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Calvo M, Romero D, Le Rolle V, Béhar N, Gomis P, Mabo P, Hernández AI. Multivariate classification of Brugada syndrome patients based on autonomic response to exercise testing. PLoS One 2018; 13:e0197367. [PMID: 29763454 PMCID: PMC5953462 DOI: 10.1371/journal.pone.0197367] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 05/01/2018] [Indexed: 01/08/2023] Open
Abstract
Ventricular arrhythmias in Brugada syndrome (BS) typically occur at rest and especially during sleep, suggesting that changes in the autonomic modulation may play an important role in arrhythmogenesis. The autonomic response to exercise and subsequent recovery was evaluated on 105 patients diagnosed with BS (twenty-four were symptomatic), by means of a time-frequency heart rate variability (HRV) analysis, so as to propose a novel predictive model capable of distinguishing symptomatic and asymptomatic BS populations. During incremental exercise, symptomatic patients showed higher HFnu values, probably related to an increased parasympathetic modulation, with respect to asymptomatic subjects. In addition, those extracted HRV features best distinguishing between populations were selected using a two-step feature selection approach, so as to build a linear discriminant analysis (LDA) classifier. The final features subset included one third of the total amount of extracted autonomic markers, mostly acquired during incremental exercise and active recovery, thus evidencing the relevance of these test segments in BS patients classification. The derived predictive model showed an improved performance with respect to previous works in the field (AUC = 0.92 ± 0.01; Se = 0.91 ± 0.06; Sp = 0.90 ± 0.05). Therefore, based on these findings, some of the analyzed HRV markers and the proposed model could be useful for risk stratification in Brugada syndrome.
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Affiliation(s)
- Mireia Calvo
- Univ Rennes, CHU Rennes, Inserm, LTSI – UMR 1099, Rennes, France
- Dept. ESAII, CREB, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Daniel Romero
- Univ Rennes, CHU Rennes, Inserm, LTSI – UMR 1099, Rennes, France
| | - Virginie Le Rolle
- Univ Rennes, CHU Rennes, Inserm, LTSI – UMR 1099, Rennes, France
- * E-mail:
| | - Nathalie Béhar
- Univ Rennes, CHU Rennes, Inserm, LTSI – UMR 1099, Rennes, France
| | - Pedro Gomis
- Dept. ESAII, CREB, Universitat Politècnica de Catalunya, Barcelona, Spain
- CIBER of Bioengineering, Biomaterials and Nanomedicine, Zaragoza, Spain
| | - Philippe Mabo
- Univ Rennes, CHU Rennes, Inserm, LTSI – UMR 1099, Rennes, France
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302
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Rave G, Fortrat JO, Dawson B, Carre F, Dupont G, Saeidi A, Boullosa D, Zouhal H. Heart rate recovery and heart rate variability: use and relevance in European professional soccer. INT J PERF ANAL SPOR 2018. [DOI: 10.1080/24748668.2018.1460053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Guillaume Rave
- Stade Lavallois MFC, Plaine des Gandonnières rue Coupeau, Laval, France
| | | | - Brian Dawson
- School of Sport Science, Exercise and Health, University of Western Australia, Perth, Australia
| | | | | | - Ayoub Saeidi
- Exercise Biochemistry Division, Faculty of Physical Education and Sport Science, University of Mazandaran, Babolsar, Iran
| | - Daniel Boullosa
- Physical Education, Catholic University of Brasilia, Brasilia-DF, Brazil
| | - Hassane Zouhal
- M2S (Laboratoire Mouvement, Sport, Santé) – EA 1274, Univ Rennes, Rennes, France
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303
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Make it easier! Evaluation of the ‘vagal-sympathetic effect’ in different conditions with R–R intervals monitoring. Eur J Appl Physiol 2018; 118:1287-1288. [DOI: 10.1007/s00421-018-3855-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/24/2018] [Indexed: 10/17/2022]
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304
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Conceição MS, Gáspari AF, Ramkrapes APB, Junior EMM, Bertuzzi R, Cavaglieri CR, Chacon-Mikahil MPT. Anaerobic metabolism induces greater total energy expenditure during exercise with blood flow restriction. PLoS One 2018; 13:e0194776. [PMID: 29596452 PMCID: PMC5875813 DOI: 10.1371/journal.pone.0194776] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/11/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We investigated the energy system contributions and total energy expenditure during low intensity endurance exercise associated with blood flow restriction (LIE-BFR) and without blood flow restriction (LIE). METHODS Twelve males participated in a contra-balanced, cross-over design in which subjects completed a bout of low-intensity endurance exercise (30min cycling at 40% of [Formula: see text]) with or without BFR, separated by at least 72 hours of recovery. Blood lactate accumulation and oxygen uptake during and after exercise were used to estimate the anaerobic lactic metabolism, aerobic metabolism, and anaerobic alactic metabolism contributions, respectively. RESULTS There were significant increases in the anaerobic lactic metabolism (P = 0.008), aerobic metabolism (P = 0.020), and total energy expenditure (P = 0.008) in the LIE-BFR. No significant differences between conditions for the anaerobic alactic metabolism were found (P = 0.582). Plasma lactate concentration was significantly higher in the LIE-BFR at 15min and peak post-exercise (all P≤0.008). Heart rate was significantly higher in the LIE-BFR at 10, 15, 20, 25, and 30min during exercise, and 5, 10, and 15min after exercise (all P≤0.03). Ventilation was significantly higher in the LIE-BFR at 10, 15, and 20min during exercise (all P≤0.003). CONCLUSION Low-intensity endurance exercise performed with blood flow restriction increases the anaerobic lactic and aerobic metabolisms, total energy expenditure, and cardiorespiratory responses.
