Effect Of Six-minute Walking Training On Autonomic Nerve Function Of Patients Having Chronic Heart Failure

Background:Heart Failure (HF) is a clinical syndrome due to cardiac dysfunction. Because of myocardial dysfunction or myocardial loss, it leads to left ventricular expansion and/or hypertrophic remodeling, as well as nerve endocrine disorders. Eventually, circulation dysfunction arises, such as systemic organ hypoperfusion and blood stasis, accompanied by typical clinical symptoms and signs, such as fluid retention, dyspnea, fatigue (especially during exercise) and so on. Chronic Heart Failure (CHF) patients showed autonomic nervous system dysfunction, activated nervus sympatheticus and decreasing parasympathetic activity. Heart rate variability (HRV) reflects the activity of the autonomic nervous system and assesses the tension of cardiac sympathetic and parasympathetic as well as the balance between them quantitatively. Decreasing HRV indicates sympathetic tension increase and has negative effects. While increasing HRV indicates parasympathetic increasing tension and belongs to the protection factors. Deceleration Capacity (DC) of rate detection is a new detection on the basis of dynamic electrocardiogram discovered in recent years. Some foreign studies have confirmed that DC, which has high sensitivity and strong specificity, can analyze and measure the magnitude of the vagus nerve function quantitatively and independently. Long term moderate intensity aerobic exercise can strengthen the regulating function of cardiovascular autonomic and make the coordination and confrontation of sympathetic and parasympathetic nervous reach a new balance at a higher level. Six-minute walking test is a secondary load exercise, which meets the requirements of the medium intensity exercise training of the body. As the rehabilitation exercise for patients having heart failure, it is widely used in clinical practice.Objective:By detecting the changes of the index of heart function (six-minute walking distance, NT-proBNP), heart rate variability (HRV) and heart rate deceleration force (DC) before and after the exercise in patients having chronic heart failure, the effect of the six-minute walking training on heart function, HRV and DC of patients with chronic heart failure could be concluded. I also investigate the influence of the six-minute walking training on autonomic nervous function patients having chronic heart failure.Research methods:80patients with heart function Ⅱ-Ⅲ grade were randomly divided into training group (n=40) and control group (n=40). Two groups were treated with conventional anti heart failure drug. Training group insist six-minute walking exercise twice a day on the basis of the conventional treatment. Changes of the index of heart function. HRV and DC before and after the treatment are tested.Results:After the treatment, the cardiac function of training group and the control group was significantly improved. The indexes of HRV (SDNN, SDANN, RMSSD, PNN50) and DC of two groups were significantly higher than those before treatment (p<0.05). After the treatment, the indexes of HRV and DC of the training group were significantly higher than those in the control group (p<0.05).Conclusion:Six-minute walking exercise therapy in patients having chronic heart failure can significantly improve the autonomic nervous function, which is an effective and safe rehabilitation exercise for patients having chronic heart failure.