High-Intensity Inspiratory Protocol Increases Heart Rate Variability in Myocardial Revascularization Patients.

Autor:	Caruso FC; Laboratory of Cardiopulmonary Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil., Simões RP; Laboratory of Cardiopulmonary Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil., Reis MS; Department of Physiotherapy, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Guizilini S; Department of Sciences of Human Movement, Federal University of São Paulo, Santos, SP, Brazil., Alves VL; Faculty of Medical Sciences at Santa Casa de São Paulo, São Paulo, SP, Brazil., Papa V; Hospital São Francisco of Ribeirão Preto, Ribeirão Preto, SP, Brazil., Arena R; Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA., Borghi-Silva A; Laboratory of Cardiopulmonary Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2016 Feb; Vol. 31 (1), pp. 38-44.
DOI:	10.5935/1678-9741.20160007
Abstrakt:	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.
Databáze:	MEDLINE
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