Associations Between Physical Activity and Autonomic Function During Deep Breathing Test: the Swedish CArdioPulmonary BioImage Study (SCAPIS)

Overview

Journal Clin Auton Res

Date 2023 Jun 21

PMID 37344567

Authors

Ensieh Memarian

Isabella Kharraziha

Viktor Hamrefors

Pyotr G Platonov

Orjan Ekblom

Anders Gottsater

Gunnar Engstrom

Affiliations

Soon will be listed here.

Abstract

Purpose: The deep breathing test (DBT) is a sensitive test of cardiovagal function. The aim of this study was to explore associations between physical activity and sedentary time, measured by accelerometer, and autonomic function, using DBT.

Methods: In the Swedish Cardio-Pulmonary bioImage Study, men and women aged 50-64 were randomly invited from the general population. A total of 4325 subjects who underwent DBT and assessment of physical activity and sedentary time by accelerometery were included. ECG files from 1-min DBT were used to calculate measures of respiratory sinus arrhythmia [RSA; expiration-inspiration (E-I) difference and E/I ratio], heart rate variability [HRV; root mean square of successive differences (RMSSD), standard deviation of heart rates and mean circular resultant]. Low RSA and HRV was defined as the lowest 10% in the population.

Results: For accelerometer-assessed physical activity, there were significant associations between high percentage of sedentary time and low E/I (p < 0.01), and low RMSSD (p < 0.01) in an age- and sex-adjusted model, and between percentage of sedentary time and low RMSSD (p = 0.04) in a risk factor-adjusted model. Low RMSSD was less common in those with a high percentage of moderate to vigorous physical activity (p = 0.04, after risk-factor adjustment). These associations became non-significant when further adjusting for heart rate.

Conclusion: We report associations between degree of physical activity and indices of autonomic dysfunction in a large population. The relationships were no longer significant after adjustments for heart rate, indicating that the relationship between physical activity and cardiovagal function partly is accounted for by reduced heart rate.

References

Wilmot E, Edwardson C, Achana F, Davies M, Gorely T, Gray L . Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012; 55(11):2895-905. DOI: 10.1007/s00125-012-2677-z. View

Galetta F, Lunardi M, Prattichizzo F, Rossi M, Cosci S, Giusti C . [Effects of physical activity on the cardiovascular autonomic function in the aged]. Minerva Cardioangiol. 1994; 42(7-8):321-6. View

Monfredi O, Lyashkov A, Johnsen A, Inada S, Schneider H, Wang R . Biophysical characterization of the underappreciated and important relationship between heart rate variability and heart rate. Hypertension. 2014; 64(6):1334-43. PMC: 4326239. DOI: 10.1161/HYPERTENSIONAHA.114.03782. View

Xhaard C, Dandine-Roulland C, de Villemereuil P, Le Floch E, Bacq-Daian D, Machu J . Heritability of a resting heart rate in a 20-year follow-up family cohort with GWAS data: Insights from the STANISLAS cohort. Eur J Prev Cardiol. 2021; 28(12):1334-1341. DOI: 10.1177/2047487319890763. View

Jandackova V, Scholes S, Britton A, Steptoe A . Healthy Lifestyle and Cardiac Vagal Modulation Over 10 Years: Whitehall II Cohort Study. J Am Heart Assoc. 2019; 8(19):e012420. PMC: 6806037. DOI: 10.1161/JAHA.119.012420. View

Gerritsen J, Dekker J, TenVoorde B, Kostense P, Heine R, Bouter L . Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease: the Hoorn Study. Diabetes Care. 2001; 24(10):1793-8. DOI: 10.2337/diacare.24.10.1793. View

Agha G, Loucks E, Tinker L, Waring M, Michaud D, Foraker R . Healthy lifestyle and decreasing risk of heart failure in women: the Women's Health Initiative observational study. J Am Coll Cardiol. 2014; 64(17):1777-85. PMC: 4254927. DOI: 10.1016/j.jacc.2014.07.981. View

