Heart rate autonomic responses during deep breathing and walking in hospitalised patients with chronic heart failure.

Objective. To evaluate the acute effect of physiotherapy (deep breathing exercises and walking) on heart rate variability in patients hospitalised with chronic heart failure (CHF). Design. Ten males with CHF (57 +/- 7 years) and 10 healthy controls (59 +/- 9 years) were included. Heart rate and RR intervals were recorded in the following conditions: supine, seated, during deep breathing exercises and during and after walking. Heart rate variability was analysed by linear and non-linear methods (alpha2, Mean HR, rMSSD, SDNN and ApEn). Results. Patients presented significantly lower SDNN (12.4 +/- 4 versus 26 +/- 8 ms), rMSSD (18.2 +/- 16.2 versus 25 +/- 19.5 ms) and ApEn (9.9 +/- 10 versus 16.68 +/- 22.6) during the walking compared to controls (p < 0.05). In addition, mean HR was significantly higher during and after walking for patients with CHF compared to controls (103 +/- 8 versus 80 +/- 2 bpm and 90 +/- 9 versus 68 +/- 2 bpm, respectively). Patients with CHF demonstrated a significant reduction of alpha2 during deep breathing (0.78 +/- 0.1) when compared to the seated position (1.08 +/- 0.1) and walking (1.15 +/- 0.2, p < 0.05). Additionally, rMSSD index increased during deep breathing when compared to walking in both groups. Conclusion. Deep breathing exercises and walking are safe and promote beneficial effects on heart rate variability in patients hospitalised for CHF.