title: Exercise training-induced modification in autonomic nervous system: An update for cardiac patients.
abstract: Patients with cardiovascular disease show autonomic dysfunction, including sympathetic activation and vagal withdrawal, which leads to fatal events. This review aims to place sympathovagal balance as an essential element to be considered in management for cardiovascular disease patients who benefit from a cardiac rehabilitation program. Many studies showed that exercise training, as non-pharmacologic treatment, plays an important role in enhancing sympathovagal balance and could normalize levels of markers of sympathetic flow measured by microneurography, heart rate variability or plasma catecholamine levels. This alteration positively affects prognosis with cardiovascular disease. In general, cardiac rehabilitation programs include moderate-intensity and continuous aerobic exercise. Other forms of activities such as high-intensity interval training, breathing exercises, relaxation and transcutaneous electrical stimulation can improve sympathovagal balance and should be implemented in cardiac rehabilitation programs. Currently, the exercise training programs in cardiac rehabilitation are individualized to optimize health outcomes. The sports science concept of the heart rate variability (HRV)-vagal index used to manage exercise sessions (for a goal of performance) could be implemented in cardiac rehabilitation to improve cardiovascular fitness and autonomic nervous system function.
authors.affiliation: Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Besnier
authors.affiliation: Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Department of Rehabilitation, Toulouse University Hospital, Toulouse, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Labrunée
authors.affiliation: Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Unit of Hypertension, Risk Factors and Heart Failure, Clinique Pasteur, Toulouse, France.
authors.forename: Atul
authors.initials: A
authors.lastname: Pathak
authors.affiliation: Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Pavy-Le Traon
authors.affiliation: Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Galès
authors.affiliation: Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Sénard
authors.affiliation: Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville, France. Electronic address: t.guiraud@clinique-saint-orens.fr.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Guiraud
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D000072038:Cardiac Rehabilitation / Q000379:methods*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D016896:Treatment Outcome
keywords: Autonomic nervous system; Cardiac rehabilitation; Cardiovascular disease; Chronic heart failure; Exercise training