Ekblom-Bak E, Borjesson M, Bergman F, Bergstrom G, Dahlin-Almevall A, Drake I . Accelerometer derived physical activity patterns in 27.890 middle-aged adults: The SCAPIS cohort study. Scand J Med Sci Sports. 2022; 32(5):866-880. PMC: 9302631. DOI: 10.1111/sms.14131. View

Dougherty R, Lose S, Gaitan J, Mergen B, Chin N, Okonkwo O . Five-year changes in objectively measured cardiorespiratory fitness, physical activity, and sedentary time in mid-to-late adulthood. Appl Physiol Nutr Metab. 2021; 47(2):206-209. PMC: 9169430. DOI: 10.1139/apnm-2021-0500. View

10.

Grassler B, Thielmann B, Bockelmann I, Hokelmann A . Effects of Different Training Interventions on Heart Rate Variability and Cardiovascular Health and Risk Factors in Young and Middle-Aged Adults: A Systematic Review. Front Physiol. 2021; 12:657274. PMC: 8107721. DOI: 10.3389/fphys.2021.657274. View

11.

Zhang J, Kesteloot H . Anthropometric, lifestyle and metabolic determinants of resting heart rate. A population study. Eur Heart J. 1999; 20(2):103-10. DOI: 10.1053/euhj.1999.1230. View

12.

Bergstrom G, Berglund G, Blomberg A, Brandberg J, Engstrom G, Engvall J . The Swedish CArdioPulmonary BioImage Study: objectives and design. J Intern Med. 2015; 278(6):645-59. PMC: 4744991. DOI: 10.1111/joim.12384. View

13.

Loef M, Walach H . The combined effects of healthy lifestyle behaviors on all cause mortality: a systematic review and meta-analysis. Prev Med. 2012; 55(3):163-70. DOI: 10.1016/j.ypmed.2012.06.017. View

14.

Kiviniemi A, Hautala A, Seppanen T, Makikallio T, Huikuri H, Tulppo M . Saturation of high-frequency oscillations of R-R intervals in healthy subjects and patients after acute myocardial infarction during ambulatory conditions. Am J Physiol Heart Circ Physiol. 2004; 287(5):H1921-7. DOI: 10.1152/ajpheart.00433.2004. View

15.

Weinberg C, Pfeifer M . An improved method for measuring heart-rate variability: assessment of cardiac autonomic function. Biometrics. 1984; 40(3):855-61. View

16.

Gibbs B, Pettee Gabriel K, Carnethon M, Gary-Webb T, Jakicic J, Rana J . Sedentary Time, Physical Activity, and Adiposity: Cross-sectional and Longitudinal Associations in CARDIA. Am J Prev Med. 2017; 53(6):764-771. PMC: 5696042. DOI: 10.1016/j.amepre.2017.07.009. View

17.

Borjesson M, Ekblom O, Arvidsson D, Heiland E, Vaisanen D, Bergstrom G . Correlates of cardiorespiratory fitness in a population-based sample of middle-aged adults: cross-sectional analyses in the SCAPIS study. BMJ Open. 2022; 12(12):e066336. PMC: 9756301. DOI: 10.1136/bmjopen-2022-066336. View

18.

Rosenberg A, Weiser-Bitoun I, Billman G, Yaniv Y . Signatures of the autonomic nervous system and the heart's pacemaker cells in canine electrocardiograms and their applications to humans. Sci Rep. 2020; 10(1):9971. PMC: 7305326. DOI: 10.1038/s41598-020-66709-z. View

19.

Hillebrand S, Gast K, de Mutsert R, Swenne C, Jukema J, Middeldorp S . Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: meta-analysis and dose-response meta-regression. Europace. 2013; 15(5):742-9. DOI: 10.1093/europace/eus341. View

20.

Alansare A, Bates L, Stoner L, Kline C, Nagle E, Jennings J . Associations of Sedentary Time with Heart Rate and Heart Rate Variability in Adults: A Systematic Review and Meta-Analysis of Observational Studies. Int J Environ Res Public Health. 2021; 18(16). PMC: 8391190. DOI: 10.3390/ijerph18168508. View