Subscribe to RSS
DOI: 10.1055/s-0032-1327577
Effects of Exercise and Hypoxia on Heart Rate Variability and Acute Mountain Sickness
Publication History
accepted after revision 25 August 2012
Publication Date:
05 February 2013 (online)
Abstract
Acute mountain sickness (AMS) is a common condition among non-acclimatized individuals ascending to high altitude. Exercise, a characteristic feature of hiking and mountaineering, has been suggested to exacerbate AMS prevalence and to cause modifications of the autonomic nervous system. A reduction of the heart rate variability (HRV) is a common finding during acute hypoxia, however characteristics of HRV during exercise in subjects suffering from AMS are unknown. Therefore, the aim of the present study was to investigate the effects of acute normobaric hypoxia (FiO2=11.0% ≙ 5 500 m) at rest (PHE) and during exercise (AHE) on the cardiac autonomic function and the development of AMS in 20 healthy, male individuals. HRV recordings were performed during normoxia and after 2, 4, 6 and 8 h in hypoxia during PHE and AHE, respectively. AMS was assessed using the Lake Louise Score. During PHE 50% of participants developed AMS and 70% during AHE (p=0.22). The analysis of HRV data showed a significant reduction of total power (TP), high frequency (HF) and low frequency (LF) components and an increase of the LF:HF ratio during PHE, however without further modification during AHE. Exercise did not increase AMS prevalence or severity, but increased “non-gastrointestinal” symptoms including headache, fatigue and dizziness. HRV indices were not related to the overall incidence of AMS or the development of “non-gastrointestinal” symptoms but we detected significant correlations between gastrointestinal complaints and HRV components. Thus, we suggest that the cardiac autonomic modulation during acute normobaric hypoxia does not play an important role in the development of AMS, but seems to be related to gastrointestinal complaints at high altitude. However, the influence of moderate exercise on HRV and AMS is minor, only “non-GI” symptoms seem to be exacerbated when exercise is applied.
-
References
- 1 Barry P, Pollard A. Altitude illness. BMJ 2003; 326: 915-919
- 2 Bernardi L, Passino C, Spadacini G, Calciati A, Robergs R, Greene R, Martignoni E, Anand L, Appenzeller O. Cardiovascular autonomic modulation and activity of carotid baroreceptors at altitude. Clin Sci (Lond) 1998; 95: 565-573
- 3 Bernardi L, Passino C, Wilmerding V, Dallam GM, Parker DL, Robergs RA, Appenzeller O. Breathing patterns and cardiovascular autonomic modulation during hypoxia induced by simulated altitude. J Hypertens 2001; 19: 947-958
- 4 Brown TE, Beightol LA, Koh J, Eckberg DL. Important influence of respiration on human R-R interval power spectra is largely ignored. J Appl Physiol 1993; 75: 2310-2317
- 5 Buchheit M, Richard R, Doutrleau S, Lonsdorfer-Wolf E, Brandenberger G, Simon C. Effect of acute hypoxia on heart rate variability at rest and during exercise. Int J Sports Med 2004; 25: 264-269
- 6 Burtscher M, Likar R, Nachbauer W, Philadelphy M, Pühringer R, Lämmle T. Effects of aspirin during exercise on the incidence of high-altitude headache: A randomized, double-blind placebo-controlled trial. Headache 2001; 41: 542-545
- 7 Calbet JA. Chronic hypoxia increases blood pressure and noradrenaline spillover in healthy humans. J Physiol 2003; 551: 379-386
- 8 Chen YC, Lin FC, Shiao GM, Chang SC. Effect of rapid ascent to high altitude on autonomic cardiovascular modulation. Am J Med Sci 2008; 336: 248-253
- 9 Cornolo J, Mollard P, Brugniaux JV, Robach P, Richalet JP. Autonomic control of the cardiovascular system during acclimatization to high altitude: effects of sildenafil. J Appl Physiol 2004; 97: 935-940
- 10 Hackett PH. The cerebral etiology of high-altitude cerebral edema and acute mountain sickness. Wilderness Environ Med 1999; 10: 97-109
- 11 Hackett PH, Roach RC. High-altitude illness. N Engl J Med 2001; 345: 107-114
- 12 Harriss DJ, Atkinson G. Update – ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
- 13 Honigmann B, Theis MK, Koziol-McLain J, Roach R, Yip R, Houston C, Moore LG. Acute mountain sickness in a general tourist population at moderate altitudes. Ann Intern Med 1993; 118: 587-592
- 14 Howley ET, Bassett DR, Welch HG. Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc 1995; 27: 1292-1301
- 15 Huang HH, Tseng CY, Fan JS, Yen DHT, Kao WF, Chang SC, Kuo TBJ, Huang CI, Lee CH. Alterations of heart rate variability at lower altitude in the predication of trekkers with acute mountain sickness at high altitude. Clin J Sport Med 2010; 20: 58-63
- 16 Hughson RL, Yamamoto Y, McCullough RE, Sutton JR, Reeves JT. Sympathetic and parasympathetic indicators of heart rate control at high altitude studied by spectral analysis. J Appl Physiol 1994; 77: 2537-2542
- 17 Kallenberg K, Bailey DM, Christ S, Mohr A, Roukens R, Menold E, Steiner T, Bärtsch P, Knauth M. Magnetic resonance imaging evidence of cytotoxic cerebral edema in acute mountain sickness. J Cereb Blood Flow Metab 2007; 27: 1064-1071
