Heart rate recovery improvement in patients following acute myocardial infarction: exercise training, β‐blocker therapy or both |
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| Authors: | Wladimir M. Medeiros Fabio A. de Luca Alcides R. de Figueredo Júnior Felipe A. R. Mendes Carlos Gun |
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| Affiliation: | 1. Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), S?o Paulo, Brazil;2. Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, Federal University of S?o Paulo (UNIFESP), S?o Paulo, Brazil;3. Department of Rehabilitation and Functional Capacity, School of Physiotherapy, Ibirapuera University (UNIB), S?o Paulo, Brazil |
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| Abstract: | Heart rate recovery (HRR) is a strong mortality predictor. Exercise training (ET) and β‐blocker therapy have significant impact on the HRR of patients following myocardial infarction (MI). However, the combination of ET and β‐blocker therapy, as well as its effectiveness in patients with a more compromised HRR (≤12 bpm), has been under‐studied. Male patients (n = 64) post‐MI were divided: Training + β‐blocker (n = 19), Training (n = 15), β‐blocker (n = 11) and Control (n = 19). Participants performed an ergometric test before and after 3 months of intervention. HRR was obtained during 5 min 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 + β‐blocker group (70·5% and 37·5%, respectively; P<0·05). A significant improvement, lasting from the 1st to the 4th minute of recovery, was also observed in the Training group (47%, 50%, 25% and 8·7%, respectively; P<0·05). In contrast, the β‐blocker group showed a reduction in HRRcorrCR during the 2nd and 3rd minutes of recovery (?21·2% and ?16·3%, respectively; P<0·05). In addition, interventions involving ET (Training + βb, Training) were significantly more effective in patients with a pre‐intervention HRR ≤ 12 bpm than for patients with HRR > 12 bpm. Combination of β‐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 β‐blocker therapy alone did not promote improvement in HRR or aerobic capacity. |
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| Keywords: | autonomic function beta‐blocker cardiac rehabilitation exercise testing exercise training heart disease heart rate recovery |
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