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Affiliation(s)
- Miguel S. Conceição
- Exercise Physiology Lab., School of Physical Education, University of Campinas–Campinas/Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Arthur F. Gáspari
- Exercise Physiology Lab., School of Physical Education, University of Campinas–Campinas/Brazil
- Endurance Sports Research Group (GEDAE-USP), School of Physical Education and Sport, University of São Paulo—São Paulo/Brazil
| | - Ana P. B. Ramkrapes
- Exercise Physiology Lab., School of Physical Education, University of Campinas–Campinas/Brazil
| | - Edson M. M. Junior
- Exercise Physiology Lab., School of Physical Education, University of Campinas–Campinas/Brazil
| | - Romulo Bertuzzi
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- Endurance Sports Research Group (GEDAE-USP), School of Physical Education and Sport, University of São Paulo—São Paulo/Brazil
| | - Cláudia R. Cavaglieri
- Exercise Physiology Lab., School of Physical Education, University of Campinas–Campinas/Brazil
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305
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Wakatsuki D, Iso Y, Mase H, Kurata M, Kyuno E, Shimojima H, Asano T, Sambe T, Suzuki H. Sudden cardiac arrest during marathon training in a young adult with short QT syndrome. IJC HEART & VASCULATURE 2018; 18:101-103. [PMID: 29876509 PMCID: PMC5988478 DOI: 10.1016/j.ijcha.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/11/2017] [Accepted: 11/14/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Daisuke Wakatsuki
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yoshitaka Iso
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan
| | - Hiroshi Mase
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Masaaki Kurata
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Etsushi Kyuno
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hisa Shimojima
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Taku Asano
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Takeyuki Sambe
- Showa University Research Institute for Sport and Exercise Sciences, Yokohama, Japan
| | - Hiroshi Suzuki
- Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
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306
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Michael S, Jay O, Graham KS, Davis GM. Influence of exercise modality on cardiac parasympathetic and sympathetic indices during post-exercise recovery. J Sci Med Sport 2018; 21:1079-1084. [PMID: 29449080 DOI: 10.1016/j.jsams.2018.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 01/23/2018] [Accepted: 01/26/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study investigated indirect measures of post-exercise parasympathetic reactivation (using heart-rate-variability, HRV) and sympathetic withdrawal (using systolic-time-intervals, STI) following upper- and lower-body exercise. DESIGN Randomized, counter-balanced, crossover. METHODS 13 males (age 26.4±4.7years) performed maximal arm-cranking (MAX-ARM) and leg-cycling (MAX-LEG). Subsequently, participants undertook separate 8-min bouts of submaximal HR-matched exercise of each mode (ARM and LEG). HRV (including natural-logarithm of root-mean-square-of-successive-differences, Ln-RMSSD) and STI (including pre-ejection-period, PEP) were assessed throughout 10-min seated recovery. RESULTS Peak-HR was higher (p=0.001) during MAX-LEG (182±7beatsmin-1) compared with MAX-ARM (171±12beatsmin-1), while HR (p<0.001) and Ln-RMSSD (p=0.010) recovered more rapidly following MAX-ARM. PEP recovery was similar between maximal bouts (p=0.106). HR during submaximal exercise was 146±7 (LEG) and 144±8beatsmin-1 (LEG) (p=0.139). Recovery of HR and Ln-RMSSD was also similar between submaximal modalities, remaining below baseline throughout recovery (p<0.001). PEP was similar during submaximal exercise (LEG 70±6ms; ARM 72±9ms; p=0.471) although recovery was slower following ARM (p=0.021), with differences apparent from 1- to 10-min recovery (p≤0.036). By 10-min post-exercise, PEP recovered to baseline (132±21ms) following LEG (130±21ms; p=0.143), but not ARM (121±17ms; p=0.001). CONCLUSIONS Compared with submaximal lower-body exercise, HR-matched upper-body exercise elicited a similar recovery of HR and HRV indices of parasympathetic reactivation, but delayed recovery of PEP (reflecting sympathetic withdrawal). Exercise modality appears to influence post-exercise parasympathetic reactivation and sympathetic withdrawal in an intensity-dependent manner. These results highlight the need for test standardization and may be relevant to multi-discipline athletes and in clinical applications with varying modes of exercise testing.
