|
HEART RATE RECOVERY AFTER EXERCISE AND NEURAL REGULATION
OF HEART RATE VARIABILITY IN 30-40 YEAR OLD FEMALE MARATHON RUNNERS
|
1Department of Sports Medicine and Sports Science, Gifu University
Graduate School of Medicine, Japan
2Faculty of Management, Shizuoka Sangyo University, Japan
3Section of Clinical Laboratory, Gifu University Hospital, Japan
| Received |
|
15 October 2004 |
| Accepted |
|
07
December 2004 |
| Published |
|
01
March 2005 |
©
Journal of Sports Science and Medicine (2005) 4, 9 - 17
Search
Google Scholar for Citing Articles
| ABSTRACT |
| The
aim of the present study was to examine the effects of endurance training
on heart rate (HR) recovery after exercise and cardiac autonomic nervous
system (ANS) modulation in female marathon runners by comparing with
untrained controls. Six female marathon runners (M group) aged 32-40
years and eight age-matched untrained females (C group) performed
a maximum-effort treadmill running exercise. Maximal oxygen uptake
(VO2max) was measured during the exercise with a gas analyzer connected
to subjects through a face mask. Heart rate, blood pressure and blood
lactate were measured before and after the exercise. Rating of perceived
exertion (RPE) to the exercise was obtained immediately after the
exercise. Holter ECG was recorded and analyzed with power spectral
analysis of heart rate variability (HRV) to investigate the cardiac
ANS modulation. The M group had significantly higher VO2max, faster
HR recovery after exercise, higher Mean RR, SDRR, HF power and lower
LF/HF ratio at rest compared with the C group. The M group also presented
greater percent decrease of blood pressure after exercise, although
their blood pressure after exercise was higher than the C group. It
is suggested that endurance training induced significant alterations
in cardiac ANS modulation at rest and significant acceleration of
HR recovery after exercise in female marathon runners. Faster HR recovery
after exercise in the female marathon runners should result from their
higher levels of HRV, higher aerobic capacity and exaggerated blood
pressure response to exercise compared with untrained controls.
KEY
WORDS: Heart rate recovery, heart rate variability, female marathon
runner.
|
| INTRODUCTION |
During
exercise, heart rate (HR) and myocardial contractility will be increased
to satisfy energy demands of working muscles. Its nervous modulation
is considered to be due to the vagal withdrawal at low-intensity exercise
and the combination of vagal withdrawal and sympathetic activation
at moderate or high-intensity exercise (Kluess et al., 2000).
With the cessation of exercise, the decrease in HR immediately after
exercise is mainly thought to be a function of a reactivation of the
parasympathetic nervous system (Arai et al., 1989).
Later, the further decrease in HR to the pre-exercise value also depends
on the gradual withdrawal of the sympathetic system (Perini et al.,
1989).
Because increased vagal activity has been associated with a reduction
in the risk of sudden cardiac death (Pardo et al., 2000),
recently, some studies have demonstrated that a delayed decrease in
HR after exercise would be a powerful and independent predictor of
all cause mortality in patients or in general population (Cole et
al., 1999;
Cole et al., 2000;
Nishime et al., 2000).
Physical training was shown to increase cardiac vagal tone (Levy et
al., 1998)
and to accelerate HR recovery after exercise (Darr et al., 1988),
which may contribute to the reduction in mortality. Which kind of
exercise could more efficiently accelerate HR recovery or increase
cardiac autonomic nervous system (ANS) modulation remains unknown.
