Routine heart rate-based and novel ECG-based biomarkers of autonomicnervous system in sports medicine

Schüttler, Dominik; Hamm, Wolfgang; Bauer, A; Brunner, Stefan

doi:10.5960/dzsm.2020.428

Cited by 6 publications

(11 citation statements)

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“…(iii) A link between HRV indices and blood lactate levels was found during resistance exercise [ 6 – 8 ], in endurance athletes [ 5 ] and team sports athletes [ 24 , 25 ]. Of note, HRV indices are dynamic and rather sensitive to environmental conditions [ 4 ]. dT° was proven to be independent of heart rate and breathing rate [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The concept of testing biomarkers of the ANS for estimating thresholds is based on the idea that the ANS exerts distinct influences on the cardiorespiratory system during exercise to regulate heart rate, cardiac contractility and blood pressure. Recently, different study groups implemented the evaluation of autonomic biomarkers to control training intensities and to detect training-induced states of fatigue [ 4 ]. Measuring ANS biomarkers is promising as it is non-invasive and cost-efficient.…”

Section: Introductionmentioning

confidence: 99%

“…As exercise is known to affect ventricular repolarization crucially [ 4 , 14 ] we previously tested repolarization instability (dT° signal) during exercise testing [ 15 ]: We demonstrated that the dT° signal shows a characteristic three-phasic pattern that allows a reliable and non-invasive estimation of the anaerobic threshold (we called it AT dT° ) in healthy recreational athletes. This pattern at the anaerobic threshold is characterized by a maximal discordance of dT° and heart rate and this point highly significantly correlated with lactate thresholds measured by the methods of Mader and Dickhuth [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study

Schüttler

Krammer

Stülpnagel

et al. 2021

BMC Sports Sci Med Rehabil

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Background Assessing lactate (LT) or anaerobic thresholds (AT) in athletes is an important tool to control training intensities and to estimate individual performance levels. Previously we demonstrated that ECG-based assessment of cardiac repolarization instability during exercise testing allows non-invasive estimation of AT in recreational athletes. Here, we validate this method in professional and amateur team sports athletes. Methods We included 65 team sports athletes (32 professionals and 33 amateur athletes; 51 men, 14 women, mean age 22.3 ± 5.2 years) undergoing a standardized incremental cycle exercise test. During exercise testing a high-resolution ECG (1000 Hz) was recorded in Frank-leads configuration and beat-to-beat vector changes of cardiac repolarization (dT°) were assessed by previously established technologies. Repolarization-based AT (ATdT°) was estimated by its typical dT°-signal pattern. Additionally, LT was detected in accordance to methods established by Mader (LTMader) and Dickhuth (LTDickhuth). Results All athletes performed exercise testing until exhaustion with a mean maximum workload of 262.3 ± 60.8 W (241.8 ± 64.4 W for amateur athletes and 283.4 ± 49.5 W for professional athletes). Athletes showed ATdT° at 187.6 ± 44.4 W, LTDickhuth at 181.1 ± 45.6 W and LTMader at 184.3 ± 52.4 W. ATdT° correlated highly significantly with LTDickhuth (r = 0.96, p < 0.001) and LTMader (r = 0.98, p < 0.001) in the entire cohort of athletes as well as in the subgroups of professional and amateur athletes (p < 0.001 for all). Conclusions ATdT°, defined by the maximal discordance between dT° and heart rate, can be assessed reliably and non-invasively via the use of a high-resolution ECG in professional and amateur athletes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study

Schüttler

Krammer

Stülpnagel

et al. 2021

BMC Sports Sci Med Rehabil

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“…Periodic repolarization dynamics (PRD) has been proposed to assess sympathetic modulation of ventricular repolarization by measuring low-frequency (LF, below 0.1 Hz) oscillations in the T-wave vector 19 . Elevated PRD has been related to increased arrhythmic risk in a range of cardiac diseases and conditions 19 – 22 .…”

