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Title: High-intensity inspiratory protocol increases heart rate variability in myocardial revascularization patients
Authors: Rossi Caruso, Flavia Cristina
Simoes, Rodrigo Polaquini
Reis, Michel Silva
Guizilini, Solange [UNIFESP]
dos Santos Alves, Vera Lucia
Papa, Valeria
Arena, Ross
Borghi-Silva, Audrey
Keywords: Autonomic Nervous System
Respiratory Muscles
Heart Rate
Physical Therapy Modalities
Coronary Artery BypassObstructive Pulmonary-Disease
Bypass Graft-Surgery
Respiratory Movements
Autonomic Function
Cabg Surgery
Issue Date: 2016
Publisher: Hospital Clinicas, Univ Sao Paulo
Citation: Brazilian Journal Of Cardiovascular Surgery. Sao paulo sp, v. 31, n. 1, p. 38-44, 2016.
Abstract: Objective: To evaluate heart rate variability during an inspiratory muscle endurance protocol at three different load levels [30%, 60% and 80% of maximal inspiratory pressure], in patients who had previously undergone coronary artery bypass grafting. Methods: Nineteen late postoperative myocardial revascularization patients participating in a cardiovascular rehabilitation program were studied. Maximal inspiratory pressure maneuvers were performed. An inspiratory muscle endurance protocol at 30%, 60% and 80% of maximal inspiratory pressure was applied for four minutes each, in random order. Heart rate and RR intervals were recorded and heart rate variability was analyzed by time (RMSSD-the mean of the standard deviations for all R-R intervals, and RMSM-root-mean square differences of successive R-R intervals) and frequency domains indices (high and low frequency) in normalized units. ANOVA for repeated measurements was used to compare heart rate variability indices and Student t-test was used to compare the maximal inspiratory pressure and maximal expiratory pressure values. Results: Heart rate increased during performance of maximal respiratory pressures maneuvers, and the maximal inspiratory pressure and maximal expiratory pressure mean values were significantly lower than predicted values (P<0.05). RMSSD increased significantly at 80% in relation to rest and 30% of maximal inspiratory pressure and RMSM decreased at 30% and 60% of maximal inspiratory pressure in relation to rest (P<0.05). Additionally, there was significant and progressive decrease in low frequency and increase in high frequency at 30%, 60% and 80% of maximal inspiratory pressure in relation to the resting condition. Conclusion: These results suggest that respiratory muscle training at high intensities can promote greater parasympathetic activity and it may confer important benefits during a rehabilitation program in post-coronary artery bypass grafting.
ISSN: 0102-7638
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