TY  -  JOUR
AU  -  Huang, Donghai
AU  -  Wahab, Muhammad Nubli Abdul
AU  -  Umunnawuike, Chika
AU  -  Okwuwa, Chigozie Charity
AU  -  Zhang, Yuan Hou Pengyun
AU  -  Wang, Heng
T1  -  Impact of heart rate variability-guided, aerobic, and combined exercise training on cardiac autonomic function in cardiovascular patients: a systematic review
PY  -  2026
Y1  -  2026-01-01
DO  -  10.1728/4733.47495
JO  -  Medicina dello Sport
JA  -  Med Sport
VL  -  79
IS  -  1
SP  -  50
EP  -  69
PB  -  Il Pensiero Scientifico Editore
SN  -  1827-1863
Y2  -  2026/06/30
UR  -  http://dx.doi.org/10.1728/4733.47495
N2  -  Summary. Aim. This review aimed to evaluate the effects of combined training, HRV-guided training, and aerobic training on cardiac autonomic function and other health-related outcomes in patients with cardiovascular disease (CVD). Review methods. A systematic search was conducted across nine electronic databases to identify relevant randomized controlled trials (RCTs). A total of 11 RCTs involving 489 participants were included. The quality of the 11 included studies was assessed using two study quality and reporting assessment scales (TESTEX and STARDHRV). Key points. Exercise interventions lasted 6–16 weeks, with 2–5 sessions per week and 30–60 min per session. Substantial heterogeneity was observed across studies in both exercise prescriptions and HRV assessment protocols. Evidence comparing different training modalities remains limited and inconsistent. Some studies reported improvements in vmHRV indices (RMSSD, HF (ms²), and SD1) following combined training or HRV-guided training, although these findings were not consistently replicated across studies. Aerobic training generally showed limited and heterogeneous effects on HRV outcomes. Exercise interventions, however, showed more consistent improvements in cardiorespiratory fitness and body composition. While current evidence does not support a definitive superiority of any single exercise modality, combined training and HRV-guided approaches show possible benefits for improving cardiac autonomic regulation and may inform individualized cardiac rehabilitation strategies. Future research may benefit from larger randomized controlled trials using standardized HRV assessment protocols.
ER  -