Marathon running exercise is an endurance-promotion exercise practiced
by a lot of athletes over the world. However, little is known about
the effects of marathon training habit on HR recovery after exercise
and cardiac ANS modulation. Time and frequency domain analysis of
heart rate variability (HRV) has been proven to be a noninvasive technique
capable of providing information on autonomic modulation of the sinus
node. Therefore, employing this method, the present study investigated
the changes over time in HR and ANS modulation both at rest and during
post-exercise recovery periods of female marathon runners by comparing
with their age-matched untrained controls. |
| METHODS |
|
Subjects
Six
female marathon runners aged 32-40 years (M group) and eight untrained
female controls aged 29- 42 years (C group) participated in this
study. M group has been doing endurance running exercise for more
than 15 years and participated in international marathon race. C
group had not been involved in regular long-term exercise training
for years, but participated in occasional recreational activity
(bicycle, table-tennis or badminton). According to the results of
questionnaire and electrocardiogram, all subjects were free of hypertension,
hyperlipemia, cardiovascular disease and diabetes mellitus. In addition,
they were nonsmokers, and none of them were taking any medicine
known to effect cardiovascular function. Characteristics of the
two groups are depicted in Table
1. This study was approved by the Ethics Committee of the Gifu
University School of Medicine, and all subjects provided written
informed consent for their participation in the experimental procedures.
Procedures
All measurements were performed in a quiet and air-conditioned (24°C)
room, and all subjects did not consume any beverages containing
alcoholic or coffee before the measurements. Body fat percentage
was measured by an analyzer (Body Fat Analyzer TBF-31O, Tanita Company,
Limited, Japan). After 10-min quiet rest in a supine position, the
subjects were asked to perform maximal running exercise on an electrically
treadmill. The running speed was chosen by the subjects according
to their individual pace. With 3-min warm up period at 0% treadmill
inclination, the gradient was increased by 1% per minute according
to Balke method till exhaustion was reached. After the maximal exercise,
the subjects rested quietly for 30 min in the supine position for
recovery. During the exercise the subject wore a face mask connected
to a gas analyzer (Cardiopulmonary Function Measuring System, Oxycon
Alpha, Fukuda Electronic Company, Limited, Japan), by which inspired
and expired gases were measured in breath by breath mode and analyzed
in 5 sec intervals. The subject breathed spontaneously throughout
the experimental procedure without the attempt to control the depth
or frequency of the respiratory pattern in order to avoid the discomfort
as well as the changes of metabolism and blood gas. The criteria
for the establishment of VO2max included a plateau in
oxygen consumption with increasing work rate, a respiratory exchange
ratio > 1.1, near achievement of age-predicted maximal HR (±10)
and failure to maintain the running speed despite encouragement.
The electrocardiogram (ECG) was monitored by Holter recorder (Ambulatory
ECG Recorder SM-50, Fukuda Electronic Company, Limited, Japan) at
a rate of 1000 samples per second during the experiment for heart
rate variability (HRV) analysis. Meanwhile, blood pressure and blood
lactate were measured before exercise, immediately after exercise,
3 min, 5 min, 10 min, 20 min and 30 min after exercise. The rating
of perceived exertion (RPE) (Borg, 1982)
to the exercise was also obtained according to an oral questionnaire
for the subjects immediately after the exercise.
Estimation
of HRV
Holter ECG was analyzed by Holter Analyzer SCM-6000 System (SCM-6000
Dual Holter Workstation System, Fukuda Electronic Company, Limited,
Japan). Spectral analysis was repeatedly performed within the selected
segments of Holter ECG R-R interval data using 256-point fast Fourier
transformation. Holter ECG R-R interval data at rest phase were
divided into two segments (rest1: 0~256s, rest2: 300~556s) and recovery
phase were divided into five segments (rec1: 300~556s, rec2: 600~856s,
rec3: 900~1156s, rec4: 1200~1456s, rec5: 1500~1756s). The results
of HRV at rest were shown by the mean values of rest1~rest2. Spectral
analysis of fast Fourier transformation requires stationarity of
the R-R interval time series and thus analysis of HRV during exercise
is often skewed and may lead to inconsistent results (Casadei et
al., 1995).
In this study, after exercise the subjects need slow down the running
to stop and then lie on a bed to rest. It was still not stationarity
during the initial recovery after exercise, and the results of HRV
analysis during this phase could not be confirmed to be true. Therefore,
HRV at the recovery of 0~300s was not quantified. Power spectra
obtained from spectral analysis were defined as two components:
0.04~0.15Hz (low frequency: LF) and 0.15~0.4Hz (high frequency:
HF). HF power was shown to be almost entirely mediated by the vagal
activity (Berger et al., 1989),
whereas LF power reflects the mixed modulation of vagal and sympathetic
activities (Bernardi et al., 1994).
