4-Second Exercise Test: Reference Values for Ages 18-81 Years

Background: Physiological reflexes modulated primarily by the vagus nerve allow the heart to decelerate and accelerate rapidly after a deep inspiration followed by rapid movement of the limbs. This is the physiological and pharmacologically validated basis for the 4-s exercise test (4sET) used to assess the vagal modulation of cardiac chronotropism. Objective: To present reference data for 4sET in healthy adults. Methods: After applying strict clinical inclusion/exclusion criteria, 1,605 healthy adults (61% men) aged between 18 and 81 years subjected to 4sET were evaluated between 1994 and 2014. Using 4sET, the cardiac vagal index (CVI) was obtained by calculating the ratio between the duration of two RR intervals in the electrocardiogram: 1) after a 4-s rapid and deep breath and immediately before pedaling and 2) at the end of a rapid and resistance-free 4-s pedaling exercise. Results: CVI varied inversely with age (r = -0.33, p < 0.01), and the intercepts and slopes of the linear regressions between CVI and age were similar for men and women (p > 0.05). Considering the heteroscedasticity and the asymmetry of the distribution of the CVI values according to age, we chose to express the reference values in percentiles for eight age groups (years): 18-30, 31-40, 41-45, 46-50, 51-55, 56-60, 61-65, and 66+, obtaining progressively lower median CVI values ranging from 1.63 to 1.24. Conclusion: The availability of CVI percentiles for different age groups should promote the clinical use of 4sET, which is a simple and safe procedure for the evaluation of vagal modulation of cardiac chronotropism..

Medienart:

Artikel

Erscheinungsjahr:

2015

Erschienen:

2015

Enthalten in:

Zur Gesamtaufnahme - volume:104

Enthalten in:

Arquivos brasileiros de cardiologia - 104(2015), 5, Seite 366-374

Sprache:

Englisch

Beteiligte Personen:

Araújo, Claudio Gil [VerfasserIn]
Castro, Claudia Lucia Barros de [Sonstige Person]
Franca, João Felipe [Sonstige Person]
Ramos, Plínio Santos [Sonstige Person]

Links:

Volltext
www.scielo.br
www.pubmedcentral.nih.gov
doaj.org

Themen:

Adult
Adulto
Autonomic Nervous System
Diseases of the circulatory (Cardiovascular) system
Drug effects
Exercise Test
Exercise Test/drug effects
Frequência Cardíaca
Heart Rate
Internal medicine
Medicine
Original
RC31-1245
RC581-951
RC666-701
Sistema Nervoso Autônomo
Specialties of internal medicine
Teste de Esforço/efeitos de drogas

doi:

10.5935/abc.20150026

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC1961947757