The role of heart rate variability in sports physiology

Jin-Guo Dong, Jin-Guo Dong

Abstract

Heart rate variability (HRV) is a relevant marker reflecting cardiac modulation by sympathetic and vagal components of the autonomic nervous system (ANS). Although the clinical application of HRV is mainly associated with the prediction of sudden cardiac death and assessing cardiovascular and metabolic illness progression, recent observations have suggested its applicability to physical exercise training. HRV is becoming one of the most useful tools for tracking the time course of training adaptation/maladaptation of athletes and in setting the optimal training loads leading to improved performances. However, little is known regarding the role of HRV and the internal effects of physical exercise on an athlete, which may be useful in designing fitness programs ensuring sufficient training load that may correspond with the specific ability of the athlete. In this review, we offer a comprehensive assessment of investigations concerning the interrelation between HRV and ANS, and examine how the application of HRV to physical exercise may play a role in sports physiology.

Keywords: autonomic nervous system; heart rate; heart rate variability; sport.

Figures

Figure 1.
Figure 1.
Electrocardiogram (ECG) as the basis of measuring heart rate variability (HRV). (A) The electrical activity of the heart is detected by ECG. The waveform components indicate an electrical event during one heart beat. The waveforms are labeled P (first short upward movement of the ECG tracing), the QRS complex (Q-larger upwards deflexion, R-a larger upwards deflexion, S-downwards wave) shows ventricular depolarization and contraction. PR indicates the transit time required for the electrical signal to travel from the sinus to the ventricles of the heart. The T-wave is normally a modest waveform representing ventricular repolarisation. (B) Representation of HRV monitored and analysed to determine the state of the nervous system controlling the heart. The ANS is determined by detecting variation in consecutive time intervals between peaks of the QRS complex, R-R interval (red). Originally, HRV was measured manually from calculation of the mean R-R interval and its deviation was measured on short-term ECGs. Lower HRV corresponds to the smaller standard deviation in R-R intervals. There are several types of arithmetic manipulation of R-R intervals to represent HVR (34,62).

