2
|
Cardio-vascular reserve index (CVRI) during exercise complies with the pattern assumed by the cardiovascular reserve hypothesis. Int J Cardiol 2017; 234:33-37. [PMID: 28256325 DOI: 10.1016/j.ijcard.2017.02.081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/10/2017] [Accepted: 02/20/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The Cardio-vascular reserve index (CVRI) had been empirically validated in diverse morbidities as a quantitative estimate of the reserve assumed by the cardiovascular reserve hypothesis. This work evaluates whether CVRI during exercise complies with the cardiovascular reserve hypothesis. DESIGN Retrospective study based on a database of patients who underwent cardio-pulmonary exercise testing (CPX) for diverse indications. METHODS Patient's physiological measurements were retrieved at four predefined CPX stages (rest, anaerobic threshold, peak exercise and after 2min of recovery). CVRI was individually calculated retrospectively at each stage. RESULTS Mean CVRI at rest was 0.81, significantly higher (p<0.001) than at all other stages. CVRI decreased with exercise, reaching an average at peak exercise of 0.35, significant lower than at other stages (p<0.001) and very similar regardless of exercise capacity (mean CVRI 0.33-0.37 in 4 groups classified by exercise capacity, p>0.05). CVRI after 2min of recovery rose considerably, most in the group with the best exercise capacity and least in those with the lowest exercise capacity. CONCLUSIONS CVRI during exercise fits the pattern predicted by the cardiovascular reserve hypothesis. CVRI decreased with exercise reaching a minimum at peak exercise and rising with recovery. The CVRI nadir at peak exercise, similar across groups classified by exercise capacity, complies with the assumed exhaustion threshold. The clinical utility of CVRI should be further evaluated.
Collapse
|
3
|
Herzig D, Eser P, Radtke T, Wenger A, Rusterholz T, Wilhelm M, Achermann P, Arhab A, Jenni OG, Kakebeeke TH, Leeger-Aschmann CS, Messerli-Bürgy N, Meyer AH, Munsch S, Puder JJ, Schmutz EA, Stülb K, Zysset AE, Kriemler S. Relation of Heart Rate and its Variability during Sleep with Age, Physical Activity, and Body Composition in Young Children. Front Physiol 2017; 8:109. [PMID: 28286485 PMCID: PMC5323426 DOI: 10.3389/fphys.2017.00109] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 02/09/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Recent studies have claimed a positive effect of physical activity and body composition on vagal tone. In pediatric populations, there is a pronounced decrease in heart rate with age. While this decrease is often interpreted as an age-related increase in vagal tone, there is some evidence that it may be related to a decrease in intrinsic heart rate. This factor has not been taken into account in most previous studies. The aim of the present study was to assess the association between physical activity and/or body composition and heart rate variability (HRV) independently of the decline in heart rate in young children. Methods: Anthropometric measurements were taken in 309 children aged 2–6 years. Ambulatory electrocardiograms were collected over 14–18 h comprising a full night and accelerometry over 7 days. HRV was determined of three different night segments: (1) over 5 min during deep sleep identified automatically based on HRV characteristics; (2) during a 20 min segment starting 15 min after sleep onset; (3) over a 4-h segment between midnight and 4 a.m. Linear models were computed for HRV parameters with anthropometric and physical activity variables adjusted for heart rate and other confounding variables (e.g., age for physical activity models). Results: We found a decline in heart rate with increasing physical activity and decreasing skinfold thickness. HRV parameters decreased with increasing age, height, and weight in HR-adjusted regression models. These relationships were only found in segments of deep sleep detected automatically based on HRV or manually 15 min after sleep onset, but not in the 4-h segment with random sleep phases. Conclusions: Contrary to most previous studies, we found no increase of standard HRV parameters with age, however, when adjusted for heart rate, there was a significant decrease of HRV parameters with increasing age. Without knowing intrinsic heart rate correct interpretation of HRV in growing children is impossible.
Collapse
Affiliation(s)
- David Herzig
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern Bern, Switzerland
| | - Prisca Eser
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern Bern, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
| | - Alina Wenger
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
| | - Thomas Rusterholz
- Institute of Pharmacology and Toxicology, University of ZurichZurich, Switzerland; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of BernBern, Switzerland
| | - Matthias Wilhelm
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern Bern, Switzerland
| | - Peter Achermann
- Institute of Pharmacology and Toxicology, University of ZurichZurich, Switzerland; Zurich Center for Integrative Human Physiology, University of ZurichZurich, Switzerland
| | - Amar Arhab
- Endocrinology, Diabetes, and Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV) Lausanne, Switzerland
| | - Oskar G Jenni
- Child Development Center, University Children's Hospital ZurichZurich, Switzerland; Children's Research Center, University Children's Hospital ZurichZurich, Switzerland
| | - Tanja H Kakebeeke
- Child Development Center, University Children's Hospital ZurichZurich, Switzerland; Children's Research Center, University Children's Hospital ZurichZurich, Switzerland
| | | | - Nadine Messerli-Bürgy
- Endocrinology, Diabetes, and Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland; Department of Clinical Psychology and Psychotherapy, University of FribourgFribourg, Switzerland
| | - Andrea H Meyer
- Department of Psychology, University of Basel Basel, Switzerland
| | - Simone Munsch
- Department of Clinical Psychology and Psychotherapy, University of Fribourg Fribourg, Switzerland
| | - Jardena J Puder
- Endocrinology, Diabetes, and Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland; Division of Pediatric Endocrinology, Diabetology and Obesity, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland
| | - Einat A Schmutz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
| | - Kerstin Stülb
- Department of Clinical Psychology and Psychotherapy, University of Fribourg Fribourg, Switzerland
| | - Annina E Zysset
- Child Development Center, University Children's Hospital Zurich Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
| |
Collapse
|
4
|
Eser P, Herzig D, Vogt M, Stämpfli R, Trovato M, Olstad DS, Trachsel L, Deluigi C, Wustmann K, Greutmann M, Tobler D, Stambach D, Schmid JP, Schwerzmann M, Wilhelm M. Vagal reactivation after exercise and cardiac autonomic nervous activity in adult Fontan patients without pacemakers. Int J Cardiol 2016; 220:527-33. [DOI: 10.1016/j.ijcard.2016.06.274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/13/2016] [Accepted: 06/27/2016] [Indexed: 01/13/2023]
|