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Assessing autonomic function by analysis of heart rate recovery from exercise in healthy subjects

      Abstract

      Although delayed recovery of heart rate (HR) after exercise indicates poor prognosis, the relative role of parasympathetic reactivation versus sympathetic withdrawal in controlling exercise HR recovery remains controversial. Quantifying HR recovery is difficult because the rate of recovery varies with exercise level. This study develops a model of HR recovery applicable to multiple exercise levels simultaneously. Using the Levenberg-Marquardt method for nonlinear models, HR curves for 11 healthy volunteers recovering from 4 different levels of exercise were fit to equations incorporating 1 first-order time constant for parasympathetic reactivation and 1 for sympathetic withdrawal. Results provided time constants for parasympathetic reactivation of 44 ± 37 seconds and for sympathetic withdrawal of 65 ± 56 seconds. The model fit the HR recovery curves very closely, explaining 99.7 ± 0.1% of the variance in the data. In conclusion, this study presents a unique method for quantitatively testing theories on the relative roles of sympathetic withdrawal and parasympathetic reactivation during recovery from exercise. It provides indexes of dynamic sympathetic and parasympathetic functions, with the parasympathetic system having a faster response time. It supports theories of coordinated interaction of parasympathetic reactivation and sympathetic withdrawal during exercise recovery and does not support using simple measures of exercise HR recovery as indexes of vagal function alone.
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      References

        • Savin W.M.
        • Davidson D.M.
        • Haskell W.L.
        Autonomic contribution to heart rate recovery from exercise in humans.
        J Appl Physiol. 1982; 53: 1572-1575
        • Imai K.
        • Sato H.
        • Hori M.
        • Kusuoka H.
        • Ozaki H.
        • Yokoyama H.
        • Takeda H.
        • Inoue M.
        • Kamada T.
        Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure.
        J Am Coll Cardiol. 1994; 24: 1529-1535
        • Perini R.
        • Orizio C.
        • Comande A.
        • Castellano M.
        • Beschi M.
        • Veicsteinas A.
        Plasma norepinephrine and heart rate dynamics during recovery from submaximal exercise in man.
        Eur J Appl Physiol. 1989; 58: 879-883
        • Jose A.D.
        • Collison D.
        The normal range and determinants of the intrinsic heart rate in man.
        Cardiovasc Res. 1970; 4: 160-167
        • Robinson S.
        • Pearcy M.
        • Brueckman F.R.
        • Nicholas J.R.
        • Miller D.I.
        Effects of atropine on heart rate and oxygen intake in working man.
        J Appl Physiol. 1953; 5: 508-512
        • Maciel B.C.
        • Gallo L.
        • Marin Neto J.A.
        • Lima Filho E.C.
        • Martins L.E.B.
        Autonomic nervous control of the heart rate during dynamic exercise in normal man.
        Clin Sci. 1986; 71: 457-460
        • Cardus D.
        • Spencer W.A.
        Recovery time of heart frequency in healthy men.
        Arch Phys Med Rehab. 1967; 48: 71-77
        • Linnarsson D.
        Dynamics of pulmonary gas exchange and heart rate changes at start and end of exercise.
        Acta Physiol Scand. 1974; 415: 7-68
        • Savin W.M.
        • Haskell W.L.
        • Schroeder J.S.
        • Stinson E.B.
        Cardiorespiratory responses of cardiac transplant patients to graded, symptom-limited exercise.
        Circulation. 1980; 62: 55-60
        • Pierpont G.L.
        • Stolpman D.R.
        • Gornick C.C.
        Heart rate recovery post-exercise as an index of parasympathetic activity.
        J Auton Nerv Syst. 2000; 80: 169-174
        • Broman S.
        • Wigertz O.
        Transient dynamics of ventilation and heart rate with step changes in work load from different load levels.
        Acta Physiol Scand. 1971; 81: 54-74
        • Crouse S.F.
        • Sterling J.
        • Tolson H.
        • Hasson S.
        The effect of beta-adrenergic blockade on heart rate recovery from exercise.
        J Cardiopulm Rehab. 1989; 9: 202-206
        • Cole C.R.
        • Blackstone E.H.
        • Pashkow F.J.
        • Snader C.E.
        • Lauer M.S.
        Heart-rate recovery immediately after exercise as a predictor of mortality.
        N Engl J Med. 1999; 341: 1351-1357
        • Cole C.R.
        • Foody J.M.
        • Blackstone E.H.
        • Lauer M.S.
        Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort.
        Ann Intern Med. 2000; 132: 552-555
        • Rosenblueth A.
        • Simeone F.A.
        The interrelations of vagal and accelerator effects on the cardiac rate.
        Am J Physiol. 1934; 110: 42-55
        • Katona P.G.
        • McLean M.
        • Dighton D.H.
        • Guz A.
        Sympathetic and parasympathetic cardiac control in athletes and nonathletes at rest.
        J Appl Physiol. 1982; 52: 1652-1657
        • Warner H.R.
        • Cox A.A.
        A mathematical model of heart rate control by sympathetic and vagus efferent information.
        J Appl Physiol. 1962; 17: 349-355
        • Warner H.R.
        • Russell R.O.
        Effect of combined sympathetic and vagal stimulation on the heart rate in the dog.
        Circ Res. 1969; 24: 567-573
        • Haggendal J.
        • Hartley L.H.
        • Saltin B.
        Arterial noradrenaline concentrations during exercise in relation to the relative work levels.
        Scand J Clin Lab Invest. 1970; 26: 337-342
        • Rowell L.B.
        Central Circulatory Adjustments to Dynamic Exercise Human Cardiovascular Control.
        in: Oxford University Press, New York1993: 163-203