Skip to main content
Top
Published in: Heart and Vessels 3/2011

01-05-2011 | Original Article

Cardiac autonomic functions derived from short-term heart rate variability recordings associated with heart rate recovery after treadmill exercise test in young individuals

Authors: Ju-Yi Chen, Yungling Leo Lee, Wei-Chuan Tsai, Cheng-Han Lee, Po-Sheng Chen, Yi-Heng Li, Liang-Miin Tsai, Jyh-Hong Chen, Li-Jen Lin

Published in: Heart and Vessels | Issue 3/2011

Login to get access

Abstract

Analysis of short-term heart rate variability (HRV) may provide useful information about autonomic nervous control of heart rate recovery. We studied 495 individuals (273 men), age range 19–85 years, submitted to treadmill exercise tests and short-term HRV evaluations over time (standard deviation of the normal-to-normal interval [SDNN], the square root of the mean squared differences of successive normal-to-normal intervals [RMSSD], the number of interval differences of successive normal-to-normal intervals greater than 50 ms [NN50 count], the proportion derived by dividing NN50 count by the total number of normal-to-normal intervals [pNN50]) and frequency (low-frequency power [LF], high-frequency power [HF], total power) domains. Among 495 patients, 106 patients (68 men) were elderly (age  ≥ 65 years). Male gender and hypertension were significantly higher in elderly patients. The young patients had higher HRR after exercise. HRR at 4 min (54 ± 13 vs 60 ± 12 beats/min; P = 0.003) was the most significant predictor for positive exercise test result. In the young group, both time domain measures (SDNN: correlation coefficient 0.34, P < 0.001; RMSSD: correlation coefficient 0.37, P < 0.001) and frequency domain measures (LF: correlation coefficient 0.21, P < 0.001; HF: correlation coefficient 0.13, P = 0.01; total power: correlation coefficient 0.22, P < 0.001) were significantly associated with HRR at 4 min. HRR at 4 min was significantly associated with short-term HRV of time and frequency domains in young individuals, but not elderly ones, receiving treadmill exercise test.
Literature
1.
go back to reference Cole CR, Blackstone EH, Pashkow FJ, Sander CE, Lauer MS (1999) Heart rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 341:1351–1357PubMedCrossRef Cole CR, Blackstone EH, Pashkow FJ, Sander CE, Lauer MS (1999) Heart rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 341:1351–1357PubMedCrossRef
2.
go back to reference Jouvn X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetière P (2005) Heart rate profile during exercise as a predictor of sudden death. N Engl J Med 352:1951–1958CrossRef Jouvn X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetière P (2005) Heart rate profile during exercise as a predictor of sudden death. N Engl J Med 352:1951–1958CrossRef
3.
go back to reference Lauer MS, Okin PM, Larson MG, Evans JC, Levy D (1998) Impaired heart rate response to graded exercise: prognostic implications of chronotropic incompetence in the Framingham Heart Study. Circulation 93:1520–1526 Lauer MS, Okin PM, Larson MG, Evans JC, Levy D (1998) Impaired heart rate response to graded exercise: prognostic implications of chronotropic incompetence in the Framingham Heart Study. Circulation 93:1520–1526
4.
go back to reference Lauer M, Mehta R, Pashkow FJ, Okin PM, Lee K, Marwick TH (1998) Association of chronotropic incompetence with myocardial ischemia and prognosis. J Am Coll Cardiol 32:1280–1286PubMedCrossRef Lauer M, Mehta R, Pashkow FJ, Okin PM, Lee K, Marwick TH (1998) Association of chronotropic incompetence with myocardial ischemia and prognosis. J Am Coll Cardiol 32:1280–1286PubMedCrossRef
5.
