Heart Rate Variability and Performance at Two Different Altitudes in Well-Trained Swimmers

The aim of this study was to compare the effects of training at two different altitudes on heart rate variability (HRV) and performance in well-trained swimmers. Eight national-level male swimmers (age = 17.0 +/- 1.8 yrs, weight = 67.0 +/- 6.6 kg, height = 180.4 +/- 7.2 cm, V(O2max) = 60.4 +/- 4.0 ml.min(-1). kg(-1)) trained 17 days at 1200 m altitude (T1200), then, after 6 weeks of moderate training at sea level, reproduced the same training plan at 1850 m (T1850). The training was mainly aerobic with 86 % and 84 % < or = anaerobic threshold for T 1200 and T1850, respectively. Four HRV analysis tests were performed during T1200 and T1850, respectively (pre-test = day 0, test 2 = day 5, test 3 = day 11, post-test = day 17), in supine and standing position. Performance was measured over a 2000-m freestyle test at the altitude of 1200 m. A difference in HRV changes was observed between the two altitudes: during T1200, addition of parasympathetic and sympathetic activity in supine (TP(SU)) (p < 0.05) and standing (TP(ST)) (p < 0.05) position, supine parasympathetic activity (HF(SU)) (p < 0.05), and standing sympathetic activity (LF(ST)) (p < 0.05) were increased and the 2000-m performance was improved (p < 0.05) whereas none of these parameters was changed during T1850. Change in performance was correlated with increase in HF(SU) (r = 0.73; p < 0.05) and tended towards correlation with increase in LF(ST) (r = 0.73; p = 0.06).

CONCLUSION

the same training loads induced a positive effect on HRV and performance at 1200 m but not at 1850 m. This may be the consequence of greater stress due to an interaction between greater hypoxic stimulus and the same training loads. These results highlight two opposing effects: aerobic training increases, whereas hypoxia decreases HF(SU), due to the correlation between HRV and changes in performance during altitude training.

Cardiac variability in critically ill adults: influence of sepsis

OBJECTIVE

To evaluate, in critically ill adults, factors associated with impaired sympathovagal balance.

DESIGN

One-month inception cohort study.

SETTING

Twenty-six-bed medical intensive care unit of a teaching hospital.

PATIENTS

Critically ill adults with an expected duration of intensive care unit stay of > or =48 hrs were enrolled. Patients with permanent arrhythmia or cardiac pacing were not included.

INTERVENTIONS

None.

MEASUREMENT AND MAIN RESULTS

Sympathovagal balance was assessed on the day after intensive care unit admission by the low-frequency/high-frequency ratio obtained from spectral components of heart rate signal: overall variability, low frequency, and high frequency.

RESULTS

Forty-one patients, 13 with sepsis and 28 without sepsis, were assessed. Predictors of low-frequency/high-frequency ratio with the automatic interaction detection method were sepsis and age. Binary logit analysis adjusted for age showed that sepsis remained a strong and independent factor of a low-frequency/high-frequency ratio of <1.50, with an odds ratio of 3.63 (95% confidence interval, 1.47-9.01, p =.005). Use of mechanical ventilation, catecholamines, or sedation did not add any information. The use of the low-frequency/high-frequency ratio in diagnosing sepsis may be supported by a likelihood ratio for low frequency/high frequency <1 at 6.47.

CONCLUSIONS

This work suggests that impaired cardiac variability and notably sympathovagal balance (i.e., a low-frequency/high-frequency ratio <1.0) may be a diagnostic test for sepsis.

Effects of neuromuscular blockade on fetal heart rate variability: a power spectrum analysis

Spectral analysis of fetal heart rate variability allows quantitative determination of the main components that affect this variability. The physiological significance of these components is unclear; however, movements appear to contribute to variability. We studied six fetuses in which immobility required for in utero magnetic resonance or invasive fetal procedures was achieved by fetal intravascular injection of curare between 32 and 36 amenorrhea weeks. For each fetus, we compared spectral density parameters of heart rate variability. After curare administration, mean spectrum power was halved. We did not observe a larger significant decrease in any (very low, low, or high) frequency band. The other parameters of spectral analysis of variability were unaltered. Fetal movements accounted for a significant proportion of human fetal heart rate variability but did not constitute a unique frequency component.

Spectral analysis of fetal heart rate in flat recordings

Flat heart rate recordings may be observed in different fetal states such as chronic distress and sleep. Their visual analysis do not allow the distinction between these two states. We used spectral analysis to study the heart rate patterns in 25 fetuses. Two significant (P < 5 x 10(-5)) groups were apparent from the determination of the position of the maximum energy peak (PMEP) in the high-frequency band (0.20-0.50 Hz): a PMEP at about 0.20 Hz (group 1), and another around 0.30 Hz (group 2). The two groups did not differ in spectral density (SD). The outcome of neonates showed that group 1 fetuses made good progress and produced healthy neonates; whereas group 2 comprised cases of chronic fetal distress, or even death in utero, and neonatal distress. The significance of this difference in PMEP between fetal heart rate patterns in chronic distress and sleep is unclear. Studies combining the assessment of fetal movements and the determination of PMEP are planned.

Quantification of the fetal heart rate variability by spectral analysis of fetal well-being and fetal distress

Our objectives were to increase the discrimination between fetal distress and fetal well-being, using fetal heart rate spectral analysis. Monitoring of the heart rate from 259 fetuses was done between 26 and 42 weeks, interpreted with classical criteria, and analysed with the spectral analysis method we developed. The fetal heart rate spectrum analysis performed on these recordings allow discrimination of fetal distress from the normal state using the energy value and frequency of the maximal energy in the high frequency band. We can conclude that the spectral analysis produces two significant parameters which could contribute to a multivariate approach to assessments of the physiological mechanisms of heart rate variability.

Human vigilance in railway and long-haul flight operation

Human operators in transport operations are often confronted with monotony, boredom, and irregular work schedules. This situation has become increasingly more acute because of the growing automation of systems. This paper presents methodology and preliminary results for two field studies on the vigilance of train drivers and long-range aircrews. The aim of these studies was to identify factors that can modify vigilance and to elaborate several specific solutions for reactivation. The method is based on the collection of physiological data in the field and on task observation of the operators. The recorded physiological data (EEG, EOG, EKG) permit an evaluation of vigilance and mental workload. The rest-activity cycles are estimated by actometry. The use of EEG and EOG are discussed in relation to monotony and sleep deprivation. For pilots, results show a high occurrence of decreased vigilance, particularly during phases of low workload (i.e., when cruising). Furthermore, it was shown that these periods of lowered vigilance can occur at the same time for two crew members. A great number of incidents of decreased vigilance were also observed for the train drivers. These incidents occurred even though the operators sometimes had high levels of activity. A direct relation was also noted between sleep duration and the onset of rest. These studies provide several means for maintaining vigilance during activities and improving the system of work schedule rotation.

[Hormone reactions to physical exercise following altitude training (author's transl)]

A three weeks physical training program at medium altitude induces some fonctional metabolic and hormonal changes in the response to physical effort. These changes vary, depending on whether the effort occurs on the 3rd or 7th day following return to sea-level. In the former case one observes a decrease in the somatotrophic response whereas in the latter one observes a decrease both in the somatotrophic and glucocorticoide response as well as in the level of blood contained lactic acids. These changes could be related to an improvement in the aerobic metabolism.