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

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 < 25 kg/m(2); 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 10 min 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 30 sec of recovery (P = 0.04). Conclusion: Among patients undergoing a CRP after ACS, increased HRR after a 6MWT, especially at 3 min, 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.
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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01873725
Contributeur : Caps - Université de Bourgogne <>
Soumis le : jeudi 13 septembre 2018 - 15:35:56
Dernière modification le : jeudi 11 avril 2019 - 16:48:01

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Tiffany Astolfi, Fabio Borrani, Milos Savcic, Vincent Grémeaux, Grégoire Millet. Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome. Annals of Physical and Rehabilitation Medicine, Elsevier Masson, 2018, 61 (2), pp.65 - 71. ⟨10.1016/j.rehab.2017.10.005⟩. ⟨hal-01873725⟩

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