有氧運動訓練對急性心肌梗塞後患者心率變異度之效果：統合分析

Whether aerobic exercise training can benefit the autonomic regulation remains disputable in patients after acute myocardial infraction (AMI). The purposes of this study were to conduct a meta-analysis to investigate the effect of aerobic exercise on heart rate variability (HRV) in patients after AMI, and to identify the possible factors influencing the above effects. Methods: Randomized or case control trials of supervised aerobic exercise for patients with uncomplicated AMI were selected for our systematic reviews and meta-analysis. Outcome measures included any HRV indices of standard deviation of NN intervals (SDNN), high frequency power (HF), normalized low frequency power (LF%), and low-high ratio (LF/ HF). Results: Six studies were finally included with a total number of 230 subjects. Meta-analysis showed supervised aerobic exercise significantly decreased LF% [effect size, d=0.61 (0.18, 1.04)] and LF/HF (d=0.54 (0.26, 0.83)). It also had small effect size on increasing SDNN [d=0.23 (-0.29, 0.75)] and HF [d=0.05(-0.61, 0.70)], but subgroups of lower functional capacity (NYHA≥class 2) and of lower SDNN (≤70ms) after AMI, could enhance SDNN and HF significantly. Conclusions: Aerobic exercise benefits patients after AMI to down-regulate the sympathetic activity and to modify the sympathovagal balance. This result may be value of a protective effect of life-threatening arrhythmia after AMI.