4 (W4) and 8 (W8) during the CRP, they performed a 6MWT on a treadmill, followed by 10-min of seated passive recovery, with HRR and HR variability (HRV) recordings. HRR was measured at 1, 3, 5 and 10min after the 6MWT (HRR1, HRR3, HRR5, HRR10), then modelized by a mono-exponential function. Time-domain (square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals [RMSSD]) and frequency-domain (with high- and low-frequency band powers) were used to analyse HRV. Participants completed a mental and physical well-being questionnaire at pre- and W8. Exhaustion after tests was assessed by the Borg scale. Pearson correlation was used to assess correlations.

Results: HRR3, HRR5 and HRR10 increased by 37%, 36% and 28%, respectively, between pre- and W8 (P<0.05), and were positively correlated with change in 6MWT distance (r=0.58, 0.66 and 0.76; P<0.05). Percentage change in HRR3 was positively correlated with change in well-being (r=0.70; P=0.01). Parasympathic reactivation (RMSSD) was improved only during the first 30sec of recovery (P=0.04).

Conclusion: Among patients undergoing a CRP after ACS, increased HRR after a 6MWT, especially at 3min, was positively correlated with 6MWT distance and improved well-being. HRR raw data seem more sensitive than post-exercise HRV analysis for monitoring functional and autonomic improvement after ACS.

Keywords: Acute coronary syndrome; Autonomic nervous system; Cardiac rehabilitation; Heart rate recovery; Heart rate variability.

Publication types

Evaluation Study

MeSH terms

Acute Coronary Syndrome / physiopathology
Acute Coronary Syndrome / rehabilitation*
Aged
Cardiac Rehabilitation / methods*
Exercise Tolerance / physiology*
Female
Heart Rate / physiology*
Humans
Male
Middle Aged
Recovery of Function / physiology*
Treatment Outcome
Walk Test