go back to reference Lipinski MJ, Vectrovec GW, Froelicher VF (2004) Importance of the first two minutes after exercise treadmill testing in predicting mortality and the presence of coronary artery disease in men. Am J Cardiol 93:445–449PubMedCrossRef Lipinski MJ, Vectrovec GW, Froelicher VF (2004) Importance of the first two minutes after exercise treadmill testing in predicting mortality and the presence of coronary artery disease in men. Am J Cardiol 93:445–449PubMedCrossRef
6.
go back to reference Ushiyama T, Mizushige K, Wakabayashi H, Nakatsu T, Ishimura K, Tsuboi Y, Maeta H, Suzuki Y (2008) Analysis of heart rate variability as an index of noncardiac surgical stress. Heart Vessels 23:53–59PubMedCrossRef Ushiyama T, Mizushige K, Wakabayashi H, Nakatsu T, Ishimura K, Tsuboi Y, Maeta H, Suzuki Y (2008) Analysis of heart rate variability as an index of noncardiac surgical stress. Heart Vessels 23:53–59PubMedCrossRef
7.
go back to reference Cheung EW, Lam WW, Cheung SC, Cheung YF (2008) Functional implications of the right ventricular myocardial performance index in patients after surgical repair of tetralogy of Fallot. Heart Vessels 23:112–117PubMedCrossRef Cheung EW, Lam WW, Cheung SC, Cheung YF (2008) Functional implications of the right ventricular myocardial performance index in patients after surgical repair of tetralogy of Fallot. Heart Vessels 23:112–117PubMedCrossRef
8.
go back to reference Biselli PM, Guerzoni AR, de Godoy MF, Pavarino-Bertelli EC, Goloni-Bertollo EM (2008) Vascular endothelial growth factor genetic variability and coronary artery disease in Brazilian population. Heart Vessels 23:371–375PubMedCrossRef Biselli PM, Guerzoni AR, de Godoy MF, Pavarino-Bertelli EC, Goloni-Bertollo EM (2008) Vascular endothelial growth factor genetic variability and coronary artery disease in Brazilian population. Heart Vessels 23:371–375PubMedCrossRef
9.
go back to reference Schwartz PJ, La Rovere MT, Vanoli E (1992) Autonomic nervous system and sudden cardiac death: experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation 85:177–191 Schwartz PJ, La Rovere MT, Vanoli E (1992) Autonomic nervous system and sudden cardiac death: experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation 85:177–191
10.
go back to reference Lown B, Verrier RL (1976) Neural activity and ventricular fibrillation. N Engl J Med 94:1165–1170 Lown B, Verrier RL (1976) Neural activity and ventricular fibrillation. N Engl J Med 94:1165–1170
11.
go back to reference Schwartz PJ, Vanoli E, Stramba-Badiale M, De Ferrari GM, Billman GE, Foreman RD (1988) Autonomic mechanisms and sudden death: new insights from analysis of baroreceptor reflexes in conscious dogs with and without a myocardial infarction. Circulation 78:969–979PubMed Schwartz PJ, Vanoli E, Stramba-Badiale M, De Ferrari GM, Billman GE, Foreman RD (1988) Autonomic mechanisms and sudden death: new insights from analysis of baroreceptor reflexes in conscious dogs with and without a myocardial infarction. Circulation 78:969–979PubMed
12.
go back to reference Imai K, Sato H, Hori M, Kusuoka H, Ozaki H, Yokoyama H, Takeda H, Inoue M, Kamada T (1994) Vaguely mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol 24:1529–1535PubMedCrossRef Imai K, Sato H, Hori M, Kusuoka H, Ozaki H, Yokoyama H, Takeda H, Inoue M, Kamada T (1994) Vaguely mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol 24:1529–1535PubMedCrossRef
13.
go back to reference Nishime EO, Cole R, Blackstone EH, Pashkow FJ, Lauer MS (2000) Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA 284:1392–1398PubMedCrossRef Nishime EO, Cole R, Blackstone EH, Pashkow FJ, Lauer MS (2000) Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA 284:1392–1398PubMedCrossRef
14.
go back to reference Dreifus LS, Agarwal JB, Botvinick EH, American College of Cardiology Cardiovascular Technology Assessment Committee (1993) Heart rate variability for risk stratification of life-threatening arrhythmias. J Am Coll Cardiol 22:948–950 Dreifus LS, Agarwal JB, Botvinick EH, American College of Cardiology Cardiovascular Technology Assessment Committee (1993) Heart rate variability for risk stratification of life-threatening arrhythmias. J Am Coll Cardiol 22:948–950