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Affiliation(s)
- Scott Michael
- Discipline of Exercise & Sports Science, Faculty of Health Sciences, University of Sydney, Australia.
| | - Ollie Jay
- Discipline of Exercise & Sports Science, Faculty of Health Sciences, University of Sydney, Australia
| | - Kenneth S Graham
- Discipline of Exercise & Sports Science, Faculty of Health Sciences, University of Sydney, Australia; New South Wales Institute of Sport, Australia
| | - Glen M Davis
- Discipline of Exercise & Sports Science, Faculty of Health Sciences, University of Sydney, Australia
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307
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Peçanha T, Forjaz CLDM, Low DA. Passive Heating Attenuates Post-exercise Cardiac Autonomic Recovery in Healthy Young Males. Front Neurosci 2017; 11:727. [PMID: 29311799 PMCID: PMC5742592 DOI: 10.3389/fnins.2017.00727] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 12/13/2017] [Indexed: 11/13/2022] Open
Abstract
Post-exercise heart rate (HR) recovery (HRR) presents a biphasic pattern, which is mediated by parasympathetic reactivation and sympathetic withdrawal. Several mechanisms regulate these post-exercise autonomic responses and thermoregulation has been proposed to play an important role. The aim of this study was to test the effects of heat stress on HRR and HR variability (HRV) after aerobic exercise in healthy subjects. Twelve healthy males (25 ± 1 years, 23.8 ± 0.5 kg/m2) performed 14 min of moderate-intensity cycling exercise (40–60% HRreserve) followed by 5 min of loadless active recovery in two conditions: heat stress (HS) and normothermia (NT). In HS, subjects dressed in a whole-body water-perfused tube-lined suit to increase internal temperature (Tc) by ~1°C. In NT, subjects did not wear the suit. HR, core and skin temperatures (Tc and Tsk), mean arterial pressure (MAP) skin blood flow (SKBF), and cutaneous vascular conductance (CVC) were measured throughout and analyzed during post-exercise recovery. HRR was assessed through calculations of HR decay after 60 and 300 s of recovery (HRR60s and HRR300s), and the short- and long-term time constants of HRR (T30 and HRRt). Post-exercise HRV was examined via calculations of RMSSD (root mean square of successive RR intervals) and RMS (root mean square residual of RR intervals). The HS protocol promoted significant thermal stress and hemodynamic adjustments during the recovery (HS-NT differences: Tc = +0.7 ± 0.3°C; Tsk = +3.2 ± 1.5°C; MAP = −12 ± 14 mmHg; SKBF = +90 ± 80 a.u; CVC = +1.5 ± 1.3 a.u./mmHg). HRR and post-exercise HRV were significantly delayed in HS (e.g., HRR60s = 27 ± 9 vs. 44 ± 12 bpm, P < 0.01; HRR300s = 39 ± 12 vs. 59 ± 16 bpm, P < 0.01). The effects of heat stress (e.g., the HS-NT differences) on HRR were associated with its effects on thermal and hemodynamic responses. In conclusion, heat stress delays HRR, and this effect seems to be mediated by an attenuated parasympathetic reactivation and sympathetic withdrawal after exercise. In addition, the impact of heat stress on HRR is related to the magnitude of the heat stress-induced thermal stress and hemodynamic changes.
