Finding
Thus, other studies are needed to further investigate these questions, with greater control of variables, in order to assess the autonomic adaptations, using better standardization of the prescription / monitoring of physical training in group of patients with Chagasic heart disease, so that we might have auspicious data.
Paper
Cardiac Medications Can Influence the Exercise Prescription in Chagas Heart Disease
Very Rigorous Journal
Citations: 0
Full textAbstract
Dear Editor, The study by Nascimento et al.1 provides information on the effects of physical training and the Heart Rate Variability (HRV) in patients with Chagasic heart disease. Changes in HRV were not observed after exercise intervention, but the intervention group showed improved functional capacity after 12 weeks of the study. Changes in the autonomic nervous system are observed in Chagasic heart disease and although physical training can improve HRV in other forms of heart failure, evidence suggests it does not happen in Chagasic heart disease2, corroborating findings by Nascimento et al1. However, in addition to the relatively few studies on the subject, which limits further conclusions, questions related to exercise prescription in the present study need to be better clarified. Although the protocol was established through a previous publication of a randomized clinical trial on the subject3, the lack of description on drug use by the study subjects such as beta blockers, which can have an effect on chronotropism, reducing the heart rate, might have altered the study outcome. Therefore, formulas that estimate the intensity of training, such as the one used in the aforementioned study, become limited in the presence of drugs with chronotropic interaction. In addition, the non-use of the ergospirometry test when prescribing exercises may have impaired the actual establishment of training intensity. In this context, it is known that different intensities produce different adaptations in the system, which, in turn, may have influenced different autonomic adaptations after the intervention period. These factors might have influenced the intervention in the clinical trial carried out by Nascimento et al.1 and influenced the measured outcome. Thus, other studies are needed to further investigate these questions, with greater control of variables, in order to assess the autonomic adaptations, using better standardization of the prescription / monitoring of physical training in group of patients with Chagasic heart disease, so that we might have auspicious data.
Authors
R. M. Cunha, R. P. Santos, A. Lehnen
Journal
Arquivos Brasileiros de Cardiologia