Exercise and cardiac regulation: What can electrocardiographic time series tell us?

Scandinavian Journal of Medicine and Science in Sports

Volumn 20, Issue 6, 2010, Pages 794-804

  Lewis, M J ^a   Short, A L ^a  

^a SWANSEA UNIVERSITY   (United Kingdom)

Author keywords

Autonomic nervous system; ECG; Exercise; Heart rate variability; Physiological time series; QT

Indexed keywords

AUTONOMIC NERVOUS SYSTEM; ELECTROCARDIOGRAPHY; EXERCISE; HEART; HEART RATE; HUMAN; LONG QT SYNDROME; PHYSIOLOGY; REVIEW; TIME;

AUTONOMIC NERVOUS SYSTEM; ELECTROCARDIOGRAPHY; EXERCISE; HEART; HEART RATE; HUMANS; LONG QT SYNDROME; TIME FACTORS;

EID: 77958611203     PISSN: 09057188     EISSN: 16000838     Source Type: Journal    
DOI: 10.1111/j.1600-0838.2010.01150.x     Document Type: Review

References (82)

1. Akselrod S, Gordon D, Ubel FA, Shannon DC, Barger AC, Cohen RJ. Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat to beat cardiovascular control. Science 1981: 213: 220-222.
2. Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 2000: 343: 1355-1361.
3. Almeida R, Gouveia S, Rocha AP, Pueyo E, Martinez JP, Laguna P. QT variability and HRV interactions in ECG: quantification and reliability. IEEE Trans Biomed Eng 2006: 53 (7): 1317-1329.
4. Arai Y, Saul JP, Albrecht P, Hartley LH, Lilly LS, Cohen RJ, Colucci WS. Modulation of cardiac autonomic activity during and immediately after exercise. Am J Physiol 1989: 256: H132-H141.
5. Atiga WL, Calkins H, Lawrence JH, Tomaselli GF, Smith JM, Berger RD. Beat-to-beat repolarization lability identifies patients at risk for sudden cardiac death. J Cardiovasc Electrophysiol 1998: 9 (9): 899-908.
6. Atiga WL, Fananapazir L, McAreavey D, Calkins H, Berger RD. Temporal repolarization lability in hypertrophic cardiomyopathy caused by beta-myosin heavy-chain gene mutations. Circulation 2000: 101 (11): 1237-1242.
7. Aubert AE, Beckers F, Ramaekers D. Short-term heart rate variability in young athletes. J Cardiol 2001: 37 (Suppl. 1): 85-88.
8. Baumert M, Brechtel L, Lock J, Hermsdorf M, Wolff R, Baier V, Voss A. Heart rate variability, blood pressure variability, and baroreflex sensitivity in overtrained athletes. Clin J Sport Med 2006: 16 (5): 412-417.
9. Berger RD, Kasper EK, Baughman KL, Marban E, Calkins H, Tomaselli GF. Beat-to-beat QT interval variability: novel evidence for repolarization lability in ischemic and nonischemic dilated cardiomyopathy. Circulation 1997: 96 (5): 1557-1565.
10. Bernardi L, Keller F, Sanders M, Reddy PS, Griffith B, Meno F, Pinsky MR. Respiratory sinus arrhythmia in the denervated human heart. J Appl Physiol 1989: 67 (4): 1447-1455.
11. Bernardi L, Salvucci F, Suardi R, Solda PL, Perlini S, Falcone C, Ricciardi L. Evidence for an intrinsic mechanism regulating heart rate variability in the transplanted and intact heart during submaximal exercise. Cardiovasc Res 1990: 24: 969-981.
12. Bidoggia H, Maciel JP, Capalozza N, Mosca S, Blaksley EJ, Valverde E, Bertran G, Arini P, Biagetti MO, Quinteiro RA. Sex differences on the electrocardiographic pattern of cardiac repolarization: possible role of testosterone. Am Heart J 2000: 140 (4): 678-683.
13. Bigger JT, Fleis JL, Rolnitzky LM, Steinman RC. Frequency domain measures of heart period variability to assess risk late after myocardial infarction. J Am Coll Cardiol 1993: 21: 729-736.
14. Casadei B, Cochrane S, Johnston J, Conway J. Pitfalls in the interpretation of spectral analysis of the heart rate variability during exercise in humans. Acta Physiol Scand 1995: 153: 125-131.
15. Casalo G, Balli E, Taddei T, Amuashi J, Gori C. Decreased spontaneous heart rate variability in congestive heart failure. Am J Cardiol 1989: 64: 1162-1167.
16. Cerutti S, Goldberger AL, Yamamoto Y. Recent advances in heart rate variability signal processing and interpretation. IEEE Trans Biomed Eng 2006: 53 (1): 1-3.
17. Chauhan VS, Krahn AD, Walker BD, Klein GJ, Skanes AC, Yee R. Sex differences in QTc interval and QT dispersion: dynamics during exercise and recovery in healthy subjects. Am Heart J 2002: 144 (5): 858-864.
18. Cottin F, Medigue C, Lepretre P, Papelier Y, Koralsztein J, Billat V. Heart rate variability during exercise performed below and above ventilatory threshold. Med Sci Sports Exerc 2004: 36: 594-600.
19. Cripps TR, Malik M, Farrell TG, Camm AJ. Prognostic value of reduced heart rate variability after myocardial infarction: clinical evaluation of a new analysis method. Br Heart J 1991: 65: 14-19.
20. Darr KC, Bassett DR, Morgan BJ, Thomas DP. Effects of age and training status on heart rate recovery after peak exercise. Am J Physiol 1988: 254 (2 Part 2): H340-H343.
21. Davey PP. QT interval measurement: Q to TApex or Q to TEnd? J Intern Med 1999: 246 (2): 145-149.
22. Egloff C, Merola P, Schiavon C, Schiavinato ML, Modena F, Stritoni P, Corbara F, Miraglia G. Sensitivity, specificity and predictive accuracy of Q wave, QX/QT ratio, QTc interval and ST depression during exercise testing in men with coronary artery disease. Am J Cardiol 1987: 60: 1006-1008.
23. Freeman JV, Dewey FE, Hadley DM, Myers J, Froelicher VF. Autonomic nervous system interaction with the cardiovascular system during exercise. Prog Cardiovasc Dis 2006: 4 (5): 342-362.
24. Furlan R, Piazza S, Dell'Orto S, Gentile E, Cerutti S, Pagani M, Malliani A. Early and late effects of exercise and athletic training on neural mechanisms controlling heart rate. Cardiovasc Res 1993: 27 (3): 482-488.
25. Galaska R, Makowiec D, Dudkowska A, Koprowski A, Chlebus K, Wdowczyk-Szulc J, Rynkiewicz A. Comparison of wavelet transform modulus maxima and multifractal detrended fluctuation analysis of heart rate in patients with systolic dysfunction of left ventricle. Ann Noninv Electrocardiol 2008: 13 (2): 155-164.
26. Hautala AJ, Makikallio TH, Seppanen T, Huikuri HV, Tulppo MP. Short-term correlation properties of R-R interval dynamics at different exercise intensity levels. Clin Physiol Funct Imaging 2003: 23 (4): 215-223.
27. Hirsch JA, Bishop B. Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate. Am J Physiol 1981: 241: H620-H629.
28. Hyndman BW, Kitney RI, Sayers BM. Spontaneous rhythms in physiological control systems. Nature 1971: 233: 339-341.
29. Ino-Oka E, Sekino H, Ohtaki Y, Inooka H. Effects of daily physical activity level on the degree of sympathetic tone. Intern Med 2009: 48 (1): 19-24.
30. Iyengar N, Peng CK, Morin R, Goldberger AL, Lipsitz LA. Age-related alterations in the fractal scaling of cardiac interbeat interval dynamics. Am J Physiol 1996: 271 (4 Part 2): R1078-R1084.
31. Janssen MJ, De Bie J, Swenne CA, Oudhof J. Supine and standing sympathovagal balance in athletes and controls. Eur J Appl Physiol Occ Physiol 1993: 67 (2): 164-167.
32. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetiere P. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005: 352: 1951-1958.
33. Kligfield P, Lax KG, Okin PM. QT interval-heart rate relation during exercise in normal men and women: definition by linear regression analysis. J Am Coll Cardiol 1996: 28 (6): 1547-1555.
34. Lahiri MK, Kannankeril PJ, Goldberger JJ. Assessment of autonomic function in cardiovascular disease. J Am Coll Cardiol 2008: 5: 1725-1733.
35. La Rovere MT, Pinna GD, Hohnloser SH, Marcus FI, Mortara A, Hohara R, Bigger T, Camm AJ, Schwartz PJ. Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials. Circulation 2001: 103: 2072-2077.
36. Lewis MJ. Heart rate variability analysis: a tool to assess cardiac autonomic function. Comput Inform Nurs 2005: 23 (6): 335-341.
37. Lewis MJ, Kingsley M, Short AL, Simpson K. Influence of high-frequency bandwidth on heart rate variability analysis during physical exercise. Biomed Sig Proc Control 2007a: 2 (1): 34-39.
38. Lewis MJ, Kingsley M, Short AL, Simpson K. Rate of reduction of heart rate variability during exercise as an index of physical work capacity. Scand J Med Sci Sports 2007b: 17: 696-702.
39. Lewis MJ, Rassi D, Short AL. Analysis of the QT interval and its variability in healthy adults during rest and exercise. Physiol Meas 2006: 27 (11): 1211-1226.
40. Lewis MJ, Short AL. Differences in QT interval determined from multi-lead ambulatory ECG during rest and physical exercise. Biomed Sig Proc Control 2006a: 1: 219-228.
41. Lewis MJ, Short AL. Hysteresis of electrocardiographic depolarization-repolarization intervals during dynamic physical exercise and subsequent recovery. Physiol Meas 2006b: 27 (2): 191-201.
42. Lewis MJ, Short AL. Sample entropy of electrocardiographic RR and QT time-series data during rest and exercise. Physiol Meas 2007: 28 (6): 731-744.
43. Lewis MJ, Short AL. Relationship between electrocardiographic RR and QT interval variability and indices of ventricular function in healthy subjects. Physiol Meas 2008: 29 (1): 1-13.
44. Macfarlane PW, McLaughlin SC, Rodger JC. Influence of lead selection and population on automated measurement of QT dispersion. Circulation 1998: 98 (20): 2160-2167.
45. Magnano AR, Holleran S, Ramakrishnan R, Reiffel JA, Bloomfield DM. Autonomic nervous system influences on QT interval in normal subjects. J Am Coll Cardiol 2002: 39: 1820-1826.
46. Malliani A. The pattern of sympathovagal balance explored in the frequency domain. News Physiol Sci 1999: 14: 111-117.
47. Malliani A, Lombardi F, Pagani M. Power spectrum analysis of heart rate variability: a tool to explore neural regulatory mechanisms. Br Heart J 1994: 71: 1-2.
48. Mandelbrot BB. The fractal geometry of nature. San Francisco: Freeman, 1982.
49. Mayuga KA, Parker M, Sukthanker ND, Perlowski A, Schwartz JB, Kadish AH. Effects of age and gender on the QT response to exercise. Am J Cardiol 2001: 87 (2): 163-167.
50. Meyer M, Rahmel A, Marconi C, Grassi B, Skinner JE, Cerretelli P. Is the heart preadapted to hypoxia? Evidence from fractal dynamics of heartbeat interval fluctuations at high altitude (5, 050 m). Integr Physiol Behav Sci 1998: 33 (1): 9-40.
51. Meyer M, Stiedl O. Self-affine fractal variability of human heartbeat interval dynamics in health and disease. Eur J Appl Physiol 2003: 90 (3-4): 305-316.
52. Mourot L, Bouhaddi M, Perrey S, Cappelle S, Henriet MT, Wolf JP, Rouillon JD, Regnard J. Decrease in heart rate variability with overtraining: assessment by the Poincaré plot analysis. Clin Physiol Funct Imaging 2004: 24 (1): 10-18.
53. Miller TD. The exercise treadmill test: estimating cardiovascular prognosis. Clev Cli J Med 2008: 75 (6): 424-430.
54. Mittleman MA, Siscovick DS. Physical exertion as a trigger of myocardial infarction and sudden cardiac death. Cardiol Clin 1996: 14: 263-270.
55. Nakamura Y, Yamamoto Y, Muraoka I. Autonomic control of heart rate during physical exercise; fractal dimension of heart rate variability. J Appl Physiol 1993: 74 (2): 875-881.
56. O'Donnell J, Lovelace DE, Knoebel SB, McHenry PL. Behavior of the terminal T wave during exercise in normal subjects, patients with symptomatic coronary artery disease and apparently healthy subjects with abnormal ST segment depression. J Am Coll Cardiol 1985: 5 (1): 78-84.
57. Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R. Power spectral analysis of heart rate; arterial pressure variabilities as a marker of sympathovagal interaction in man; conscious dog. Circ Res 1986: 59: 178-193.
58. Peng CK, Havlin S, Stanley HE, Goldberger AL. Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 1995: 5 (1): 82-87.
59. Penttilä J, Helminen A, Jartti T, Kuusela T, Huikuri HV, Tulppo MP, Scheinin H. Effect of cardiac vagal outflow on complexity and fractal correlation properties of heart rate dynamics. Auton Autacoid Pharmacol 2003: 23 (3): 173-179.
60. Perini R, Milesi S, Biancardi L, Pendergast DR, Veicsteinas A. Heart rate variability in exercising humans: effect of water immersion. Eur J Appl Physiol 1998: 77: 326-332.
61. Perini R, Milesi S, Fisher NM, Pendergast DR, Veicsteinas A. Heart rate variability during dynamic exercise in elderly males and females. Eur J Appl Physiol 2000: 82 (1-2): 8-15.
62. Perini R, Orizio C, Baselli G, Cerutti S, Veicsteinas A. The influence of exercise intensity on the power spectrum of heart rate variability. Eur J Appl Physiol 1990: 61: 143-148.
63. Pichon AP, De Bisschop C, Roulaud M, Denjean A, Papelier Y. Spectral analysis of heart rate variability during exercise in trained subjects. Med Sci Sports Exerc 2004: 36 (10): 1702-1708.
64. Pichot V, Busso T, Roche F, Garet M, Costes F, Duverney D, Lacour JR, Barthélémy JC. Autonomic adaptations to intensive and overload training periods: a laboratory study. Med Sci Sports Exerc 2002: 34 (10): 1660-1666.
65. Pikkujamsa SM, Mäkikallio TH, Sourander LB, Räihä IJ, Puukka P, Skyttä J, Peng CK, Goldberger AL, Huikuri HV. Cardiac interbeat interval dynamics from childhood to senescence: comparison of conventional and new measures based on fractals and chaos theory. Circulation 1999: 100 (4): 393-399.
66. Pipilis A, Flather M, Ormerod O, Sleight P. Heart rate variability in acute myocardial infarction and its association with infarct site and clinical course. Am J Cardiol 1991: 67: 1137-1139.
67. Porta A, Baselli G, Caiani E, Malliani A, Lombardi F, Cerutti S. Quantifying electrocardiogram RT-RR variability interactions. Med Biol Eng Comput 1998: 36 (1): 27-34.
68. Richman JS, Moorman JR. Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol 2000: 278 (6): H2039-H2049.
69. Rimoldi O, Furlan R, Pagani MR, Piazza S, Guazzi M, Pagani M, Malliani A. Analysis of neural mechanisms accompanying different intensities of dynamic exercise. Chest 1992: 101 (Suppl. 5): 226S-230S.
70. Sandercock GR, Brodie DA. The use of heart rate variability measures to assess autonomic control during exercise. Scand J Med Sci Sports 2006: 16: 302-313.
71. Saul JP, Arai Y, Berger RD, Lilly LS, Colucci WS, Cohen RJ. Assessment of autonomic regulation in chronic congestive heart failure by heart rate spectral analysis. Am J Cardiol 1988: 61: 1292-1299.
72. Sayers BM. Analysis of fetal heart rate variability. Ergonomics 1973: 16: 17-32.
73. Schroeder EB, Liao D, Chambless LE, Prineas RJ, Evans Heiss G. Hypertension, blood pressure and heart rate variability: the atherosclerosis risk in communities (ARIC) study. Hypertension 2003: 43: 1106-1111.
74. Shimizu W, Tsuchioka Y, Karakawa S, Nagata K, Mukai J, Yamagata T, Matsuura H, Kajiyama G, Matsuura Y. Differential effect of pharmacological autonomic blockade on some electrophysiological properties of the human ventricle and atrium. Br Heart J 1994: 71: 34-37.
75. Sugawara J, Murakami H, Maeda S, Kuno S, Matsuda M. Change in post-exercise vagal reactivation with exercise training and detraining in young men. Eur J Appl Physiol 2001: 85 (3-4): 259-263.
76. Sundaram S, Carnethon M, Polito K, Kadish AH, Goldberger JJ. Autonomic effects on QT-RR interval dynamics after exercise. Am J Physiol Heart Circ Physiol 2008: 294: H490-H497.
77. Task Force of the European Society of Cardiology and The North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996: 17 (3): 354-381.
78. Tulppo MP, Hughson RL, Mäkikallio TH, Airaksinen KEJ, Seppänen T, Huikuri HV. Effects of exercise; passive head-up tilt on fractal; complexity properties of heart rate dynamics. Am J Physiol Heart Circ Physiol 2001: 280 (3): H1081-H1087.
79. Tulppo MP, Mäkikallio TH, Takala TES, Seppanen T, Huikuri HV. Quantitative beat-to-beat analysis of heart rate dynamics during exercise. Am J Physiol Heart Circ Physiol 1996: 271 (40): H244-H252.
80. Valkama JO, Huikuri HV, Airaksinen KEJ, Linnaluoto MK, Takkunen JT. Determinants of frequency domain measures of heart rate variability in the acute and convalescent phases of myocardial infarction. Cardiovasc Res 1994: 28: 1273-1276.
81. Watanabe T, Harumi K, Akutsu Y, Yamanaka H, Michihata T, Okazaki O, Katagiri T. Relation between exercise-induced myocardial ischemia as assessed by nitrogen-13 ammonia positron emission tomography and QT interval behavior in patients with right bundle branch block. Am J Cardiol 1998: 81 (7): 816-821.
82. Yamamoto Y, Hughson RL, Peterson JC. Autonomic control of heart rate during exercise studied by heart rate variability spectra analysis. J Appl Physiol 1991: 71 (3): 1136-1142.