15.
go back to reference Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 93:1043–1065 Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 93:1043–1065
16.
go back to reference Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213:220–222PubMedCrossRef Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213:220–222PubMedCrossRef
17.
go back to reference Pomeranz B, Macaulay RJ, Caudill MA, Kutz I, Adam D, Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ, Benson H (1985) Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 248:H151–H153PubMed Pomeranz B, Macaulay RJ, Caudill MA, Kutz I, Adam D, Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ, Benson H (1985) Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 248:H151–H153PubMed
18.
go back to reference Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17:354-381 Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17:354-381
19.
go back to reference Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, Mark DB, Marwick TH, McCallister BD, Thompson PD Jr, Winters WL, Yanowitz FG, Ritchie JL, Gibbons RJ, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Lewis RP, O’Rourke RA, Ryan TJ (1997) ACC/AHA guidelines for exercise testing. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on Exercise Testing). J Am Coll Cardiol 30:260–311PubMedCrossRef Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, Mark DB, Marwick TH, McCallister BD, Thompson PD Jr, Winters WL, Yanowitz FG, Ritchie JL, Gibbons RJ, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Lewis RP, O’Rourke RA, Ryan TJ (1997) ACC/AHA guidelines for exercise testing. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on Exercise Testing). J Am Coll Cardiol 30:260–311PubMedCrossRef
20.
go back to reference Mara S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR, Blumenthal RS (2003) Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. JAMA 290:1600–1607CrossRef Mara S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR, Blumenthal RS (2003) Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. JAMA 290:1600–1607CrossRef
21.
go back to reference Brinkworth GD, Noakes M, Buckley JD, Clifton PM (2006) Weight loss improves heart rate recovery in overweight and obese men with features of the metabolic syndrome. Am Heart J 152:693.e1–693.e6CrossRef Brinkworth GD, Noakes M, Buckley JD, Clifton PM (2006) Weight loss improves heart rate recovery in overweight and obese men with features of the metabolic syndrome. Am Heart J 152:693.e1–693.e6CrossRef
22.
go back to reference Vivekananthan DP, Blackstone EH, Pothier CE, Lauer MS (2003) Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of coronary disease. J Am Coll Cardiol 42:831–838PubMedCrossRef Vivekananthan DP, Blackstone EH, Pothier CE, Lauer MS (2003) Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of coronary disease. J Am Coll Cardiol 42:831–838PubMedCrossRef
23.
go back to reference Panzer C, Lauer MS, Brieke A, Blackstone E, Hoogwerf B (2002) Association of fasting plasma glucose with heart rate recovery in healthy adults. A population-based study. Diabetes 51:803–807PubMedCrossRef Panzer C, Lauer MS, Brieke A, Blackstone E, Hoogwerf B (2002) Association of fasting plasma glucose with heart rate recovery in healthy adults. A population-based study. Diabetes 51:803–807PubMedCrossRef
24.
go back to reference Cheng YL, Lauer MS, Earnest CP, Church TS, Kampert JB, Gibbons LW, Blair SN (2003) Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all cause mortality in men with diabetes. Diabetes Care 26:2052–2057PubMedCrossRef Cheng YL, Lauer MS, Earnest CP, Church TS, Kampert JB, Gibbons LW, Blair SN (2003) Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all cause mortality in men with diabetes. Diabetes Care 26:2052–2057PubMedCrossRef