References

    1. Boudoulas KD, Paraskevaidis IA, Boudoulas H, Triposkiadis FK. The left atrium: From the research laboratory to the clinic. Cardiology. 2014;129:1–17.
    1. Acharya Rajendra U, Paul Joseph K, Kannathal N, Lim CM, Suri JS. Heart rate variability: A review. Med Biol Eng Comput. 2006;44:1031–1051. doi: 10.1007/s11517-006-0119-0.
    1. Hemingway H, Shipley M, Brunner E, Britton A, Malik M, Marmot M. Does autonomic function link social position to coronary risk? The Whitehall II study. Circulation. 2005;111:3071–3077. doi: 10.1161/CIRCULATIONAHA.104.497347.
    1. Boullosa DA, Tuimil JL, Leicht AS, Crespo-Salgado JJ. Parasympathetic modulation and running performance in distance runners. J Strength Cond Res. 2009;23:626–631. doi: 10.1519/JSC.0b013e31818dc44e.
    1. Khandoker AH, Jelinek HF, Palaniswami M. Identifying diabetic patients with cardiac autonomic neuropathy by heart rate complexity analysis. Biomed Eng Online. 2009;8:3. doi: 10.1186/1475-925X-8-3.
    1. Tereshchenko LG, Cygankiewicz I, McNitt S, Vazquez R, Bayes-Genis A, Han L, Sur S, Couderc JP, Berger RD, de Luna AB, et al. Predictive value of beat-to-beat QT variability index across the continuum of left ventricular dysfunction: Competing risks of noncardiac or cardiovascular death and sudden or nonsudden cardiac death. Circ Arrhythm Electrophysiol. 2012;5:719–727. doi: 10.1161/CIRCEP.112.970541.
    1. Amano M, Kanda T, Ue H, Moritani T. Exercise training and autonomic nervous system activity in obese individuals. Med Sci Sports Exerc. 2001;33:1287–1291. doi: 10.1097/00005768-200108000-00007.
    1. Oliveira RS, Leicht AS, Bishop D, Barbero-Álvarez JC, Nakamura FY. Seasonal changes in physical performance and heart rate variability in high level futsal players. Int J Sports Med. 2013;34:424–430.
    1. Plews DJ, Laursen PB, Kilding AE, Buchheit M. Heart rate variability in elite triathletes, is variation in variability the key to effective training? A case comparison. Eur J Appl Physiol. 2012;112:3729–3741. doi: 10.1007/s00421-012-2354-4.
    1. Kaikkonen P, Hynynen E, Mann T, Rusko H, Nummela A. Heart rate variability is related to training load variables in interval running exercises. Eur J Appl Physiol. 2012;112:829–838. doi: 10.1007/s00421-011-2031-z.
    1. Vesterinen V, Häkkinen K, Hynynen E, Mikkola J, Hokka L, Nummela A. Heart rate variability in prediction of individual adaptation to endurance training in recreational endurance runners. Scand J Med Sci Sports. 2013;23:171–180. doi: 10.1111/j.1600-0838.2011.01365.x.
    1. Mourot L, Bouhaddi M, Tordi N, Rouillon JD, Regnard J. Short- and long-term effects of a single bout of exercise on heart rate variability: Comparison between constant and interval training exercises. Eur J Appl Physiol. 2004;92:508–517. doi: 10.1007/s00421-004-1119-0.
    1. Triposkiadis F, Karayannis G, Giamouzis G, Skoularigis J, Louridas G, Butler J. The sympathetic nervous system in heart failure physiology, pathophysiology, and clinical implications. J Am Coll Cardiol. 2009;54:1747–1762. doi: 10.1016/j.jacc.2009.05.015.
    1. Aubert AE, Seps B, Beckers F. Heart rate variability in athletes. Sports Med. 2003;33:889–919. doi: 10.2165/00007256-200333120-00003.
    1. Bosquet L, Papelier Y, Léger L, Legros P. Night heart rate variability during overtraining in male endurance athletes. J Sports Med Phys Fitness. 2003;43:506–512.
    1. Malpas SC, Purdie GL. Circadian variation of heart rate variability. Cardiovasc Res. 1990;24:210–213. doi: 10.1093/cvr/24.3.210.
    1. Hill LK, Hu DD, Koenig J, Sollers JJ, III, Kapuku G, Wang X, Snieder H, Thayer JF. Ethnic differences in resting heart rate variability: A systematic review and meta-analysis. Psychosom Med. 2015;77:16–25. doi: 10.1097/PSY.0000000000000133.
    1. Makivić B, Nikić M.D, Willis MS, Education P, Parovića Heart rate variability (HRV) as a tool for diagnostic and monitoring performance in sport and physical activities. Volume 16 Number. 2013;3:103–131.
    1. Campbell GD, Edwards FR, Hirst GD, O'Shea JE. Effects of vagal stimulation and applied acetylcholine on pacemaker potentials in the guinea-pig heart. J Physiol. 1989;415:57–68. doi: 10.1113/jphysiol.1989.sp017711.
    1. Ogliari G, Mahinrad S, Stott DJ, Jukema JW, Mooijaart SP, Macfarlane PW, Clark EN, Kearney PM, Westendorp RG, de Craen AJ, et al. Resting heart rate, heart rate variability and functional decline in old age. CMAJ. 2015;187:E442–E449. doi: 10.1503/cmaj.150462.
    1. Schmitt L, Regnard J, Parmentier AL, Mauny F, Mourot L, Coulmy N, Millet GP. Typology of ‘Fatigue’ by Heart Rate Variability Analysis in Elite Nordic-skiers. Int J Sports Med. 2015;36:999–1007. doi: 10.1055/s-0035-1548885.
