Heart Rate Is a Better Predictor of Cardiorespiratory Fitness Than Heart Rate Variability in Overweight/Obese Children: The ActiveBrains Project.

Abel Plaza-Florido,Carlos De Teresa,Maria Rodriguez-Ayllon,Cristina Cadenas-Sanchez,Nathalie Michels,Ángel Gutiérrez,Pablo Molina-Garcia,Irene Esteban-Cornejo,Francisco B Ortega,Jerzy Sacha,Jairo H Migueles,Jose Mora-Gonzalez,Patricio Solis-Urra

doi:10.3389/fphys.2019.00510

Abstract

Cardiac autonomic function can be quantified through mean heart rate (HR) or heart rate variability (HRV). Numerous studies have supported the utility of different HRV parameters as indicators of cardiorespiratory fitness (CRF). However, HR has recently shown to be a stronger predictor of CRF than HRV in healthy young adults, yet these findings need to be replicated, in other age groups such as children. Therefore, this study aimed: (1) to study the associations between indicators of cardiac autonomic function (HR, standard and corrected HRV parameters) and CRF in overweight/obese children; and (2) to test which of the two indicators (i.e., HR or HRV) is a stronger predictor of CRF. This study used cross-sectional baseline data of 107 overweight/obese children (10.03 ± 1.13 years, 58% boys) from the ActiveBrains project. Cardiac autonomic indicators were measured with Polar RS800CX®. CRF was assessed using a gas analyzer while performing a maximal incremental treadmill test. Correlations and stepwise linear regressions were performed. Mean HR and standard HRV parameters (i.e., pNN50, RMSSD, and SDNN) were associated with CRF (r coefficients ranging from -0.333 to 0.268; all p ≤ 0.05). The association of HR with CRF persisted after adjusting for sex, peak height velocity (PHV), adiposity moderate-to-vigorous physical activity, energy intake and circadian-related variable intradaily variability of activity patterns whilst for HRV parameters (i.e., pNN50, RMSSD, and SDNN) disappeared. Stepwise linear regression models entering HR and all HRV parameters showed that mean HR was the strongest predictor of CRF (β = -0.333, R2 = 0.111, p < 0.001). Standard and corrected HRV parameters did not provide additional value to the coefficient of determination (all p > 0.05). Our findings suggest that HR is the strongest indicator of CRF. It seems that quantification of HRV parameters in time and frequency domain do not add relevant clinical information about the cardiovascular health status (as measured by CRF) in overweight/obese children beyond the information already provided by the simple measure of HR.

Highlights

A number of comorbidities linked to childhood obesity could be explained by their altered cardiac autonomic functions (Thayer and Lane, 2007; Zhou et al, 2012)
Significant correlations found between the standard heart rate variability (HRV) parameters and Heart rate (HR) (r ranging from −0.802 to 0.250; all p ≤ 0.009) disappeared after the correction procedure (r ranging from −0.120 to 0.033; p ≥ 0.220)
After correction for the prevailing HR, the RMSSD, pNN50 and standard deviation of all normal R-R intervals (SDNN) completely lost their association with cardiorespiratory fitness (CRF), i.e., none of the corrected HRV parameter correlated with CRF

Summary

Introduction

A number of comorbidities linked to childhood obesity could be explained by their altered cardiac autonomic functions (Thayer and Lane, 2007; Zhou et al, 2012). Heart rate (HR) and heart rate variability (HRV) have been proposed as indicators of the cardiac autonomic nervous system functioning (Koizumi et al, 1985; Task Force, 1996; Lahiri et al, 2008). HRV refers to the variability in time intervals between consecutive heart beats, namely between the R peaks registered in the electrocardiogram (ECG) (Task Force, 1996). Both HR and HRV have been used as predictors of CVD, showing that higher HR and lower HRV at rest are related to a higher CVD risk (Kannel et al, 1987; Thayer and Lane, 2007; Trimmel et al, 2015; Dilaveris and Tousoulis, 2018)

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