The ratio of LF power to HF power (LF/HF) was considered to reflect
the sympathovagal balance, and high values suggested a sympathetic
predominance (Pagani et al., 1986).
Data
analysis
All corresponding data between the two groups were compared by student's
t-test. All data are expressed as means (±SE). Statistical significance
was set at p < 0.05.
|
| RESULTS |
|
Characteristics of the subjects (Table
1)
Body fat percentage was significantly lower (p < 0.05) in
M group than in C group. VO2max was significantly higher (p <
0.01) in M group than in C group. Treadmill gradient at maximal
exercise was significantly higher (p < 0.01) in M group than
in C group. Treadmill running speed chosen by M group was also significantly
faster (p < 0.01) than that chosen by C group. The RPE to the
exercise was almost the same for the two groups.
Changes of the systolic blood pressure (SBP) and diastolic blood
pressure (DBP) (Figure 1)
Resting blood pressure was almost the same for the two groups. SBP
was significantly higher (p < 0.01) immediately after exercise,
3 min after exercise and 5 min after exercise in M group than in
C group. DBP also showed a higher value (p < 0.01) immediately
after exercise in M group than in C group.
Percent decrease of the systolic blood pressure (SBP) and diastolic
blood pressure (DBP) after exercise (Figure
2)
At 3 min, 5 min, 10 min, 20 min and 30 min after exercise, percent
decrease of SBP or DBP from the peak exercise BP was significantly
higher (p < 0.01 or p < 0.05) in M group than in C group.
Changes of blood lactate (Figure
3)
Blood lactate was almost the same for the two groups at rest or
at recovery phases. Within 30 min after exercise, blood lactate
did not return to the pre-exercise values for both groups.
Changes
of HR (Figure 4)
Resting HR was significantly lower (p < 0.05) in M group than
in C group. Maximal exercise HR was almost the same for the two
groups. HR recovery after exercise indicated the initial fast phase
and the followed slow phase in both groups. However, post-exercise
HR was significantly lower (p < 0.01 or p < 0.05) in M group
than in C group. Within 30 min after exercise, HR gradually decreased
but did not return to the pre-exercise values for both groups.
Percent decrease of HR after exercise (Figure
5)
At 2 min to 30 min after exercise, percent decrease of HR from the
peak exercise HR was significantly higher (p < 0.01 or p <
0.05) in M group than in C group.
Parameters of HRV in time domains (Table
2)
Mean RR intervals were higher (p <0 .05) at rest or at recovery
phases in M group than in C group. SDRR at rest phase was higher
(p < 0.05) in M group than in C group. In addition, within 30
min after exercise, Mean RR and SDRR did not return to the pre-exercise
values for both groups.
Parameters
of HRV in frequency domains (Table
2)
At rest, LF spectral power was slightly higher, whereas HF spectral
power was significantly higher (p < 0.05) and LF/HF ratio was
significantly lower (p < 0.05) in M group than in C group. At
recovery phases, HF power was higher and LF/HF ratio was lower in
M group than in C group, but there was no statistical significance.
LF power, HF power and LF/HF ratio did not return to the pre-exercise
values within 30 min after exercise for both groups.
|
| DISCUSSION |
|
This
study showed that as compared with untrained controls, female marathon
runners had 1) a higher aerobic capacity; 2) a higher blood pressure
after exercise; 3) a higher percent decrease of blood pressure after
exercise; 4) a faster HR recovery after exercise; 5) higher HRV
parameters and lower LF/HF ratio at rest. These results suggested
that endurance training increased cardiorespiratory function and
accelerated HR recovery after exercise.
HR recovery after exercise depends on several factors: the intensity
of exercise, the cardiorespiratory fitness, cardiac ANS modulation,
hormones changes and baroreflex sensitivity. Different degrees of
intensity of exercise would result in diverse types of HR recovery.
