Patients with coronary artery disease (CAD) often experience anger events before cardiovascular events. Anger is a psychological risk factor and causes underlying psychophysiological mechanisms to lose balance of the autonomic nervous system (ANS). The heart rate variability (HRV) was the common index for ANS regulation. It has been confirmed that heart rate variability biofeedback (HRV-BF) restored ANS balance in patients with CAD during the resting state. However, the effects of HRV-BF during and after the anger event remain unknown. This study aimed to examine the effects of HRV-BF on ANS reactivity and recovery during the anger recall task in patients with CAD. This study was a randomized control trial with a wait-list control group design, with forty patients in the HRV-BF group (for six sessions) and 44 patients in the control group. All patients received five stages of an anger recall task, including baseline, neutral recall task, neutral recovery, anger recall task, and anger recovery. HRV reactivity in the HRV-BF group at the post-test was lower than that in the control group. HRV recovery at the post-test in the HRV-BF group was higher than that in the control group. The HRV-BF reduced ANS reactivity during anger events and increased ANS recovery after anger events for CAD patients. The possible mechanisms of HRV-BF may increase total HRV, ANS regulation, and baroreflex activation at anger events for patients with CAD, and may be a suitable program for cardiac rehabilitation.

冠状动脉疾病 (CAD) 患者经常在心血管事件之前经历愤怒事件。愤怒是一种心理风险因素，会导致潜在的心理生理机制失去自主神经系统 (ANS) 的平衡。心率变异性（HRV）是 ANS 调节的常用指标。已经证实，心率变异性生物反馈 (HRV-BF) 在静息状态下恢复了 CAD 患者的 ANS 平衡。然而，HRV-BF 在愤怒事件期间和之后的影响仍然未知。本研究旨在检查 HRV-BF 对 CAD 患者愤怒回忆任务期间 ANS 反应性和恢复的影响。这项研究是一项随机对照试验，采用等待名单对照组设计，HRV-BF 组有 40 名患者（6 个疗程），对照组有 44 名患者。所有患者都接受了五个阶段的愤怒回忆任务，包括基线、中性回忆任务、中性恢复、愤怒回忆任务和愤怒恢复。HRV-BF组在后测时的HRV反应性低于对照组。HRV-BF组的后测HRV恢复率高于对照组。HRV-BF 降低了愤怒事件期间的 ANS 反应性，并增加了 CAD 患者愤怒事件后 ANS 的恢复。HRV-BF 的可能机制可能会增加 CAD 患者在愤怒事件时的总 HRV、ANS 调节和压力反射激活，并且可能是心脏康复的合适方案。HRV-BF组在后测时的HRV反应性低于对照组。HRV-BF组的后测HRV恢复率高于对照组。HRV-BF 降低了愤怒事件期间的 ANS 反应性，并增加了 CAD 患者愤怒事件后 ANS 的恢复。HRV-BF 的可能机制可能会增加 CAD 患者在愤怒事件时的总 HRV、ANS 调节和压力反射激活，并且可能是心脏康复的合适方案。HRV-BF组在后测时的HRV反应性低于对照组。HRV-BF组的后测HRV恢复率高于对照组。HRV-BF 降低了愤怒事件期间的 ANS 反应性，并增加了 CAD 患者愤怒事件后 ANS 的恢复。HRV-BF 的可能机制可能会增加 CAD 患者在愤怒事件时的总 HRV、ANS 调节和压力反射激活，并且可能是心脏康复的合适方案。