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Sex differences in heart rate variability: a longitudinal study in international elite cross-country skiers

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Abstract

Purpose

Exercise-related sudden cardiac deaths (SCD) occur with a striking male predominance. A higher sympathetic tone in men has been suggested as risk factor for SCD. Elite athletes have the highest risk for exercise-related SCD. We aimed to analyze the autonomic nervous system of elite cross-country skiers from Norway, Russia and Switzerland in supine position and after orthostatic challenge in various training periods (TP).

Method

Measurements of heart rate variability (HRV) were performed on a weekly basis over 1 year using an orthostatic challenge test with controlled breathing. Main outcome parameters were the high-frequency power in supine position (HFsupine) as marker of cardiac parasympathetic activity and the low-frequency/high-frequency power ratio after orthostatic challenge (LF/HFstand) as marker of cardiac sympathetic activation. Training intensity and duration were recorded daily and expressed as training strain. The training year was divided into three TPs. An average of weekly HRV measurements was calculated for each TP.

Result

Female (n = 19, VO2max 62.0 ± 4.6 ml kg−1 min−1, age 25.8 ± 4.3 years) and male (n = 16, VO2max 74.3 ± 6.3 ml kg−1 min−1, age 24.4 ± 4.2 years) athletes were included. Training strain was comparable between sexes (all p > 0.05) and changed between TPs (all p < 0.05) while no HRV parameters changed over time. There were no sex differences in HFsupine while the LF/HFstand was significantly higher in male athletes in all TPs.

Conclusion

For a comparable amount of training, male athletes showed constantly higher markers of sympathetic activity after a provocation maneuver. This may explain part of the male predominance in sports-related SCD.

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Abbreviations

ANOVA:

Analysis of variance

ANS:

Autonomic nervous system

CP:

Competition period

HF:

High-frequency power

HRV:

Heart rate variability

LF:

Low-frequency power

LF/HF:

Low-frequency/high-frequency power ratio

MeanRR:

Mean of the R–R intervals

PP1:

Preparation period 1

PP2:

Preparation period 2

RMSSD:

The square root of the mean squared differences of successive R–R intervals

RPE:

Rate of perceived exertion

SDNN:

Standard deviation of all R–R intervals

SCD:

Sudden cardiac death

Sup:

In supine position

Stand:

Standing after orthostatic challenge

TP:

Training periods

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Acknowledgments

We thank all study participants, their coaches and physicians for their contribution and Polar Electro Oy for providing us equipment and technical support.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Division of Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Inselspital University Hospital and University of Bern, 3010, Bern, Switzerland

    Daniela Schäfer, David Herzig, Lukas Daniel Trachsel, Prisca Eser, Hugo Saner & Matthias Wilhelm

  2. Section of Vascular Investigations, Oslo University Hospital, Bjorknes College, Oslo, Norway

    Gard Filip Gjerdalen

  3. Diakonhjemmet Sykehus, Oslo, Norway

    Erik Ekker Solberg

  4. Moscow Department of Public Health, Moscow Research and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia

    Maria Khokhlova & Victoria Badtieva

  5. Swiss Olympic Medical Base, St. Gallen, Switzerland

    Patrik Noack

  6. Polar Electro Oy, Kempele, Finland

    Laura Karavirta

Authors
  1. Daniela Schäfer
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  2. Gard Filip Gjerdalen
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  3. Erik Ekker Solberg
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  4. Maria Khokhlova
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  5. Victoria Badtieva
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  6. David Herzig
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  7. Lukas Daniel Trachsel
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  9. Laura Karavirta
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  10. Prisca Eser
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  11. Hugo Saner
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  12. Matthias Wilhelm
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Corresponding author

Correspondence to Matthias Wilhelm.

Additional information

Communicated by Keith Phillip George.

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Schäfer, D., Gjerdalen, G.F., Solberg, E.E. et al. Sex differences in heart rate variability: a longitudinal study in international elite cross-country skiers. Eur J Appl Physiol 115, 2107–2114 (2015). https://doi.org/10.1007/s00421-015-3190-0

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  • DOI: https://doi.org/10.1007/s00421-015-3190-0

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