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Vol. 22. Issue 2.
Pages 97-104 (01 March 2018)
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Vol. 22. Issue 2.
Pages 97-104 (01 March 2018)
Systematic Review
DOI: 10.1016/j.bjpt.2017.06.014
Exercise training to reduce sympathetic nerve activity in heart failure patients. A systematic review and meta-analysis
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María Javiera Saavedraa,e, Fernando Romerob,e, Jorge Roac,e, Iván Rodríguez-Núñezd,e,
Corresponding author
ivan.rodriguez@uss.cl

Corresponding author at: Faculty of Health Science, San Sebastián University, Los Maitenes Building, 4th Floor, 1457 Leintur, Concepción, Chile.
a Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile
b Centro de Neurociencias y Biología de Péptidos – CEBIOR, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
c Departamento de Fisiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
d Laboratorio de Biología del Ejercicio, Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile
e Departamento de Cirugía y CEMyQ, Universidad de La Frontera, Temuco, Chile
Highlights

  • Heart failure is associated to autonomic dysfunction of cardiovascular system characterized by sympathetic hyperactivity.

  • Exercise intervention promotes mechanisms that restores the autonomic balance.

  • The effects of exercise training on sympathetic nerve activity in heart failure patients have not been summarized.

  • In patients with heart failure, exercise training reduces sympathetic nerve activity compared with non-trained patients.

  • The quality of evidence across the studies was moderate and the heterogeneity across the studies was high.

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Table 1. Characteristics of the included articles.
Abstract
Objective

To determine the effects of exercise training on sympathetic nerve activity in heart failure patients.

Methods

A systematic review was performed. An electronic search of MEDLINE, ProQuest, SciELO, SPORTDiscus, Rehabilitation and Sport Medicine Source, Cumulative Index to Nursing and Allied Health Literature, Tripdatabase, Science Direct and PEDrO was performed from their inception to February 2017. Clinical trials and quasi-experimental studies were considered for primary article selection. The studies should include patients diagnosed with chronic heart failure that performed exercise training for at least 4 weeks. Sympathetic nerve activity should be measured by microneurography before and after the intervention. The Cochrane Collaboration's Risk of Bias Tool was used to evaluate risk of bias, and the quality of evidence was rated following the GRADE approach. Standardized mean differences (SMD) were calculated for control and experimental groups. Meta-analysis was performed using the random effects model.

Results

Five trials were included. Overall, the trials had moderate risk of bias. The experimental group indicated a significant decrease in the number of bursts per minute (SMD −2.48; 95% CI −3.55 to −1.41) when compared to the control group. Meanwhile, a significant decrease was also observed in the prevalence of bursts per 100 beats in the experimental group when compared to the control group (SMD −2.66; 95% CI −3.64 to −1.69).

Conclusion

Exercise training could be effective in reducing sympathetic nerve activity in patients with heart failure. The quality of evidence across the studies was moderate. Future studies are necessary to confirm these results.

Keywords:
Physical training
Heart failure
Muscle sympathetic nerve activity
Autonomic nervous system

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