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Title: Heart rate recovery improvement in patients following acute myocardial infarction: exercise training, -blocker therapy or both
Authors: Medeiros, Wladimir Musetti [UNIFESP]
Luca, Fabio A. de
Figueredo Junior, Alcides R. de [UNIFESP]
Mendes, Felipe A. R.
Gun, Carlos
Keywords: autonomic function
cardiac rehabilitation
exercise testing
exercise training
heart disease
heart rate recovery
Issue Date: 2018
Publisher: Wiley
Citation: Clinical Physiology And Functional Imaging. Hoboken, v. 38, n. 3, p. 351-359, 2018.
Abstract: Heart rate recovery (HRR) is a strong mortality predictor. Exercise training (ET) and -blocker therapy have significant impact on the HRR of patients following myocardial infarction (MI). However, the combination of ET and -blocker therapy, as well as its effectiveness in patients with a more compromised HRR (12bpm), has been under-studied. Male patients (n=64) post-MI were divided: Training+-blocker (n=19), Training (n=15), -blocker (n=11) and Control (n=19). Participants performed an ergometric test before and after 3months of intervention. HRR was obtained during 5min of recovery and corrected by the cardiac reserve (HRRcorrCR). Compared to pre-intervention, HRRcorrCR was significantly increased during the 1st and 2nd minutes of recovery in the Training+-blocker group (70<bold></bold>5% and 37<bold></bold>5%, respectively
P<0<bold></bold>05). A significant improvement, lasting from the 1st to the 4th minute of recovery, was also observed in the Training group (47%, 50%, 25% and 8<bold></bold>7%, respectively
P<0<bold></bold>05). In contrast, the -blocker group showed a reduction in HRRcorrCR during the 2nd and 3rd minutes of recovery (-21<bold></bold>2% and -16<bold></bold>3%, respectively
P<0<bold></bold>05). In addition, interventions involving ET (Training+b, Training) were significantly more effective in patients with a pre-intervention HRR12bpm than for patients with HRR>12bpm. Combination of -blocker therapy with ET does not compromise the effect of training and instead promotes HRR and aerobic capacity improvement. In addition, this combination is particularly beneficial for individuals presenting with a more compromised HRR. However, chronic administration of -blocker therapy alone did not promote improvement in HRR or aerobic capacity.
ISSN: 1475-0961
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