    1. Stein PK, Bosner MS, Kleiger RE, Conger BM. Heart rate variability: A measure of cardiac autonomic tone. Am Heart J. 1994;127:1376–1381. doi: 10.1016/0002-8703(94)90059-0.
    1. van Ravenswaaij-Arts CM, Kollée LA, Hopman JC, Stoelinga GB, van Geijn HP. Heart rate variability. Ann Intern Med. 1993;118:436–447. doi: 10.7326/0003-4819-118-6-199303150-00008.
    1. Reed MJ, Robertson CE, Addison PS. Heart rate variability measurements and the prediction of ventricular arrhythmias. QJM. 2005;98:87–95. doi: 10.1093/qjmed/hci018.
    1. Aubert AE, Seps B, Beckers F. Heart rate variability in athletes. Sports Med. 2003;33:889–919. doi: 10.2165/00007256-200333120-00003.
    1. Mainardi LT, Bianchi AM, Baselli G, Cerutti S. Pole-tracking algorithms for the extraction of time-variant heart rate variability spectral parameters. IEEE Trans Biomed Eng. 1995;42:250–259. doi: 10.1109/10.364511.
    1. Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell'Orto S, Piccaluga E. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res. 1986;59:178–193. doi: 10.1161/01.RES.59.2.178.
    1. Malik M, Camm AJ. Components of heart rate variability - what they really mean and what we really measure. Am J Cardiol. 1993;72:821–822. doi: 10.1016/0002-9149(93)91070-X.
    1. Tulppo MP, Mäkikallio TH, Takala TE, Seppänen T, Huikuri HV. Quantitative beat-to-beat analysis of heart rate dynamics during exercise. Am J Physiol. 1996;271:H244–H252.
    1. Strano S, Lino S, Calcagnini G, Di Virgilio V, Ciardo R, Cerutti S, Calcagnini G, Caselli G. Respiratory sinus arrhythmia and cardiovascular neural regulation in athletes. Med Sci Sports Exerc. 1998;30:215–219. doi: 10.1097/00005768-199802000-00007.
    1. de Oliveira, Ottone V, de Castro Magalhães F, de Paula F, Avelar NC, Aguiar PF, da Matta Sampaio PF, Duarte TC, Costa KB, Araújo TL, Coimbra CC, et al. The effect of different water immersion temperatures on post-exercise parasympathetic reactivation. PLoS One. 2014;9:e113730. doi: 10.1371/journal.pone.0113730.
    1. Plews DJ, Laursen PB, Stanley J, Kilding AE, Buchheit M. Training adaptation and heart rate variability in elite endurance athletes: Opening the door to effective monitoring. Sports Med. 2013;43:773–781. doi: 10.1007/s40279-013-0071-8.
    1. Hottenrott K, Hoos O, Esperer HD. Heart rate variability and physical exercise. Current status. Herz. 2006;31:544–552. doi: 10.1007/s00059-006-2855-1. (In German)
    1. Kaikkonen P, Rusko H, Martinmäki K. Post-exercise heart rate variability of endurance athletes after different high-intensity exercise interventions. Scand J Med Sci Sports. 2008;18:511–519. doi: 10.1111/j.1600-0838.2007.00728.x.
    1. Kaikkonen P, Nummela A, Rusko H. Heart rate variability dynamics during early recovery after different endurance exercises. Eur J Appl Physiol. 2007;102:79–86. doi: 10.1007/s00421-007-0559-8.
    1. Vanderlei LC, Silva RA, Pastre CM, Azevedo FM, Godoy MF. Comparison of the Polar S810i monitor and the ECG for the analysis of heart rate variability in the time and frequency domains. Braz J Med Biol Res. 2008;41:854–859. doi: 10.1590/S0100-879X2008005000039.
    1. Lee S, Lee MS, Choi JY, Lee SW, Jeong SY, Ernst E. Acupuncture and heart rate variability: A systematic review. Auton Neurosci. 2010;155:5–13. doi: 10.1016/j.autneu.2010.02.003.
    1. Posadzki P, Kuzdzal A, Lee MS, Ernst E. Yoga for Heart Rate Variability: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Appl Psychophysiol Biofeedback. 2015;40:239–249. doi: 10.1007/s10484-015-9291-z.
    1. Kemp AH, Quintana DS, Gray MA, Felmingham KL, Brown K, Gatt JM. Impact of depression and antidepressant treatment on heart rate variability: A review and meta-analysis. Biol Psychiatry. 2010;67:1067–1074. doi: 10.1016/j.biopsych.2009.12.012.
    1. Cottin F, Médigue C, Leprêtre PM, Papelier Y, Koralsztein JP, Billat V. Heart rate variability during exercise performed below and above ventilatory threshold. Med Sci Sports Exerc. 2004;36:594–600. doi: 10.1249/01.MSS.0000121982.14718.2A.
    1. 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;36:1702–1708. doi: 10.1249/01.MSS.0000142403.93205.35.
    1. Chwyczko T, Sterliński M, Maciag A, Firek B, Labecka A, Jankowska A, Kośmicki M, Kowalik I, Malczewska B, Szwed H. Impact of cardiac resynchronisation therapy on adaptation of circulatory and respiratory systems to exercise assessed by cardiopulmonary exercise test in patients with chronic heart failure. Kardiol Pol. 2008;66:406–412. discussion 413–414.
    1. He X, Zhao M, Bi X, Sun L, Yu X, Zhao M, Zang W. Novel strategies and underlying protective mechanisms of modulation of vagal activity in cardiovascular diseases. Br J Pharmacol. 2015;172:5489–5500. doi: 10.1111/bph.13010.
