Analysis of initial autonomic adjustments to moderate exercise in humans.

OBJECTIVE

To determine whether signs of cardiac sympathetic activation (together with vagal withdrawal) can be observed in the autonomic balance modulating the sino-atrial node as early as the initial levels of a graded light dynamic exercise.

PATIENTS AND METHODS

We studied 15 healthy ambulant subjects (mean +/- SD age 32 +/- 9 years; systolic/diastolic blood pressure 120 +/- 19/77 +/- 7 mmHg; heart rate 65 +/- 9 beats/min), who underwent a control recording of 10 min, followed by a three-step progressive (10, 20 and 30% of nominal maximum for age and sex) supine bicycle exercise. Spectral and cross-spectral analysis of RR and systolic arterial pressure variabilities were used to obtain non-invasive markers of the autonomic adjustments to exercise.

RESULTS

The low-frequency component of RR interval variability (which, in normalized units, is a marker of sympathetic modulation of the sino-atrial (SA) node) was progressively increased during all three stages of bicycle exercise. No significant changes were observed in the low-frequency component of systolic arterial pressure variability (i.e. a marker of sympathetic drive to the vasculature) in the early stages of exercise, while a significant increase was observed at 30% of maximum. The index alpha (which provides a measure of the gain of the arterial pressure-heart period baroreflex) was progressively reduced during all three stages of exercise.

CONCLUSIONS

While the sympathovagal balance modulating the SA node is immediately shifted towards sympathetic predominance (and vagal withdrawal), markers of peripheral vascular sympathetic activation appear increased only when 30% of maximum exercise is attained.