title: Randomized controlled trial of heart rate variability biofeedback in cardiac autonomic and hostility among patients with coronary artery disease.
abstract: Hostility is a psychosocial risk factor that may decrease heart rate variability (HRV) in coronary artery disease (CAD) through cardiac autonomic imbalance. Heart rate variability biofeedback (HRV-BF) increases HRV indices and baroreflex gain. This study examines the effectiveness of HRV-BF in restoring cardiac autonomic balance and decreasing hostility among patients with CAD. One hundred and fifty-four patients with CAD were assigned randomly to receive 6 weeks of HRV-BF, in addition to the standard medical care received by the wait-list control (WLC) group. A 5-min electrocardiogram, blood pressure, and hostility were assessed pre-intervention, post-intervention, and at 1-month follow-up. The standard deviation of normal-to-normal intervals (SDNN), low frequency (LF), and log LF at post-intervention was significantly higher than that at pre-intervention in the HRV-BF group. Baseline log LF was significantly higher post-intervention and at follow-up after HRV-BF training than at pre-intervention. The treatment curve of log LF pre-session increased significantly after session 2, which was maintained to post-intervention. Expressive hostility, suppressive hostility, and hostility total score at post-intervention and one-month follow-up after HRV-BF were significantly lower than at pre-intervention. This study showed increased HRV and decreased expressive and suppressive hostility behavior in patients with CAD following HRV-BF.
authors.affiliation: Department of Psychology, Kaohsiung Medical University, Taiwan. Electronic address: psyiml@kmu.edu.tw.
authors.forename: I-Mei
authors.initials: IM
authors.lastname: Lin
authors.affiliation: Institute of Gerontology, National Cheng Kung University, Taiwan.
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Fan
authors.affiliation: Department of Psychology, Kaohsiung Medical University, Taiwan.
authors.forename: Hsueh-Chen
authors.initials: HC
authors.lastname: Lu
authors.affiliation: Division of Cardiology, Kaohsiung Medical University Hospital, Taiwan.
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Kaohsiung Medical University Hospital, Taiwan; Division of Cardiology, Kaohsiung Municipal Ta-Tung Hospital, Taiwan.
authors.forename: Chih-Sheng
authors.initials: CS
authors.lastname: Chu
authors.affiliation: Division of Cardiology, Kaohsiung Municipal Ta-Tung Hospital, Taiwan.
authors.forename: Hsuan-Fu
authors.initials: HF
authors.lastname: Kuo
authors.affiliation: Division of Cardiology, Kaohsiung Medical University Hospital, Taiwan.
authors.forename: Chee-Siong
authors.initials: CS
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Kaohsiung Medical University Hospital, Taiwan.
authors.forename: Ye-Hsu
authors.initials: YH
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology; D001676:Biofeedback, Psychology / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000523:psychology*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Cardiac autonomic; Coronary artery disease; Heart rate variability biofeedback; Hostility