title: Effects of neuromuscular electrical stimulation and aerobic exercise training on arterial stiffness and autonomic functions in patients with chronic heart failure.
abstract: Neuromuscular electrical stimulation (NMES) of leg muscles has been introduced in clinical practice as a rehabilitation (RHB) method in patients with chronic heart failure (CHF); however, the role of NMES on the reduction of arterial stiffness and autonomic disbalance in these patients has not yet been studied. Sixty-one patients with stable CHF (mean age 58.9 [2.1] years; mean ejection fraction 31 [4.2]%, New York Heart Association II-III) were randomly assigned into two groups. Patients in (i) exercise training group (ET; n = 30) underwent 12 weeks of bicycle ET (3 × 40 min/week); (ii) group NMES (n = 31) performed 12 weeks of NMES of quadriceps and calf muscles (frequency 10 Hz, mode "20 s on-20 s off," intensity 60 mA), 2 × 60 min/day. Noninvasive assessment of arterial stiffness was done using the cardio-ankle vascular index (CAVI). CAVI and heart rate variability (HRV) and ·VO(2peak) were evaluated before and after RHB program. Both types of RHB reduced significantly CAVI (ET from 9.6 [0.2] to 8.9 [0.2], P < 0.012; NMES from 9.3 [0.2] to 8.7 [0.2], P < 0.013), increased high frequency (HF) component of HRV (+65.6%; P = 0.001) and decreased ratio of low frequency (LF) component with HF component (LF/HF ratio) in group ET (-39.8%; P < 0.001). Changes of HRV parameters in group NMES were not significant; however, a marked tendency to autonomic stabilization was present. Both types of RHB led also to significant increase of ·VO(2peak) (ET from 18.7 [0.7] to 20.8 [0.7] mL/kg/min, P < 0.004; NMES from 17.3 [0.7] to 19.0 [0.7] mL/kg/min, P < 0.001). ET or NMES has been shown to improve significantly arterial stiffness and to stabilize autonomic balance.
authors.affiliation: Department of Sports Medicine and Rehabilitation, St. Anna Faculty Hospital in Brno, 65691 Brno, Czech Republic. petr.dobsak@fnusa.cz
authors.forename: Petr
authors.initials: P
authors.lastname: Dobšák
authors.forename: Josef
authors.initials: J
authors.lastname: Tomandl
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarova
authors.forename: Jiri
authors.initials: J
authors.lastname: Vitovec
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dusek
authors.forename: Marie
authors.initials: M
authors.lastname: Novakova
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
authors.forename: Jan
authors.initials: J
authors.lastname: Krejci
authors.forename: Petr
authors.initials: P
authors.lastname: Hude
authors.forename: Tomáš
authors.initials: T
authors.lastname: Honek
authors.forename: Jarmila
authors.initials: J
authors.lastname: Siegelova
authors.forename: Pavel
authors.initials: P
authors.lastname: Homolka
mesh_terms: D000368:Aged; D001158:Arteries / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006339:Heart Rate; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology; D059289:Vascular Stiffness