Increase in the heart rate variability with deep breathing in diabetic patients after 12-month exercise training.

Department of Physiology, Kasturba Medical College, Mangalore, India.
The Tohoku Journal of Experimental Medicine (Impact Factor: 1.37). 01/2010; 220(2):107-13. DOI: 10.1620/tjem.220.107
Source: PubMed

ABSTRACT Autonomic neuropathy in diabetes leads to impaired regulation of blood pressure and heart rate variability (HRV), which is due to a shift in cardiac autonomic balance towards sympathetic dominance. Lower HRV has been considered a predictor of cardiac mortality and morbidity. Deep breathing test is a simple method to measure HRV and it provides a sensitive measure of cardiac autonomic function. The effect of long-term physical activity on HRV in type-2 diabetes mellitus is inconclusive. We aimed to evaluate the effects of regular physical exercise on HRV with deep breathing in type 2 diabetes (n = 105). Thirty normotensive diabetic patients and 25 hypertensive diabetic patients underwent physical exercise program for 12 months, and the other 50 patients (22 normotensive and 28 hypertensive diabetic patients) were considered the non-exercised group. Electrocardiogram was recorded during deep breathing and HRV was measured. Regular exercise significantly increased HRV in diabetic patients with and without hypertension. The degree of the increase in HRV was greater in hypertensive diabetic patients (p < 0.01) than in normotensive diabetic patients (p < 0.05). After exercise, glycosylated hemoglobin levels were decreased in both groups of diabetic patients. Moreover, the hypertensive diabetic patients showed a decrease (p < 0.05) in blood pressure after regular exercise. Thus, regular exercise training increases HRV, suggesting that there is a shift in the cardiac sympathovagal balance in favor of parasympathetic dominance in diabetic patients. Long-term physical training may be an effective means to reverse the autonomic dysregulation seen in type 2 diabetes.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Heart rate variability (HRV) analysis is a popular tool for the assessment of autonomic cardiac control. These measurements are increasingly employed in studies ranging from investigations of central autonomic regulation; to studies exploring the link between psychological processes and physiological functioning; to the indication of ANS activity in response to exercise, training and overtraining. Many publications elaborate on the effect of exercise on HRV and by implication on cardiac functioning. However, results on the effects of exercise on the autonomic control of the heart are often contradictory and incomplete in the normal population and in disease. In order to understand and employ the effects of exercise in patients with cardiovascular disorders it is of primary importance that agreement should be reached on the effects of exercise in the normal and healthy population. In this chapter, a selection of older and more recent publications, investigating autonomic training effects as measured by cardiovascular variability indicators, are summarized. Reasons for heterogeneous results are identified and discussed. The chapter concludes with specific recommendations for future research.
    Cardiovascular System: Anatomy and Physiology, Short and Long-Term Effects of Exercise and Abnormalities, Edited by Mark E. Oberfield and Thomas A. Speiser, 10/2013: chapter Autonomic Cardiovascular Control: Measurement and the Effects of Exercise; NOVA Publishers., ISBN: 978-1-62948-308-5
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To compare the impact of walking with a recreational activity on postprandial glycemia, heart rate variability, and mood state following the dinner meal. Design Participants with type 2 diabetes (T2D) participated in 3 trials on different days in random order after ingestion of a standardized dinner meal (300 ± 6 kcals). Setting University clinical testing laboratory. Participants Twelve participants (9 female, 3 male; 58.7 ± 2.4 years) with uncomplicated T2D not taking insulin or beta-blocker medications. Intervention Thirty minutes of self-paced walking on a treadmill (TM), 30 minutes of table tennis played continuously against the iPong robot (TT), and 30 minutes of rest (CON) undertaken 30 minutes after the start of ingestion of the same dinner meal on three occasions within a week. Measurements Blood glucose was measured at 30-minute intervals through 180 minutes starting immediately prior to the dinner meal. Profile of Mood States was completed before and immediately following exercise or rest. Sympathovagal balance (heart rate variability) was measured prior to eating and 30 minutes after trial completion. Results Compared with TT or CON, TM resulted in significantly lower postprandial blood glucose (P < .05), as well as a greater quantity of physical activity than TT (+72%) or rest (+91%; P < .01). Mean heart rate during TM was significantly greater than during TT (+25.9 beats per minute; P < .01). However, neither mood state nor HRV were significantly different among trials. Conclusions Thirty minutes of self-paced walking following the dinner meal may be more effective at lowering postprandial glycemia in T2D than a similar duration of table tennis played continuously against a robot.
    Journal of the American Medical Directors Association 04/2014; · 5.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Biofeedback of heart rate variability (HRV) was applied to patients with diabetic polyneuropathy using a new mobile device allowing regularly scheduled self-measurements without the need of visits to a special autonomic laboratory. Prolonged generation of data over an eight-week period facilitated more precise investigation of cardiac autonomic function and assessment of positive and negative trends of HRV parameters over time. Statistical regression analyses revealed significant trends in 11 of 17 patients, while no significant differences were observed when comparing autonomic screening by short-term HRV and respiratory sinus arrhythmia at baseline and after the 8 weeks training period. Four patients showed positive trends of HRV parameters despite the expected progression of cardiac autonomic dysfunction over time. Patient compliance was above 50% in all but two patients. The results of this preliminary study indicate a good practicality of the handheld device and suggest a potential positive effect on cardiac autonomic neuropathy in patients with type 2 diabetes.
    Clinical Physiology and Functional Imaging 01/2014; · 1.33 Impact Factor