    1. Tulppo MP, Mäkikallio TH, Seppänen T, Laukkanen RT, Huikuri HV. Vagal modulation of heart rate during exercise: Effects of age and physical fitness. Am J Physiol. 1998;274:H424–H429.
    1. Berkoff DJ, Cairns CB, Sanchez LD, Moorman CT., III Heart rate variability in elite American track-and-field athletes. J Strength Cond Res. 2007;21:227–231. doi: 10.1519/00124278-200702000-00041.
    1. Hautala A, Tulppo MP, Mäkikallio TH, Laukkanen R, Nissilä S, Huikuri HV. Changes in cardiac autonomic regulation after prolonged maximal exercise. Clin Physiol. 2001;21:238–245. doi: 10.1046/j.1365-2281.2001.00309.x.
    1. de Freitas VH, Pereira LA, de Souza EA, Leicht AS, Bertollo M, Nakamura FY. Sensitivity of the Yo-Yo Intermittent Recovery Test and cardiac autonomic responses to training in futsal players. Int J Sports Physiol Perform. 2015;10:553–558. doi: 10.1123/ijspp.2014-0365.
    1. Soares-Caldeira LF, de Souza EA, de Freitas VH, de Moraes SM, Leicht AS, Nakamura FY. Effects of additional repeated sprint training during preseason on performance, heart rate variability, and stress symptoms in futsal players: A randomized controlled trial. J Strength Cond Res. 2014;28:2815–2826. doi: 10.1519/JSC.0000000000000461.
    1. Flatt AA, Esco MR. Smartphone-Derived Heart-Rate Variability and Training Load in a Women's Soccer Team. Int J Sports Physiol Perform. 2015;10:994–1000. doi: 10.1123/ijspp.2014-0556.
    1. Plews DJ, Laursen PB, Le Meur Y, Hausswirth C, Kilding AE, Buchheit M. Monitoring training with heart rate-variability: How much compliance is needed for valid assessment? Int J Sports Physiol Perform. 2014;9:783–790. doi: 10.1123/IJSPP.2013-0455.
    1. Nakamura FY, Flatt AA, Pereira LA, Ramirez-Campillo R, Loturco I, Esco MR. Ultra-Short-Term Heart Rate Variability is Sensitive to Training Effects in Team Sports Players. J Sports Sci Med. 2015;14:602–605.
    1. Seiler S, Haugen O, Kuffel E. Autonomic recovery after exercise in trained athletes: Intensity and duration effects. Med Sci Sports Exerc. 2007;39:1366–1373. doi: 10.1249/mss.0b013e318060f17d.
    1. Buchheit M, Millet GP, Parisy A, Pourchez S, Laursen PB, Ahmaidi S. Supramaximal training and postexercise parasympathetic reactivation in adolescents. Med Sci Sports Exerc. 2008;40:362–371. doi: 10.1249/mss.0b013e31815aa2ee.
    1. 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;34:1660–1666. doi: 10.1097/00005768-200210000-00019.
    1. Pichot V, Roche F, Gaspoz JM, Enjolras F, Antoniadis A, Minini P, Costes F, Busso T, Lacour JR, Barthélémy JC. Relation between heart rate variability and training load in middle-distance runners. Med Sci Sports Exerc. 2000;32:1729–1736. doi: 10.1097/00005768-200010000-00011.
    1. Kiviniemi AM, Hautala AJ, Kinnunen H, Nissilä J, Virtanen P, Karjalainen J, Tulppo MP. Daily exercise prescription on the basis of HR variability among men and women. Med Sci Sports Exerc. 2010;42:1355–1363. doi: 10.1249/MSS.0b013e3181cd5f39.
    1. Kiviniemi AM, Hautala AJ, Kinnunen H, Tulppo MP. Endurance training guided individually by daily heart rate variability measurements. Eur J Appl Physiol. 2007;101:743–751. doi: 10.1007/s00421-007-0552-2.
    1. 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;24:10–18. doi: 10.1046/j.1475-0961.2003.00523.x.
    1. Hynynen E, Uusitalo A, Konttinen N, Rusko H. Heart rate variability during night sleep and after awakening in overtrained athletes. Med Sci Sports Exerc. 2006;38:313–317. doi: 10.1249/01.mss.0000184631.27641.b5.
    1. Tian Y, He ZH, Zhao JX, Tao DL, Xu KY, Earnest CP, McNaughton LR. Heart rate variability threshold values for early-warning nonfunctional overreaching in elite female wrestlers. J Strength Cond Res. 2013;27:1511–1519. doi: 10.1519/JSC.0b013e31826caef8.
    1. Hedelin R, Kenttä G, Wiklund U, Bjerle P, Henriksson-Larsén K. Short-term overtraining: Effects on performance, circulatory responses, and heart rate variability. Med Sci Sports Exerc. 2000;32:1480–1484. doi: 10.1097/00005768-200008000-00017.
    1. Hedelin R, Wiklund U, Bjerle P, Henriksson-Larsén K. Cardiac autonomic imbalance in an overtrained athlete. Med Sci Sports Exerc. 2000;32:1531–1533. doi: 10.1097/00005768-200009000-00001.
    1. Uusitalo AL, Uusitalo AJ, Rusko HK. Heart rate and blood pressure variability during heavy training and overtraining in the female athlete. Int J Sports Med. 2000;21:45–53. doi: 10.1055/s-2000-8853.
    1. Quintana DS, Heathers JA, Kemp AH. On the validity of using the Polar RS800 heart rate monitor for heart rate variability research. Eur J Appl Physiol. 2012;112:4179–4180. doi: 10.1007/s00421-012-2453-2.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere