Influence of Autonomic Nervous Dysfunction Characterizing Effect of Diabetes Mellitus on Heart Rate Response and Exercise Capacity in Patients Undergoing Cardiac Rehabilitation for Acute Myocardial Infarction

Yusuke Kasahara; Kazuhiro Izawa; Kazuto Omiya; Naohiko Osada; Satoshi Watanabe; Masakazu Saitoh; Atsuhiko Matsunaga; Takashi Masuda

doi:10.1253/circj.70.1017

Clinical Investigation

Influence of Autonomic Nervous Dysfunction Characterizing Effect of Diabetes Mellitus on Heart Rate Response and Exercise Capacity in Patients Undergoing Cardiac Rehabilitation for Acute Myocardial Infarction

Yusuke Kasahara, Kazuhiro Izawa, Kazuto Omiya, Naohiko Osada, Satoshi Watanabe, Masakazu Saitoh, Atsuhiko Matsunaga, Takashi Masuda

Author information

Yusuke Kasahara
Department of Rehabilitation Medicine, St Marianna University School of Medicine Yokohama City Seibu Hospital
Graduate School of Medical Science
Kazuhiro Izawa
Department of Rehabilitation Medicine, St Marianna University School of Medicine
Kazuto Omiya
Division of Cardiology, St Marianna University School of Medicine
Naohiko Osada
Division of Cardiology, St Marianna University School of Medicine
Satoshi Watanabe
Department of Rehabilitation Medicine, St Marianna University School of Medicine
Masakazu Saitoh
Graduate School of Medical Science
Atsuhiko Matsunaga
Department of Rehabilitation, School of Allied Health Sciences, Kitasato University
Takashi Masuda
Department of Rehabilitation, School of Allied Health Sciences, Kitasato University

Keywords: Acute myocardial infarction, Autonomic nervous system, Diabetes mellitus, Exercise, Rehabilitation

JOURNAL FREE ACCESS

2006 Volume 70 Issue 8 Pages 1017-1025

DOI https://doi.org/10.1253/circj.70.1017

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Abstract

Background The aim of this study was to clarify the influence of sympathetic and parasympathetic nerve (SN and PN) dysfunction on the heart rate (HR) response to exercise and the exercise capacity of patients with acute myocardial infarction (AMI) and diabetes mellitus (DM). Methods and Results Fifty-two male patients who underwent cardiopulmonary exercise testing (CPX) 1 month after onset of AMI were divided into 2 groups: (DM (+) group, n=20; DM (-) group, n=32). HR, peak oxygen uptake (VO_2peak), and plasma norepinephrine (NE) levels were measured during CPX. The high-frequency power (HF) was analyzed by HR variability. The ΔHR/log ΔNE obtained from changes of HR and NE from rest to peak exercise and HR change from baseline to the minimum HF (ΔHR_HF) were calculated as parameters of HR response derived from SN and PN activities, respectively. ΔHR, VO_2peak, ΔHR/log ΔNE, and ΔHR_HF were significantly lower in the DM (+) group than in the DM (-) group, and both of them showed positive correlations with VO_2peak. Conclusion An inadequate HR response to exercise is a major factor causing a decline of exercise capacity, which is derived from both of SN and PN dysfunction, in AMI patients with DM. (Circ J 2006; 70: 1017 - 1025)

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