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      Reliability and validity of heart rate variability threshold assessment during an incremental shuttle-walk test in middle-aged and older adults

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          Abstract

          Studies on the assessment of heart rate variability threshold (HRVT) during walking are scarce. We determined the reliability and validity of HRVT assessment during the incremental shuttle walk test (ISWT) in healthy subjects. Thirty-one participants aged 57 ± 9 years (17 females) performed 3 ISWTs. During the 1st and 2nd ISWTs, instantaneous heart rate variability was calculated every 30 s and HRVT was measured. Walking velocity at HRVT in these tests (WV-HRVT1 and WV-HRVT2) was registered. During the 3rd ISWT, physiological responses were assessed. The ventilatory equivalents were used to determine ventilatory threshold (VT) and the WV at VT (WV-VT) was recorded. The difference between WV-HRVT1 and WV-HRVT2 was not statistically significant (median and interquartile range = 4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h); the correlation between WV-HRVT1 and WV-HRVT2 was significant (r = 0.84); the intraclass correlation coefficient was high (0.92; 0.82 to 0.96), and the agreement was acceptable (-0.08 km/h; -0.92 to 0.87). The difference between WV-VT and WV-HRVT2 was not statistically significant (4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h) and the agreement was acceptable (0.04 km/h; -1.28 to 1.36). HRVT assessment during walking is a reliable measure and permits the estimation of VT in adults. We suggest the use of the ISWT for the assessment of exercise capacity in middle-aged and older adults.

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          Estimation of the anaerobic threshold from heart rate variability in an incremental swimming test.

          This study aimed to evaluate, in swimming, the agreement between the anaerobic threshold (AT) as determined from the analysis of blood lactate concentration ([La]) and from a new method based on the heart rate (HR) variability (HRV). Fourteen high-level swimmers completed an incremental 7 × 200-m front crawl test, during which the HRV was measured continuously and [La] was collected after each step. To individuate the AT, the trends of the high-frequency HRV spectral power (HFPOW) and of the fraction of HFPOW relative to the respiratory sinus arrhythmia (HFPOW-RSA) were analyzed. In all the subjects, an abrupt increase of both HFPOW and HFPOW-RSA was observed and associated with the AT. The AT parameters determined, respectively, from [La] and HFPOW-RSA were similar (p > 0.05) and highly correlated (HR: 182.0 ± 8.1 vs. 181.1 ± 8.2 b·min, r = 0.93, 95% limits of agreement [LoA]: -6.7 to 4.9 b·min; velocity: 1.47 ± 0.11 vs. 1.47 ± 0.11 m·s, r = 0.98, 95% LoA: -0.05 to 0.05 m·s). Instead, the AT HR and velocity obtained from HFPOW (179.2 ± 8.4 b·min; 1.45 ± 0.11 m·s) were correlated to the corresponding parameters determined from [La] (HR: r = 0.84; velocity: r = 0.94) but underestimated them slightly (95% LoA: -11.9 to 6.3 b·min and -0.11 to 0.05 m·s). These results demonstrate that the AT can be assessed from the HRV in swimming, providing an important testing tool for coaches. Furthermore, using the actual respiratory spectral component, rather than the total HF spectral power, allows us to obtain a more accurate estimate of AT parameters.
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            Threshold for muscle lactate accumulation during progressive exercise.

            The purpose of this study was to investigate the relationship between muscle and blood lactate concentrations during progressive exercise. Seven endurance-trained male college students performed three incremental bicycle ergometer exercise tests. The first two tests (tests I and II) were identical and consisted of 3-min stage durations with 2-min rest intervals and increased by 50-W increments until exhaustion. During these tests, blood was sampled from a hyperemized earlobe for lactate and pH measurement (and from an antecubital vein during test I), and the exercise intensities corresponding to the lactate threshold (LT), individual anaerobic threshold (IAT), and onset of blood lactate accumulation (OBLA) were determined. The test III was performed at predetermined work loads (50 W below OBLA, at OBLA, and 50 W above OBLA), with the same stage and rest interval durations of tests I and II. Muscle biopsies for lactate and pH determination were taken at rest and immediately after the completion of the three exercise intensities. Blood samples were drawn simultaneously with each biopsy. Muscle lactate concentrations increased abruptly at exercise intensities greater than the "below-OBLA" stage [50.5% maximal O2 uptake (VO2 max)] and resembled a threshold. An increase in blood lactate and [H+] also occurred at the below-OBLA stage; however, no significant change in muscle [H+] was observed. Muscle lactate concentrations were highly correlated to blood lactate (r = 0.91), and muscle-to-blood lactate ratios at below-OBLA, at-OBLA, and above-OBLA stages were 0.74, 0.63, 0.96, and 0.95, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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              Reliability of heart rate variability measurements in patients with a history of myocardial infarction.

              Despite a well-established prognostic value in cardiac patients, HRV (heart rate variability) indexes have been used little in the clinical setting. Poor reliability of the measurements might be a possible explanation for this. In the present study, we assessed the reliability of short-term HRV indexes in post-MI (myocardial infarction) patients. We studied 61 MI patients [50 males; age, 59+/-8 years; and LVEF (left ventricular ejection fraction), 46+/-6%; values are means +/-S.D.],who underwent a 5+5 min ECG recording during spontaneous and paced breathing on two consecutive days. Standard time-domain [SDNN (S.D. of RR interval values) and RMSSD (root- mean-square of successive RR interval differences)] and frequency-domain [LF (low-frequency) and HF (high-frequency) power, and LF/HF] indexes of HRV were computed. Absolute and relative reliability were assessed by the 95% limits of random variation and by the ICC (intra-class correlation coefficient). The agreement between the two measurements in classifying patients at low or high risk, according to different cut-points, and the sample size needed to detect a clinically relevant change, were also assessed. During spontaneous breathing, individual changes in test-retest measurements ranged from -41 to + 61% (SDNN; best case) and from -76 to + 316% (LF/HF; worst case). The ICC ranged from 0.72 to 0.81. Most patients (79-90 %) were assigned to the same class by the two measurements. Paced breathing did not improve reliability. In conclusion, short-term HRV parameters in MI patients may have large day-to-day variations, making the detection of treatment effects in individual patients difficult; however, the ICC values and the analysis of the consistency of classification between repeated tests indicate that HRV measurements fulfill the criteria required to be used for diagnostic or classification purposes.
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                Author and article information

                Journal
                Braz J Med Biol Res
                Braz. J. Med. Biol. Res
                Brazilian Journal of Medical and Biological Research
                Associação Brasileira de Divulgação Científica
                0100-879X
                1414-431X
                01 February 2013
                February 2013
                : 46
                : 2
                : 194-199
                Affiliations
                [1]Laboratório de Estudos da Motricidade Humana, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
                Author notes
                Correspondence: V.Z. Dourado, Av. Ana Costa, 95, 11060-001 Santos, SP, Brasil. Fax: +55-13-3261-3324, E-mail: vzdourado@ 123456yahoo.com.br and/or victor.dourado@ 123456unifesp.br
                Article
                10.1590/1414-431X20122376
                3854360
                23369974
                3c4f93dd-ac11-41c9-b721-e18c30ad188b

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 May 2012
                : 17 September 2012
                Page count
                Figures: 2, Tables: 1, References: 27, Pages: 6
                Categories
                Clinical Investigation

                heart rate variability,exercise,walking,adults
                heart rate variability, exercise, walking, adults

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