25.
go back to reference Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS (2001) Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: the case of stress echocardiography. Circulation 104:1911–1916PubMed Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS (2001) Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: the case of stress echocardiography. Circulation 104:1911–1916PubMed
26.
go back to reference Pitsavos CH, Chrysohoou C, Panagiotakos DB, Kokkinos P, Skoumas J, Papaioannou I, Michaelides AP, Singh S, Stefanadis CI (2004) Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous familial hypercholesterolemia. Atherosclerosis 173:347–352PubMedCrossRef Pitsavos CH, Chrysohoou C, Panagiotakos DB, Kokkinos P, Skoumas J, Papaioannou I, Michaelides AP, Singh S, Stefanadis CI (2004) Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous familial hypercholesterolemia. Atherosclerosis 173:347–352PubMedCrossRef
27.
go back to reference Georgoulias P, Orfanakis A, Demakopoulos N, Xaplanteris P, Mortzos G, Vardas P, Karkavitsas N (2003) Abnormal heart rate recovery immediately after treadmill testing: correlation with clinical, exercise testing, and myocardial perfusion parameters. J Nucl Cardiol 10:498–505PubMedCrossRef Georgoulias P, Orfanakis A, Demakopoulos N, Xaplanteris P, Mortzos G, Vardas P, Karkavitsas N (2003) Abnormal heart rate recovery immediately after treadmill testing: correlation with clinical, exercise testing, and myocardial perfusion parameters. J Nucl Cardiol 10:498–505PubMedCrossRef
28.
go back to reference Georgoulias P, Demakopoulos N, Orfanakis A, Xydis K, Xaplanteris P, Vardas P, Fezoulidis I (2007) Evaluation of abnormal heart-rate recovery after exercise testing in patients with diabetes mellitus: correlation with myocardial SPECT and chronotropic parameters. Nucl Med Commun 28:165–171PubMedCrossRef Georgoulias P, Demakopoulos N, Orfanakis A, Xydis K, Xaplanteris P, Vardas P, Fezoulidis I (2007) Evaluation of abnormal heart-rate recovery after exercise testing in patients with diabetes mellitus: correlation with myocardial SPECT and chronotropic parameters. Nucl Med Commun 28:165–171PubMedCrossRef
29.
go back to reference Frenneaux MP (2004) Autonomic changes in patients with heart failure and in post-myocardial infarction patients. Heart 90:1248–1255PubMedCrossRef Frenneaux MP (2004) Autonomic changes in patients with heart failure and in post-myocardial infarction patients. Heart 90:1248–1255PubMedCrossRef
30.
go back to reference Cole CR, Foody JM, Blackstone EH, Lauer MS (2000) Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med 132:552–555PubMed Cole CR, Foody JM, Blackstone EH, Lauer MS (2000) Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med 132:552–555PubMed
31.
go back to reference Antelmi I, Chuang EY, Grupi CJ, Latorre Mdo R, Mansur AJ (2008) Heart rate recovery after treadmill electrocardiographic exercise stress test and 24-hour heart rate variability in healthy individuals. Arq Bras Cardiol 90:380–385PubMedCrossRef Antelmi I, Chuang EY, Grupi CJ, Latorre Mdo R, Mansur AJ (2008) Heart rate recovery after treadmill electrocardiographic exercise stress test and 24-hour heart rate variability in healthy individuals. Arq Bras Cardiol 90:380–385PubMedCrossRef
32.
go back to reference Sundaram S, Shoushtari C, Carnethon M (2004) Autonomic and nonautonomic determinants of heart rate recovery. Heart Rhythm 1:S100–S101 Sundaram S, Shoushtari C, Carnethon M (2004) Autonomic and nonautonomic determinants of heart rate recovery. Heart Rhythm 1:S100–S101
33.
go back to reference Lahiri MK, Kannankeril PJ, Goldberger JJ (2008) Assessment of autonomic function in cardiovascular disease. J Am Coll Cardiol 51:1725–1733PubMedCrossRef Lahiri MK, Kannankeril PJ, Goldberger JJ (2008) Assessment of autonomic function in cardiovascular disease. J Am Coll Cardiol 51:1725–1733PubMedCrossRef
