리컴번트 자전거 운동이 심방세동 환자의 심박 자율신경계 반응과 혈류역학적 변인에 미치는 영향
Effects of Recumbent Bicycle Exercise on Cardiac Autonomic Responses and Hemodynamics Variables in Patients with Atrial Fibrillation
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초록
연구배경: 본 연구의 목적은 심박변이도(heart rate variavariability) 와 혈류역학적 변인을 이용하여 리컴번트 자전거(recumbent bicycle ergometer) 운동 적용이 심방세동(atrial fibrillation) 환자를 위한 심장재활의 안전성과 효율성에 미치는 영향을 조사하는 것이다. 방법: 본 연구에 참여한 13명의 심방세동 환자는 직립 자전거(upright bicycle) 운동과 리컴번트 자전거 운동이 각각교차되도록 무작위 배정되었다. 운동강도는 점진적으로 부하되었다. 심박변이도, 심근산소소비량(rate pressure productproduct) 등은 안정 시와 운동 종료 직후에 측정되었다. 측정된모든 데이터는 일원반복측정 분산분석을 이용하여 분석하였다. 결과: 심박변이도 지표 중 교감신경활성도는 운동 종료직후 집단 간 차이가 나타나지 않았다. 심근산소소비량은 운동 종료 직후 리컴번트 자전거 운동 집단이 직립 자전거 운동 집단에 비해 유의하게 낮은 것으로 나타났다(104.8±14.3 vs. 151.8±51.4 mmHg×beats/min×10-2, P<0.01). 결론: 리컴번트 자전거 운동은 심장활동을 조절하는 자율신경계의 활성에 변화를 초래하지 않으면서도 심부담도를감소시킴으로써 심방세동 환자를 위한 심장재활의 안전성과 효율성을 향상시킨다.
Abstract
Background: The purpose of this study is to investigate the safety and efficiency of recumbent bicycle ergometer exercise by observing heart rate variability (HRV) and hemodynamic variables in patients with atrial fibrillation. Methods: In a balanced crossover study, 13 patients with atrial fibrillation (mean age, 62.2±5.3 years) were asked to perform a bicycle exercise twice, once in the upright position and once in the recumbent position at an angle of 30°, with a 1-week interval between both. The exercise intensity was set initially at 10 W and increased by 15 W every 2 minutes up to 70 W. HRV and hemodynamic variables were measured. All data were analyzed using one-way repeated-measures analysis of variance. Results: Low-frequency normalization in HRV was increased with no intergroup differences immediately after exercise. The rate pressure product was significantly lower in the recumbent than in the upright position right after exercise (104.8±14.3 vs. 151.8±51.4 mmHg×beats/min×10-2, P<0.01). Conclusions: Recumbent exercise improves the safety and efficiency of cardiac rehabilitation for atrial fibrillation patients by reducing myocardial workload without compromising the activation of the autonomic nervous system that regulates cardiac activity.
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