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European Heart Journal 1995 16(10):1380-1386;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Circadian pattern of heart rate variability in chronic heart failure patients Effects of physical training

S. ADAMOPOULOS*,{dagger}, P. PONIKOWSKI*, E. CERQUETANI*, M. PIEPOLI*,{dagger}, G. ROSANO*, P. SLEIGHT{dagger} and A. J. S. COATS*

*Cardiac Medicine, National Heart & Lung Institute, University of London London
{dagger}Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford Oxford, U.K

revised 5 September 1994; accepted 30 November 1994.

Correspondence. Dr Massimo Piepoli, Department of Cardiac Medicine, National Heart & Lung Institute, London, SW3 6LY, U.K.

Abstract

The effect of physical training on the circadian pattern of heart rate variability (recorded over 24 h in relation to both time and frequency) was assessed in 12 chronic heart failure patients randomized, in a cross-over design, to 8 weeks training or detraining, and compared with 12 age-matched normals. Training improved heart rate variability indices: all R-R interval 5 min standard deviations increased by 17.6%, the root mean square of the differences of successive R-R intervals by 34.9%, the percentage difference between adjacent normal R~R intervals>50 ms by 112.5%, total power by 58.3%, high frequency by 128.5% and low frequency by 65.0%. Compared with controls, circadian variations in autonomic parameters were maintained in chronic heart failure. Training-induced changes were observed at different time intervals throughout the day: the highest values were at 0100 h-0700 h (detraining: low frequency 361±83 ms2, high frequency 126±47 ms2; training: low frequency 535±202 ms2, high frequency 227±115 ms2, P<0.01) and the lowest at 1300 h-1900 h (detraining: low frequency 91±23 ms2, high frequency 39±14 ms2; training: low frequency 154±42 ms2, high frequency 133±67 ms2, P<0.05). In chronic heart failure, training maintains and improves circadian variations in heart rate variability measures.

Key Words: Heart rate variability • 24 h ECG Holter monitoring • autonomic nervous system • power spectral analysis • heart failure • training


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