34.
go back to reference Saul JP (1990) Beat-to-beat variations of heart rate reflect modulation of cardiac autonomic outflow. News Physiol Sci 5:32–37 Saul JP (1990) Beat-to-beat variations of heart rate reflect modulation of cardiac autonomic outflow. News Physiol Sci 5:32–37
35.
go back to reference Thayer JF, Lane RD (2007) The role of vagal function in the risk for cardiovascular disease and mortality. Biol Psychol 74:224–242PubMedCrossRef Thayer JF, Lane RD (2007) The role of vagal function in the risk for cardiovascular disease and mortality. Biol Psychol 74:224–242PubMedCrossRef
36.
go back to reference Antelmi I, de Paula RS, Shinzato AR, Peres CA, Mansur AJ, Grupi CJ (2004) Influence of age, gender, body mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease. Am J Cardiol 93:381–385PubMedCrossRef Antelmi I, de Paula RS, Shinzato AR, Peres CA, Mansur AJ, Grupi CJ (2004) Influence of age, gender, body mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease. Am J Cardiol 93:381–385PubMedCrossRef
37.
go back to reference Ergun U, Demirci M, Nurlu G, Komürcü F (2008) Power spectral analysis of heart rate variability: normal values of subjects over 60 years old. Int J Neurosci 118:1165–1173PubMedCrossRef Ergun U, Demirci M, Nurlu G, Komürcü F (2008) Power spectral analysis of heart rate variability: normal values of subjects over 60 years old. Int J Neurosci 118:1165–1173PubMedCrossRef
38.
go back to reference Paolisso G, Manzella D, Barbieri M, Rizzo MR, Gambardella A, Varricchio M (1999) Baseline heart rate variability in healthy centenarians: differences compared with aged subjects (>75 years old). Clin Sci 97:579–584PubMedCrossRef Paolisso G, Manzella D, Barbieri M, Rizzo MR, Gambardella A, Varricchio M (1999) Baseline heart rate variability in healthy centenarians: differences compared with aged subjects (>75 years old). Clin Sci 97:579–584PubMedCrossRef
39.
go back to reference Ooie T, Saikawa T, Hara M, Ono H, Seike M, Sakata T (1999) H2-blocker modulates heart rate variability. Heart Vessels 14:137–142PubMedCrossRef Ooie T, Saikawa T, Hara M, Ono H, Seike M, Sakata T (1999) H2-blocker modulates heart rate variability. Heart Vessels 14:137–142PubMedCrossRef
40.
go back to reference Atherton JJ, Blackman DJ, Moore TD, Bachmann AW, Tunny TJ, Thomson HL, Gordon RD, Frenneaux MP (1998) Diastolic ventricular interaction in chronic heart failure: relation to heart rate variability and neurohumoral status. Heart Vessels 13:269–277PubMed Atherton JJ, Blackman DJ, Moore TD, Bachmann AW, Tunny TJ, Thomson HL, Gordon RD, Frenneaux MP (1998) Diastolic ventricular interaction in chronic heart failure: relation to heart rate variability and neurohumoral status. Heart Vessels 13:269–277PubMed
41.
go back to reference Ooie T, Takakura T, Shiraiwa H, Yoshimura A, Hara M, Saikawa T (1998) Change in heart rate variability preceding ST elevation in a patient with vasospastic angina pectoris. Heart Vessels 13:40–44PubMedCrossRef Ooie T, Takakura T, Shiraiwa H, Yoshimura A, Hara M, Saikawa T (1998) Change in heart rate variability preceding ST elevation in a patient with vasospastic angina pectoris. Heart Vessels 13:40–44PubMedCrossRef
Metadata
Title
Cardiac autonomic functions derived from short-term heart rate variability recordings associated with heart rate recovery after treadmill exercise test in young individuals
Authors
Ju-Yi Chen
Yungling Leo Lee
Wei-Chuan Tsai
Cheng-Han Lee
Po-Sheng Chen
Yi-Heng Li
Liang-Miin Tsai
Jyh-Hong Chen
Li-Jen Lin
Publication date
01-05-2011
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 3/2011
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-010-0048-6

Other articles of this Issue 3/2011

Heart and Vessels 3/2011 Go to the issue