Int J Sports Med 2013; 34(12): 1099-1105
DOI: 10.1055/s-0033-1343408
Training & Testing
© Georg Thieme Verlag KG Stuttgart · New York

Aerobic Exercise Affects T-wave Alternans and Heart Rate Variability in Postmenopausal Women

T.-W. Shen
1   Department of Medical Informatics, Tzu-Chi University, Hualien, Taiwan
H.-J. Wen
2   Center of Physical Education, Tzu-Chi University, Hualien, Taiwan
› Author Affiliations
Further Information

Publication History

accepted after revision 07 March 2013

Publication Date:
11 June 2013 (online)


The purpose of this study was to investigate the effects of a 10-week high-intermediate exercise intervention on heart rate variability/microscopic T-wave alternans (HRV/MTWA) in healthy postmenopausal women (PMW). 62 healthy PMW were recruited and randomly divided into an exercise group (EG, n=32) or a control group (CG, n=30). The EG attended a progressively high-intermediate intensity (75–85% heart rate reserve, HRR) group-based step aerobic exercise program for 10 weeks, whereas the CG did not receive any intervention. HRV/MTWA, blood chemistry and physical function-related indices were measured before and within 24 h following the 10-week exercise program. Following a 10-week exercise intervention, the EG had significant mean decreases in SDNN (22.4%), CV (21.4%), NN50 (72.6%), LF (ms2; 55.8%), HF (ms2; 39.9%), LF (n.u.; 11.2%), and LF/HF (34.5%). The EG showed a significant increase in HF (n.u.; 40.0%) and CAV (44.4%), whereas there was no significant finding in the CG. The coupling effect of MTWA and HRV after intervention suggests that exercise intervention potentially affects regulation changes of the autonomic nervous system and cardiovascular condition synchronically in PMW. The rebound effect of biomarkers has proven to be a considerable factor on HRV/MTWA measurements.

