Ahmet Selman GULDAGİ, Ayhan PEKTAS, Mehmet ÇELEĞEN, Mehmet Bilgehan PEKTAŞ

How do different types of physical activity affect echocardiography findings and heart rate variability in children?

This study aims to investigate how different types of regular physical activity affect cardiac functions in school children. This is a cross-sectional review of 15 children who are not engaged with any regular physical activity (controls) and 60 athletes who swim (n=15), play basketball (n=15), play volleyball (n=15), and play tennis (n=15) regularly. The children who are not engaged with any sports, the children who swim, and the children who play basketball, volleyball and tennis are statistically similar with respect to age, sex, height, weight and body mass index (p>0.05 for all). When compared to the controls and other athletes, the swimmer children have significantly higher left ventricle diastolic mass, higher left ventricle posterior wall systolic thickness, lower mitral A wave, higher mitral annular plane systolic excursion and higher mitral E/A ratio (p=0.006, p=0.035, p=0.030, p=0.025 and p=0.043 respectively). The swimmer children have significantly lower interventricular septum E and A waves and significantly longer left ventricle IVRT than the controls and other athletes (p=0.001, p=0.040 and p=0.004 respectively). When compared with the controls and other athletes, the swimmer children have significantly lower p-wave dispersion and QT dispersion values (p=0.038 and p=0.035 respectively). The swimmer children have significantly higher total power and SDNN values than the controls and other athletes (p=0.046 and p=0.026 respectively). Swimming might contribute to the growth of cardiac muscles and help to improve the cardiac conduction system and enhance parasympathetic innervation of the heart in children.

PDF

___

1. Bazett HC. The time relations of the blood-pressure changes after excision of the adrenal glands, with some observations on blood volume changes. J Physiol. 1920;53:320-39.

2. Besnier F, Labrunée M, Pathak A, et al. Exercise training-induced modification in autonomic nervous system: An update for cardiac patients. Ann Phys Rehabil Med. 2017;60:27-35.

3. Brateanu A. Heart rate variability after myocardial infarction: what we know and what we still need to find out. Curr Med Res Opin. 2015;31:1 855-60.

4. Coe DP. Exercise prescription in special populations: women, pregnancy, children and older adults. In: Swain DP, editor. ACSM’s resource manual for exercise testing and prescription. 7th ed. China: Wolters Kluver Health- Lippincott Wiliams & Wilkins; p. 569.

5. Cygankiewicz I, Zareba W. Heart rate variability. Handb Clin Neurol. 2013;117:379-93.

6. D'Andrea A, Morello A, Iacono AM, et al. Right Ventricular Changes in Highly Trained Athletes: Between Physiology and Pathophysiology. J Cardiovasc Echogr. 2015;25:97-102.

7. Doyen B, Matelot D, Carré F. Asymptomatic bradycardia amongst endurance athletes. Phys Sportsmed. 2019;47.249-52.

8. Felber Dietrich D, Ackermann-Liebrich U, Schindler C, et al. Effect of physical activity on heart rate variability in normal weight, overweight and obese subjects: results from the SAPALDIA study. Eur J Appl Physiol. 2008;104.557–65.

9. Fox KR. Department of Health. Start active, stay active: report on physical activity in the UK: a report on physical activity from the four home countried Chief Medical Officers. London, 2011.

10. Henje Blom E, Olsson EM, Serlachius E, et al. Heart rate variability is related to self-reported physical activity in a healthy adolescent population. Eur J Appl Physiol. 2009;106.877–83.

11. Islam SKMA, Kim D, Lee YS, et al. Association between diabetic peripheral neuropathy and heart rate variability in subjects with type 2 diabetes. Diabetes Res Clin Pract. 2018;140:18-26.

12. Izci F, Hocagil H, Izci S, et al. P-wave and QT dispersion in patients with conversion disorder. Ther Clin Risk Manag. 2015;26:475-80.

13. Kaikkonen KM, Korpelainen RI, Tulppo MP, et al. Physical activity and aerobic fitness are positively associated with heart rate variability in obese adults. J Phys Act Health. 2014;11.1614–21.

14. Kuryanova EV, Tryasuchev AV, Stupin VO, et al. Effect of stimulation of neurotransmitter systems on heart rate variability and β-adrenergic responsiveness of erythrocytes in outbred rats. Bull Exp Biol Med. 2017;163.31-6.

15. Kuryanova EV, Tryasuchev AV, Stupin,VO, et al. Effect of atropine on adrenergic responsiveness of erythrocyte and heart rhythm variability in outbred rats with stimulation of the central neurotransmitter systems. Bull Exp Biol Med. 2018;165:597-601.

16. Lammers AE, Munnery E, Hislop AA, et al. Heart rate variability predicts outcome in children with pulmonary arterial hypertension. Int J Cardiol. 2010;142:159-65.