- 18 Kanai M, Nishihara F, Shiga T, Shimada H, Saito S. Alterations in autonomic nervous control of the heart rate among tourists at 2 700 and 3 700 m above sea level. Wilderness Environ Med 2001; 12: 8-12
- 19 Lanfranchi PA, Colombo R, Cremona G, Baderna P, Spagnolatti L, Mazzuero G, Wagner P, Perini L, Wagner H, Cavallaro C, Giannuzzi P. Autonomic cardiovascular regulation in subjects with acute mountain sickness. Am J Physiol 2005; 289: H2364-H2372
- 20 Larson EB, Roach RC, Schoene RB, Hornbein TF. Acute mountain sickness and acetazolamide: clincical efficiency and effect on ventilation. JAMA 1982; 248: 328-332
- 21 Loeppky JA, Icenogle MV, Maes D, Riboni K, Scotto P, Roach RC. Body temperature, autonomic responses and acute mountain sickness. High Alt Med Biol 2003; 4: 947-950
- 22 Maggiorini M, Bühler B, Walter M, Oelz O. Prevalence of acute mountain sickness in the Swiss Alps. BMJ 1990; 13: 853-855
- 23 Mairer K, Wille M, Bucher T, Burtscher M. Prevalence of acute mountain sickness in the Eastern Alps. High Alt Med Biol 2009; 10: 239-245
- 24 Mairer K, Wille M, Burtscher M. Prevalence of and risk factors for acute mountain sickness in the Eastern and Western Alps. High Alt Med Biol 2010; 11: 343-348
- 25 Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation 1991; 84: 482-492
- 26 Mazzeo RS. Altitude, exercise and immune function. Exerc Immunol Rev 2005; 11: 6-16
- 27 Midgley AW, McNaughton LR, Polman R, Marchant D. Criteria for determination of maximal oxygen uptake. A brief critique and recommendations for future research. Sports Med 2007; 37: 1019-1028
- 28 Nunan D, Jakovljevic GD, Donovan G, Hodges LD, Sandercock GRH, Brodie DA. Levels of agreement for RR intervals and short-term heart rate variability obtained from the Polar S810 and an alternative system. Eur J Appl Physiol 2008; 103: 529-537
- 29 Nunan D, Donovan G, Jakovljevic DG, Hodges LD, Sandercock GRH, Brodie DA. Validity and reliability of short-term heart rate variability from the Polar S810. Med Sci Sports Exerc 2009; 41: 243-250
- 30 Perini R, Milesi S, Biancardi L, Veicsteinas A. Effects of high altitude acclimatization on heart rate variability in resting humans. Eur J Appl Physiol 1996; 73: 521-528
- 31 Rawat N, Connor CW, Jones JA, Kozlovskaya IB, Sullivan P. The correlation between aerobic fitness and motion sickness susceptibility. Aviat Space Environ Med 2002; 73: 216-218
- 32 Roach RC, Bärtsch P, Hackett PH, Oelz O. The Lake Louise acute mountain sickness coring system. In: Sutton JR, Houston CS, Coates G. (eds.). Hypoxia and Mountain Medicine: Proceeding of the International Hypoxia Symposium. Burlington VT: Queen City Printers; 1993: 272-274
- 33 Roach RC, Loeppky JA, Icenogle MV. Acute mountain sickness: increased severity during simulated altitude compared with normobaric hypoxia. J Appl Physiol 1996; 81: 1908-1910
- 34 Roach RC, Maes D, Sandoval D, Robergs RA, Icenogle M, Hinghofer-Szalkay H, Lium D, Loeppky JA. Exercise exacerbates acute mountain sickness at simulated high altitude. J Appl Physiol 2000; 88: 581-585
- 35 Roach RC, Hackett PH. Frontiers of hypoxia research: acute mountain sickness. J Exp Biol 2001; 204: 3161-3170
- 36 Saito S, Nishihara F, Iakazawa T, Kanai M, Aso C, Shiga T, Shimada H. Exercise-induced cerebral deoxygenation among untrained trekkers at moderate altitudes. Arch Environ Health 1999; 54: 271-276
- 37 Schneider M, Bernasch D, Weymann J, Holle R, Bärtsch P. Acute mountain sickness: influence of susceptibility, preexposure and ascent rate. Med Sci Sports Exerc 2002; 34: 1886-1891
- 38 Schommer K, Hammmer M, Hotz L, Menold E, Bärtsch P, Berger MM. Exercise intensity typical of mountain climbing does not exacerbate acute mountain sickness in normobaric hypoxia. J Appl Physiol 2012; (Epub ahead of print)
- 39 Schoonman GG, Sándor PS, Nirkko AC, Lange T, Jaermann T, Dydak U, Kremer C, Ferrari MD, Boesiger P, Baumgartner RW. Hypoxia-induced acute mountain sickness is associated with intracellular cerebral edema: a 3 T magnetic resonance imaging study. J Cereb Blood Flow Metab 2008; 28: 198-206
- 40 Task force . Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 1996; 93: 1043-1065
- 41 Uchino M, Ishii K, Kuwahara M, Ebukuro S, Tsubone H. Role of autonomic nervous system for development and suppression of motion sickness in Suncus murinus. Auton Neurosci 2001; 94: 46-51
- 42 Vanderlei LCM, 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
- 43 Wille M, Mairer K, Gatterer H, Philippe M, Faulhaber M, Burtscher M. Changes in cardiac autonomic activity during a passive 8 h acute exposure to 5 500 m normobaric hypoxia are not related to the development of acute mountains sickness. Int J Sports Med 2012; 33: 186-191
- 44 Yamamoto Y, Hoshikawa Y, Miyashita M. Effects of acute exposure to simulated altitude on heart rate variability during exercise. J Appl Physiol 1996; 81: 1223-1229