After light exercise, HR follows an exponential decline to resting
level. After moderate or heavy exercise, however, the recovery pattern
is characterized by two distinct phases, an initial exponential
drop followed by a slower decline to resting level (Darr et al.,
1988). In the present study, the initial fast phase and the
followed slow phase of HR recovery after the maximum-effort exercise
were also presented in both groups. But the female marathon runners
showed a significantly faster decrease in HR to pre-exercise value
than the untrained controls. Since the two age-matched groups performed
the maximal exercise until exhaustion was reached, furthermore,
the RPE to the exercise and the changes of blood lactate after exercise
were almost the same for both groups, the relative intensity of
exercise for the two groups may be expected to be identical. Obviously,
other factors such as influences from long-term endurance training
are suggested to be responsible for the faster HR recovery after
exercise in the female marathon runners. It should be noted that
the RPE to maximal exercise was only 17.6 for M group and 17.7 for
C group, which were less than the expected maximal RPE values of
19-20. Since the local feeling in breathing or leg earlier appear
exhaustion during the exercise, which made them have to stop running,
while the overall feeling of the RPE to exercise still did not reach
19 or 20.
High aerobic capacity is associated with fast HR recovery after
exercise. For males, HR recovery was shown to be faster in athletes,
who had a higher aerobic capacity than nonathletes (Darr et al.,
1988). The present study based on the females indicated that
the marathon runners remarkably had a faster HR recovery after exercise
and an anticipated higher aerobic capacity than untrained controls.
This could imply that for females it is consistent with the previous
studies based on males that the faster HR recovery after exercise
depends on the higher aerobic capacity.
A number of studies have shown that physically active men or women
demonstrated higher levels of HRV compared with sedentary controls
(Jensen-Urstad et al., 1997; Davy et al., 1998; Rossy and Thayer, 1998). The present study also showed that the female marathon
runners had significantly higher SDRR, HF power at rest and slightly
higher HF power at recovery after exercise than untrained controls.
High levels of HRV are associated with rapid HR recovery after exercise.
Ohuchi et al. (2000) demonstrated that the greater cardiac parasympathetic
activity at rest should be in part responsible for the faster HR
recovery after exercise. Dixon et al. (1992) found that athletes, who had higher vagal activity and
lower sympathetic activity, also had faster HR recovery after exercise
than nonathletes. Javorka et al. (2002)
showed that the percent decrease of HR during the first minute of
recovery was positively correlated with HRV indices at post-exercise
recovery. However, in the above-mentioned studies, most subjects
are based on males. There were almost no studies based on females
that have presented the relationship between HRV variables and HR
recovery after exercise. Unfortunately, we could not find the significant
correlations between HRV variables and HR recovery in our present
study based on the female subjects. It is confused and it may be
possible that the limited number of subjects investigated in this
study was insufficient to reach statistical significance.
The change of blood pressure brings about reflex HR change by the
arterial baroreceptors, which are important in attenuating the rapid
change of blood pressure during daily perturbation (Lanfranchi and
Somers, 2002). Studies have shown baroreflex sensitivity to be augmented
in high-fit male subjects (Barney et al., 1988; Shin et al., 1995). Likewise, physically active women indicate higher baroreflex
sensitivity than sedentary women (Davy et al., 1996; 1998), although baroreflex responsiveness is lower in
women compared with men (Huikuri et al., 1996). The baroreflex-mediated response of HR to change in
arterial blood pressure indicates the capacity of reflex cardiac
autonomic modulation (Huikuri et al., 1996). Significant correlations between baroreflex sensitivity
and HRV have been observed in a previous study (Pellizzer et al.,
1996). In the present study, the marathon runners showed significantly
higher cardiac vagal tone at rest and slightly higher cardiac vagal
tone at post-exercise recovery, which suggested a greater baroreflex-mediated
cardiac vagal outflow than untrained controls. From the results
of HRV analysis and the literatures mentioned above, we could suggest
that the faster HR recovery after exercise in the female marathon
runners may be related to their augmented baroreflex function.
It is noteworthy that blood pressure at rest was almost the same
for the two groups, but after exercise it was significantly higher
in the female marathon runners. This exhibited an exaggerated blood
pressure response to maximal exercise in the female marathon runners.