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Affiliation(s)
- Tiago Peçanha
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Cláudia L de Moraes Forjaz
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - David A Low
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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308
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Different autonomic responses to occupational and leisure time physical activities among blue-collar workers. Int Arch Occup Environ Health 2017; 91:293-304. [PMID: 29177943 PMCID: PMC5845059 DOI: 10.1007/s00420-017-1279-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/15/2017] [Indexed: 12/19/2022]
Abstract
Purpose The differential effect of occupational and leisure time physical activity on cardiovascular health is termed the physical activity health paradox. Cardiac autonomic modulation could bring insights about the underlying mechanism behind this differential effect. The aim was to compare heart rate variability (HRV) during different activities (sitting, standing and moving) at work and leisure among blue-collar workers. Methods One hundred thirty-eight workers from the NOMAD cohort were included. Data from physical activity and HRV were obtained for 3–4 days using tri-axial accelerometers (Actigraph GT3X+) and a heart rate monitor (Actiheart). HRV indices were determined during sitting, standing and moving both at work and leisure. Linear mixed-models with two fixed factors (activities and domains) were applied to investigate differences in HRV indices adjusting for individual and occupational factors. Results The results showed significant effects of domain (p < 0.01), physical activity type (p < 0.01) and interaction between domain and activity type (p < 0.01) on HRV indices. Mean heart rate (IBI) and parasympathetic measures of HRV (RMSSD and HF) were lower for sitting (p < 0.01) and higher for moving (p < 0.01) during work compared with leisure, while no difference between domains was found for standing (p > 0.05). Sympathovagal balance (LF/HF) was higher during work for sitting and moving (p < 0.01), but showed no difference for standing (p = 0.62). Conclusions Differences in cardiac autonomic modulation between work and leisure were found, indicating sympathetic predominance during work and parasympathetic predominance during leisure for sitting. Autonomic responses can be part of the mechanism that explains the differential effect of occupational and leisure time physical activity on health.
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309
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Weippert M, Behrens M, Mau-Moeller A, Bruhn S, Behrens K. Cycling before and after Exhaustion Differently Affects Cardiac Autonomic Control during Heart Rate Matched Exercise. Front Physiol 2017; 8:844. [PMID: 29163192 PMCID: PMC5671980 DOI: 10.3389/fphys.2017.00844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/10/2017] [Indexed: 11/17/2022] Open
Abstract
During cycling before (PRE) and after exhaustion (POST) different modes of autonomic cardiac control might occur due to different interoceptive input and altered influences from higher brain centers. We hypothesized that heart rate variability (HRV) is significantly affected by an interaction of the experimental period (PRE vs. POST) and exercise intensity (HIGH vs. LOW; HIGH = HR > HR at the lactate threshold (HRLT), LOW = HR ≤ HRLT) despite identical average HR. Methods: Fifty healthy volunteers completed an incremental cycling test until exhaustion. Workload started with 30 W at a constant pedaling rate (60 revolutions · min−1) and was gradually increased by 30 W · 5 min−1. Five adjacent 60 s inter-beat (R-R) interval segments from the immediate recovery period (POST 1–5 at 30 W and 60 rpm) were each matched with their HR-corresponding 60 s-segments during the cycle test (PRE 1–5). An analysis of covariance was carried out with one repeated-measures factor (PRE vs. POST exhaustion), one between-subject factor (HIGH vs. LOW intensity) and respiration rate as covariate to test for significant effects (p < 0.050) on the natural log-transformed root mean square of successive differences between adjacent R-R intervals (lnRMSSD60s). Results: LnRMSSD60s was significantly affected by the interaction of experimental period × intensity [F(1, 242) = 30.233, p < 0.001, ηp2 = 0.111]. LnRMSSD60s was higher during PRE compared to POST at LOW intensity (1.6 ± 0.6 vs. 1.4 ± 0.6 ms; p < 0.001). In contrast, at HIGH intensity lnRMSSD60s was lower during PRE compared to POST (1.0 ± 0.4 vs. 1.2 ± 0.4 ms; p < 0.001). Conclusion: Identical net HR during cycling can result from distinct autonomic modulation patterns. Results suggest a pronounced sympathetic-parasympathetic coactivation immediately after the cessation of peak workload compared to HR-matched cycling before exhaustion at HIGH intensity. On the opposite, at LOW intensity cycling, a stronger coactivational cardiac autonomic modulation pattern occurs during PRE-exhaustion if compared to POST-exhaustion cycling. The different autonomic modes during these phases might be the result of different afferent and/or central inputs to the cardiovascular control centers in the brainstem.
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Affiliation(s)
| | - Martin Behrens
- Institute of Sport Science, University of Rostock, Rostock, Germany
| | - Anett Mau-Moeller
- Institute of Sport Science, University of Rostock, Rostock, Germany.,Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
| | - Sven Bruhn
- Institute of Sport Science, University of Rostock, Rostock, Germany
| | - Kristin Behrens
- Institute of Sport Science, University of Rostock, Rostock, Germany
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