17. Larosa C, Infusino F, Sgueglia GA, et al. Effect of primary percutaneous coronary intervention versus thrombolysis on ventricular arrhythmias and heart rate variability in acute myocardial infarction. Ital Heart J. 2005;6:629-33.

18. Lavie CJ, Church TS, Milani RV, et al. Impact of physicalactivity, cardiorespiratory fitness, and exercise training on markers of inflammation. J Cardiopulm Rehabil Prev. 2011;31:137–45.

19. Lazar JM, Khanna N, Chesler R, et al. Swimming and the heart. Int J Cardiol. 2013;168:19–26.

20. Lin YY, Lu WA, Hsieh YC, et al. Effect of position on the residual heart rate variability in patients after orthotopic heart transplantation. J Chin Med Assoc. 2017;80:63-71.

21. Lucini D, de Giacomi G, Tosi F, et al. Altered cardiovascular autonomic regulation in overweight children engaged in regular physical activity. Heart. 2013,99:376–81.

22. Madan K, Garg P, Deepak KK, et al. Heart rate variability in patients undergoing univentricular heart repair. Asian Cardiovasc Thorac Ann, 2014;22:402-8.

23. Maged AM, Abbassy AH, Sakr HRS, et al. Effect of swimming exercise on premenstrual syndrome. Arch Gynecol Obstet. 2018;297:951-9.

24. Martinez V, la Garza MS, Grazioli G, et al. Cardiac performance after an endurance open water swimming race. Eur J Appl Physiol. 2019;119:961- 70.

25. Medeiros A, Oliveira EM, Gianolla R, et al. Swimming training increases cardiac vagal activity and induces cardiac hypertrophy in rats. Braz J Med Biol Res. 2004;37:1909–17.

26. Moraes IAP, Silva TD, Massetti T, et al. Fractal correlations and linear analyses of heart rate variability in healthy young people with different levels of physical activity. Cardiol Young. 2019;29:1236-42.

27. Nagai N, Moritani T. Effect of physical activity on autonomic nervous system function in lean and obese children. Int J Obes Relat Metab Disord. 2004;28:27–33.

28. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17:1321-60.

29. Ozyilmaz I, Ergul Y, Tola HT, et al. Heart rate variability improvement in children using transcatheter atral septal defect closure. Anatol J Cardiol. 2016;16:290-5.

30. Prodel E, Peçanha T, Silva LPD, et al. Different times of day do not change heart rate variability recovery after light exercise in sedentary subjects: 24 hours Holter monitoring. Chronobiol Int. 2017;34:1354-65.

31. Nualnim N, Parkhurst K, Dhindsa,M, et al. Effects of swimming training on blood pressure and vascular function in adults >50 years of age. Am J Cardiol. 2012;109:1005–10.

32. Plews DJ, Laursen PB, Stanley J, et al. Training adaptation and heart rate variability in elite endurance athletes: opening the doorto effective monitoring. Sports Med. 2013;43:773–81.

33. Sandercock GRH, Bromley PD, Brodie DA. Effects of exercise on heart rate variability: inferences from meta-analysis. Med Sci Sports Exerc. 2005;37:433–9.

34. Shaffer F, Ginsberg JP. An overview of heart rate variability metrics and norms. Front Public Health. 2017;5:258.

35. Sharma VK, Subramanian SK, Arunachalam V, et al. Heart rate variability in adolescents—normative data stratified by sex and physical activity. J Clin Diagn Res. 2015;9:08–13.

36. Sen J, McGill D. Fractal analysis of heart rate variability as a predictor of mortality: A systematic review and meta-analysis. Chaos. 2018;28:072101.

37. Sharma VK, Subramanian SK, Radhakrishnan K, et al Comparison of structured and unstructured physical activity training on predicted vo2max and heart rate variability in adolescents - A Randomized Control Trial. J Basic Clin Physiol Pharmacol. 2017;28:225-38.

38. Sessa F, Anna V, Messina G, et al. Heart rate variability as predictive factor for sudden cardiac death. Aging (Albany NY). 2018;10:166-77.

39. Shoemaker LN, Wilson LC, Lucas SJE, et al. Swimming-related effects on cerebrovascular and cognitive function. Physiol Rep. 2019;7,e14247.

40. Tanaka, H. Swimming exercise: impact of aquatic exercise on cardiovascular health. Sports Med. 2009;39:377–87.

41. Tian J, Yu T, Xu Y, et al. Swimming training reduces neuroma pain by regulating neurotrophins. Med Sci Sports Exerc. 2018;50:54-61. 42. World Health Organization. Global strategy on diet, physical activity and health. Information sheet: global recommendations on physical activity for health 5–17 years old.2011.

43. Xhyheri B, Manfrini O, Mazzolini M, et al. Heart rate variability toda