Physical activity was shown to increase left ventricular (LV) mass
(Maron, 1986; Levy et al., 1993; Whyte et al., 2004), which was related to maximal blood pressure during exercise
(Michelsen et al., 1990; Molina et al., 1999; Kamarck et al., 2000; Sung et al., 2003). The large increment of blood pressure during the maximum-effort
running exercise may be necessary for the marathon runners to achieve
great work capacity of fast treadmill running speed and high treadmill
gradient. Whether exaggerated exercise blood pressure is responsible
for rapid HR recovery after exercise is unclear and further studies
are need to clarify. Although blood pressure after exercise was
higher in the female marathon runners, their percent decrease of
blood pressure after exercise was significantly greater than untrained
controls'. This also reflects that the female marathon runners have
a greater capacity of reflex cardiovascular modulation after exercise
than untrained controls (Laukkanen et al., 2004).
It is unlikely that hormonal changes contribute to the faster HR
recovery in the marathon runners because according to some studies,
endurance training could enhance plasma catecholamine concentration
in response to moderate or strenuous exercise (Kjaer et al., 1986; Silverman and Mazzeo, 1996; Greiwe et al., 1999; Jacob et al., 2004) and the clearance rate of post-exercise plasma catecholamine
was shown not to be significantly changed by training (Hagberg et
al., 1979).
|
| CONCLUSIONS |
In
summary, female marathon runners indicated faster HR recovery after
exercise and altered cardiac ANS modulation at rest than untrained
controls. The higher levels of HRV, higher aerobic capacity and exaggerated
blood pressure response to exercise in the female marathon runners
are suggested to be responsible for their faster HR recovery after
exercise compared with untrained controls.
|
| KEY
POINTS |
- The
effects of endurance training on HR recovery after exercise and
cardiac ANS modulation were investigated in female marathon runners
by comparing with untrained controls.
- Time
and frequency domain analysis of HRV was used to investigate cardiac
ANS modulation.
- As
compared with untrained controls, the female marathon runners
showed faster HR recovery after exercise, which should result
from their higher levels of HRV, higher aerobic capacity and exaggerated
blood pressure response to exercise.
|
| AUTHORS
BIOGRAPHY |
Na DU
Employment:Depart. of Sports Medicine and Sports Science,
Gifu Univ. Graduate School of Medicine
Degree: MD
Research interests: Cardiology, adaptation to altitude
E-mail: g2103004@guedu.cc.gifu-u.ac.jp |
|
Siqin BAI
Employment: Depart. of Sports Medicine and Sports Science,
Gifu Univ. Graduate School of Medicine
Degree: MS
Research interests: Plasticity, balance
E-mail: i2111302@guedu.cc.gifu-u.ac.jp
|
|
Kazuo OGURI
Employment: Faculty of Management, Shizuoka Sangyo University
Degree: PhD
Research interests: Muscle metabolism, body composition
assessment.
E-mail: oguri@iwata.ssu.ac.jp |
|
Yoshihiro
KATO
Employment: Depart. of Sports Medicine and Sports Science,
Gifu Univ. Graduate School of Medicine
Degree: MD, PhD
Research interests: Cardiology, pediatrics
E-mail: yoshi-kt@cc.gifu-u.ac.jp |
|
Ichie
MATSUMOTO
Employment:
Depart. of Sports Medicine and Sports Science, Gifu Univ.
Graduate School of Medicine.
Degree: MS
Research interests: Body composition.
E-mail: michie@cc.gifu-u.ac.jp |
|
Harumi KAWASE
Employment: Section of Clinical
Laboratory, Gifu Univ. Hospital.
Degree: MS
Research interests: Cardiology.
E-mail: kkawase@cc.gifu-u.ac.jp
|
|
Toshio
MATSUOKA
Employment:
Professor, Depart. of Sports Medicine and Sports Science,
Gifu Univ. Graduate School of Medicine.
Degree: PhD
Research interests: Anaerobic threshold, lactate threshold.
E-mail: matsuoka@cc.gifu-u.ac.jp
|
|
|
|
|