Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease.

The objective of this research was to investigate whether heart rate variability (HRV)-guided training improves mortality predictors to a greater extent than predefined training in coronary artery disease patients. Twenty-one patients were randomly allocated to the HRV-guided training group (HRV-G) or the predefined training group (PRED-G). They measured their HRV at home daily and trained three times a week for six weeks. Resting heart rate, isolated vagal-related HRV indices (i.e., RMSSD, HF, and SD1), weekly averaged RMSSD, heart rate recovery, and maximum oxygen uptake were assessed before and after the training period. There was a statistically significant difference (p = 0.034) in the change in weekly averaged RMSSD in favor of the HRV-G, while no differences were found in the remaining analyzed variables (p > 0.050). Regardless of the training prescription method, exercise training decreased resting heart rate (p = 0.001; -4.10 [95% CI = -6.37--1.82] beats per minute (bpm)), and increased heart rate recovery at 2 min (p = 0.010; 4.33 [95% CI = 1.15-7.52] bpm) and maximum oxygen uptake (p < 0.001; 3.04 [95% CI = 1.70-4.37] mL·kg-1·min-1). HRV-guided training is superior to predefined training in improving vagal-related HRV when methodological factors are accounted for.

Estrategias de prevención secundaria del síndrome coronario agudo / Secondary Prevention Strategies for Acute Coronary Syndrome

La enfermedad cardiovascular es el principal problema de salud en Europa y el resto del mundo y la primera causa de mortalidad y gasto sanitario. Las estrategias de prevención tienen un papel fundamental en el paciente que ha tenido un síndrome coronario agudo, pues consiguen un declive en la mortalidad de estos pacientes y una reducción en la recurrencia de eventos isquémicos. Sin embargo, estas estrategias de prevención, que se han centrado en la población de alto riesgo con gran éxito, deben utilizarse también para la población general, en la que se está observando un incremento en la prevalencia de obesidad, diabetes mellitus y otras comorbilidades que pueden invertir la tendencia. En este artículo se pretende hacer una puesta al día sobre las principales medidas de prevención cardiovascular, especialmente las novedades aparecidas en el último año, y las particularidades de dichas medidas cuando se orientan al paciente que ha presentado un síndrome coronario agudo (AU)

Cardiovascular disease is the main health problem in Europe and the rest of the world and is the leading cause of death and health care expenditure. By reducing mortality and ischemic event recurrence, prevention strategies play a fundamental role in patients who have had an acute coronary syndrome. Although these prevention strategies have focused with great success on high-risk individuals, they should also be used in the general population, which is showing an increase in the prevalence of obesity, diabetes mellitus, and other comorbidities that may reverse this trend toward reduced mortality. The present article consists of an up-to-date review of the main cardiovascular prevention measures, particularly the new developments of the last year, as well as the particularities of these measures when they are targeted at patients with a prior acute coronary síndrome (AU)

Update: Acute coronary syndromes (IX). Secondary prevention strategies for acute coronary syndrome.

Cardiovascular disease is the main health problem in Europe and the rest of the world and is the leading cause of death and health care expenditure. By reducing mortality and ischemic event recurrence, prevention strategies play a fundamental role in patients who have had an acute coronary syndrome. Although these prevention strategies have focused with great success on high-risk individuals, they should also be used in the general population, which is showing an increase in the prevalence of obesity, diabetes mellitus, and other comorbidities that may reverse this trend toward reduced mortality. The present article consists of an up-to-date review of the main cardiovascular prevention measures, particularly the new developments of the last year, as well as the particularities of these measures when they are targeted at patients with a prior acute coronary syndrome.