Section: Introductionmentioning

confidence: 99%

Periodic repolarization dynamics as predictor of risk for sudden cardiac death in chronic heart failure patients

Palacios

Cygankiewicz

Luna

et al. 2021

Sci Rep

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The two most common modes of death among chronic heart failure (CHF) patients are sudden cardiac death (SCD) and pump failure death (PFD). Periodic repolarization dynamics (PRD) quantifies low-frequency oscillations in the T wave vector of the electrocardiogram (ECG) and has been postulated to reflect sympathetic modulation of ventricular repolarization. This study aims to evaluate the prognostic value of PRD to predict SCD and PFD in a population of CHF patients. 20-min high-resolution (1000 Hz) ECG recordings from 569 CHF patients were analyzed. Patients were divided into two groups, $$\hbox {PRD}^+$$ PRD + and $$\hbox {PRD}^-$$ PRD - , corresponding to PRD values above and below the optimum cutoff point of PRD in the study population. Univariate Cox regression analysis showed that SCD risk in the $$\hbox {PRD}^+$$ PRD + group was double the risk in the $$\hbox {PRD}^-$$ PRD - group [hazard ratio (95% CI) 2.001 (1.127–3.554), $$\hbox {p}<0.05$$ p < 0.05 ]. The combination of PRD with other Holter-based ECG indices, such as turbulence slope (TS) and index of average alternans (IAA), improved SCD prediction by identifying groups of patients at high SCD risk. PFD could be predicted by PRD only when combined with TS [hazard ratio 2.758 (1.572–4.838), $$\hbox {p}<0.001$$ p < 0.001 ]. In conclusion, the combination of PRD with IAA and TS can be used to stratify the risk for SCD and PFD, respectively, in CHF patients.

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“…HRV has been considered to assess panic disorder [ 11 ], mental health resilience [ 12 ], and depressive disorder [ 13 ]. The effects of electronic cigarette [ 14 ], exercise [ [15] , [16] ], and alcohol use [ 17 ] have been also evaluated using HRV.…”

Section: Introductionmentioning

confidence: 99%

Judgement of valence of musical sounds by hand and by heart, a machine learning paradigm for reading the heart

Idrobo-Ávila

Correa

Muñoz-Bolaños

et al. 2021

Heliyon

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The intention of the experiment is to investigate whether different sounds have influence on heart signal features in the situation the observer is judging the different sounds as positive or negative. As the heart is under (para)sympathetic control of the nervous system this experiment could give information about the processing of sound stimuli beyond the conscious processing of the subject. As the nature of the influence on the heart signal is not known these signals are to be analysed with AI/machine learning techniques. Heart rate variability (HRV) is a variable derived from the R-R interval peaks of electrocardiogram which exposes the interplay between the sympathetic and parasympathetic nervous system. In addition to its uses as a diagnostic tool and an active part in the clinic and research domain, the HRV has been used to study the effects of sound and music on the heart response; among others, it was observed that heart rate is higher in response to exciting music compared with tranquilizing music while heart rate variability and its low-frequency and high-frequency power are reduced. Nevertheless, it is still unclear which musical element is related to the observed changes. Thus, this study assesses the effects of harmonic intervals and noise stimuli on the heart response by using machine learning. The results show that noises and harmonic intervals change heart activity in a distinct way; e.g., the ratio between the axis of the ellipse fitted in the Poincaré plot increased between harmonic intervals and noise exposition. Moreover, the frequency content of the stimuli produces different heart responses, both with noise and harmonic intervals. In the case of harmonic intervals, it is also interesting to note how the effect of consonance quality could be found in the heart response.

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Routine heart rate-based and novel ECG-based biomarkers of autonomicnervous system in sports medicine

Cited by 6 publications

References 0 publications

Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study

Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study

Periodic repolarization dynamics as predictor of risk for sudden cardiac death in chronic heart failure patients

Judgement of valence of musical sounds by hand and by heart, a machine learning paradigm for reading the heart

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