© 1990 by European Society of Cardiology
Copyright © 1990, European Society of Cardiology
Evidence for an intrinsic mechanism regulating heart rate variability in the transplanted and the intact heart during submaximal dynamic exercise?
L Bernardi, F Salvucci, P L Soldá, A Calciati, S Perlini, Department of Internal Medicine, Clinica Medica 1, University of Pavia, 27100 Pavia, Italy
C Falcone, Department of Internal Medicine, Cardiologia, University of Pavia, 27100 Pavia, Italy
R Suardi, Department of Sports Medicine, University of Pavia, 27100 Pavia, Italy
L Ricciardi, Departments of Physiology and Sports Medicine, University of Pavia, 27100 Pavia, Italy
Correspondence to: Dr Bernardi
Study objective – The aim was to assess the changes in sympatho-vagal balance which occur with exercise.
Design – The power spectnun of RR interval fluctuations (low frequency [LF] and high frequency components [HF]) was determined before, during, and after graded work load exercise on a cycle ergometer. The power spectrum of the respiratory signal, oxygen consumption, and respiratory volumes were also evaluated. In all subjects HF was considered to be an index of respiratory sinus arrhythmia. In normal subjects HF and LF were considered to be indices of relative vagal and sympathetic activity, respectively, whereas in heart transplant subjects HF was considered as a respiratory modulation of the intrinsic heart rate, and not dependent on autonomic tone. Heart rate variability was evaluated as RR interval variance.
Subjects – 15 normal subjects (six trained cyclists and nine healthy sedentary subjects) and six orthotopic heart transplant recipients took part in the study.
Measurements and main results – During the fust part of exercise, heart rate increased, RR interval variance decreased, HF decreased, and the relative amount of LF increased both in sedentary and athletic subjects, suggesting a relative increase in sympathetic tone. However, when approaching peak exercise, while heart rate further increased and the variance slightly decreased, the relative proportion of LF decreased and HF proportionally increased. At peak exercise HF accounted for 99.9% of heart rate variability in athletic subjects and for 88.9% in sedentary subjects (p<0.001 v baseline and v LF in both groups). In heart transplant subjects both the variance and the HF increased from the beginning of exercise (p<0.05), and showed a direct correlation with ventilatory variables and an inverse correlation with heart rate (r=0.794, p<0.001, multiple regression analysis). No measurable LF components could be obtained in these subjects. During recovery, while the heart rate decreased and the RR interval variance increased, there was a relative increase in LF and a relative decrease in HF in normal subjects (either sedentary or athletic). Similariy, in heart transplant subjects, there was a decrease in HF during recovery. Thus the increase in HF at peak exercise in normal subjects contrasts with all the other data which suggest a prevalence in sympathetic tone during the entire exercise and the early recovery period, but appears similar to the increase in HF observed in heart transplant subjects due to the effect of increased ventilation during exercise.
Conclusions – These findings suggest that at peak exercise a non-autonomic mechanism, possibly intrinsic to the heart muscle, may determine heart rate fluctuations in synchrony with ventilation in the intact as well as in the denervated human heart.
KEYWORDS exercise test; autonomic nervous system; intrinsic heart rate; heart rate variability; power spectral analysis; heart transplantation
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Ng, S. Sundaram, A. H. Kadish, and J. J. Goldberger Autonomic effects on the spectral analysis of heart rate variability after exercise Am J Physiol Heart Circ Physiol, October 1, 2009; 297(4): H1421 - H1428. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Blain, O. Meste, A. Blain, and S. Bermon Time-frequency analysis of heart rate variability reveals cardiolocomotor coupling during dynamic cycling exercise in humans Am J Physiol Heart Circ Physiol, May 1, 2009; 296(5): H1651 - H1659. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Mase, M. Disertori, and F. Ravelli Cardiorespiratory interactions in patients with atrial flutter J Appl Physiol, January 1, 2009; 106(1): 29 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Mangoni and J. Nargeot Genesis and Regulation of the Heart Automaticity Physiol Rev, July 1, 2008; 88(3): 919 - 982. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Goldberger, F. K. Le, M. Lahiri, P. J. Kannankeril, J. Ng, and A. H. Kadish Assessment of parasympathetic reactivation after exercise Am J Physiol Heart Circ Physiol, June 1, 2006; 290(6): H2446 - H2452. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Blain, O. Meste, and S. Bermon Influences of breathing patterns on respiratory sinus arrhythmia in humans during exercise Am J Physiol Heart Circ Physiol, February 1, 2005; 288(2): H887 - H895. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Manfrini, G. Morgagni, C. Pizzi, F. Fontana, and R. Bugiardini Changes in autonomic nervous system activity: spontaneous versus balloon-induced myocardial ischaemia Eur. Heart J., September 1, 2004; 25(17): 1502 - 1508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. N. Bartels, S. Jelic, P. Ngai, R. C. Basner, and R. E. DeMeersman High-Frequency Modulation of Heart Rate Variability During Exercise in Patients With COPD Chest, September 1, 2003; 124(3): 863 - 869. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Reland, N. S. Ville, S. Wong, H. Gauvrit, G. Kervio, and F. Carre Exercise Heart Rate Variability of Older Women in Relation to Level of Physical Activity J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2003; 58(7): B585 - 591. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Toledo, O. Gurevitz, H. Hod, M. Eldar, and S. Akselrod Wavelet analysis of instantaneous heart rate: a study of autonomic control during thrombolysis Am J Physiol Regulatory Integrative Comp Physiol, April 1, 2003; 284(4): R1079 - R1091. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Lanfranchi and V. K Somers Arterial baroreflex function and cardiovascular variability: interactions and implications Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2002; 283(4): R815 - R826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Van De Borne, N. Montano, K. Narkiewicz, J. P. Degaute, A. Malliani, M. Pagani, and V. K. Somers Importance of ventilation in modulating interaction between sympathetic drive and cardiovascular variability Am J Physiol Heart Circ Physiol, February 1, 2001; 280(2): H722 - H729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. El-Omar, A. Kardos, and B. Casadei Mechanisms of respiratory sinus arrhythmia in patients with mild heart failure Am J Physiol Heart Circ Physiol, January 1, 2001; 280(1): H125 - H131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Chemla, E. Aptecar, J.-L. Hebert, C. Coirault, D. Loisance, Y. Lecarpentier, and A. Nitenberg Short-term variability of pulse pressure and systolic and diastolic time in heart transplant recipients Am J Physiol Heart Circ Physiol, July 1, 2000; 279(1): H122 - H129. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ponikowski, M. Piepoli, T.P. Chua, W. Banasiak, D. Francis, S.D. Anker, and A.J.S. Coats The impact of cachexia on cardiorespiratory reflex control in chronic heart failure Eur. Heart J., November 2, 1999; 20(22): 1667 - 1675. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Sleight and L. Bernardi Sympathovagal Balance Circulation, December 8, 1998; 98(23): 2640 - 2640. [Full Text] [PDF]
|
|
|
|
|
|
L. Bernardi, C. Valenti, J. Wdowczyck-Szulc, A. W. Frey, M. Rinaldi, G. Spadacini, C. Passino, L. Martinelli, M. Vigano, and G. Finardi Influence of Type of Surgery on the Occurrence of Parasympathetic Reinnervation After Cardiac Transplantation Circulation, April 14, 1998; 97(14): 1368 - 1374. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Uechi, K. Asai, M. Osaka, A. Smith, N. Sato, T. E. Wagner, Y. Ishikawa, H. Hayakawa, D. E. Vatner, R. P. Shannon, et al. Depressed Heart Rate Variability and Arterial Baroreflex in Conscious Transgenic Mice With Overexpression of Cardiac Gs{alpha} Circ. Res., March 9, 1998; 82(4): 416 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ponikowski, T. P. Chua, M. Piepoli, D. Ondusova, K. Webb-Peploe, D. Harrington, S. D. Anker, M. Volterrani, R. Colombo, G. Mazzuero, et al. Augmented Peripheral Chemosensitivity as a Potential Input to Baroreflex Impairment and Autonomic Imbalance in Chronic Heart Failure Circulation, October 21, 1997; 96(8): 2586 - 2594. [Abstract] [Full Text]
|
|
|
|
|
|
E. Oida, T. Moritani, and Y. Yamori Tone-entropy analysis on cardiac recovery after dynamic exercise J Appl Physiol, June 1, 1997; 82(6): 1794 - 1801. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Piepoli, P. Sleight, S. Leuzzi, F. Valle, G. Spadacini, C. Passino, J. Johnston, and L. Bernardi Origin of Respiratory Sinus Arrhythmia in Conscious Humans : An Important Role for Arterial Carotid Baroreceptors Circulation, April 1, 1997; 95(7): 1813 - 1821. [Abstract] [Full Text]
|
|
|
|
|
|
S.M. Horner, C.F. Murphy, B. Coen, D.J. Dick, F.G. Harrison, Z. Vespalcova, and M.J. Lab Contribution to Heart Rate Variability by Mechanoelectric Feedback: Stretch of the Sinoatrial Node Reduces Heart Rate Variability Circulation, October 1, 1996; 94(7): 1762 - 1767. [Abstract] [Full Text]
|
|
|
|
|
|
T. F. o. t. E. S. o. C. t. N. A. S. o. P. Electrophysiology Heart Rate Variability : Standards of Measurement, Physiological Interpretation, and Clinical Use Circulation, March 1, 1996; 93(5): 1043 - 1065. [Full Text]
|
|
|
|
|
|
L. Bernardi, B. Bianchini, G. Spadacini, S. Leuzzi, F. Valle, E. Marchesi, C. Passino, A. Calciati, M. Vigano, M. Rinaldi, et al. Demonstrable Cardiac Reinnervation After Human Heart Transplantation by Carotid Baroreflex Modulation of RR Interval Circulation, November 15, 1995; 92(10): 2895 - 2903. [Abstract] [Full Text]
|
|
|
|
|
|
E. Toledo, I. Pinhas, D. Aravot, Y. Almog, and S. Akselrod Functional restitution of cardiac control in heart transplant patients Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2002; 282(3): R900 - R908. [Abstract] [Full Text] [PDF]
|
|