  • References

  • 1 American College of Sports M . Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009; 41: 1510-1530
  • 2 Armoundas AA, Tomaselli GF, Esperer HD. Pathophysiological basis and clinical application of T-wave alternans. J Am Coll Cardiol 2002; 40: 207-217
  • 3 Aubert AE, Seps B, Beckers F. Heart rate variability in athletes. Sports Med 2003; 33: 889-919
  • 4 Carnethon MR, Golden SH, Folsom AR, Haskell W, Liao D. Prospective investigation of autonomic nervous system function and the development of type 2 diabetes: the Atherosclerosis Risk In Communities study, 1987–1998. Circulation 2003; 107: 2190-2195
  • 5 Chaudhuri A, Borade NG, Hazra SK. A study of heart rate variablity tests and lipid profile in postmenopausal women. J Indian Med Assoc 2012; 110: 230-222
  • 6 Chiuve SE, Fung TT, Rexrode KM, Spiegelman D, Manson JE, Stampfer MJ, Albert CM. Adherence to a low-risk, healthy lifestyle and risk of sudden cardiac death among women. JAMA 2011; 306: 62-69
  • 7 de Chazal P, Heneghan C, Sheridan E, Reilly R, Nolan P, O'Malley M. Automated processing of the single-lead electrocardiogram for the detection of obstructive sleep apnoea. IEEE Trans Biomed Eng 2003; 50: 686-696
  • 8 Deo R, Vittinghoff E, Lin F, Tseng ZH, Hulley SB, Shlipak MG. Risk factor and prediction modeling for sudden cardiac death in women with coronary artery disease. Arch Intern Med 2011; 171: 1703-1709
  • 9 Dubbert PM, Vander Weg MW, Kirchner KA, Shaw B. Evaluation of the 7-day physical activity recall in urban and rural men. Med Sci Sports Exerc 2004; 36: 1646-1654
  • 10 Earnest CP, Blair SN, Church TS. Heart rate variability and exercise in aging women. J Women’s Health (Larchmt) 2012; 21: 334-339
  • 11 Estes 3rd NA, Michaud G, Zipes DP, El-Sherif N, Venditti FJ, Rosenbaum DS, Albrecht P, Wang PJ, Cohen RJ. Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias. Am J Cardiol 1997; 80: 1314-1318
  • 12 Furlan R, Piazza S, Dell’Orto S, Gentile E, Cerutti S, Pagani M, Malliani A. Early and late effects of exercise and athletic training on neural mechanisms controlling heart rate. Cardiovasc Res 1993; 27: 482-488
  • 13 Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP. American College of Sports M . American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359
  • 14 Groh WJ, Groh MR, Saha C, Kincaid JC, Simmons Z, Ciafaloni E, Pourmand R, Otten RF, Bhakta D, Nair GV, Marashdeh MM, Zipes DP, Pascuzzi RM. Electrocardiographic abnormalities and sudden death in myotonic dystrophy type 1. N Engl J Med 2008; 358: 2688-2697
  • 15 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
  • 16 Hedreville M, Barthelemy JC, Tripette J, Roche F, Hardy-Dessources MD, Pichot V, Hue O, Connes P. Effects of strenuous exercise on autonomic nervous system activity in sickle cell trait carriers. Auton Neurosci 2008; 143: 68-72
  • 17 Hull Jr. SS, Vanoli E, Adamson PB, Verrier RL, Foreman RD, Schwartz PJ. Exercise training confers anticipatory protection from sudden death during acute myocardial ischemia. Circulation 1994; 89: 548-552
  • 18 Janusek D, Pawlowski Z, Maniewski R. Evaluation of the T-wave alternans detection methods: a simulation study. Anadolu Kardiyol Derg 2007; 7 (Suppl. 01) 116-119
  • 19 Jurca R, Church TS, Morss GM, Jordan AN, Earnest CP. Eight weeks of moderate-intensity exercise training increases heart rate variability in sedentary postmenopausal women. Am Heart J 2004; 147: e21
  • 20 Klingenheben T, Zabel M, D'Agostino RB, Cohen RJ, Hohnloser SH. Predictive value of T-wave alternans for arrhythmic events in patients with congestive heart failure. Lancet 2000; 356: 651-652
  • 21 Kudaiberdieva G, Görenek B, Timuralp B. Heart rate variability as a predictor of sudden cardiac death. Anadolu Kardiyol Derg 2007; 7: 68-70
  • 22 Lai FC, Tu ST, Huang CH, Jeng C. A home-based exercise program improves heart rate variability and functional capacity among postmenopausal women with coronary artery disease. J Cardiovasc Nurs 2011; 26: 137-144
  • 23 Laukkanen RMT, Oja P, Pasanen ME, Vuori IM. A two-kilometer walking test: effect of walking speed on the prediction of maximal oxygen uptake. Scand J Med Sci Sports 1993; 3: 263-266
  • 24 Malik M, Bigger JT, Camm AJ, Kleiger RE, Malliani A, Moss AJ, Schwartz PJ. Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996; 17: 354-381
  • 25 Martin RL, Mohtadi NG, Safran MR, Leunig M, Martin HD, McCarthy J, Guanche CA, Kelly BT, Byrd JW, Clohisy JC, Philippon MJ, Sekiya JK. Differences in physician and patient ratings of items used to assess hip disorders. Am J Sports Med 2009; 37: 1508-1512
  • 26 Metsavaht L, Leporace G, Riberto M, de Mello Sposito MM, Batista LA. Translation and cross-cultural adaptation of the Brazilian version of the International Knee Documentation Committee Subjective Knee Form: validity and reproducibility. Am J Sports Med 2010; 38: 1894-1899
  • 27 Oja P, Laukkanen R, Pasanen M, Tyry T, Vuori I. A 2-km walking test for assessing the cardiorespiratory fitness of healthy adults. Int J Sports Med 1991; 12: 356-362
  • 28 Pham Q, Quan KJ, Rosenbaum DS. T-wave alternans: marker, mechanism, and methodology for predicting sudden cardiac death. J Electrocardiol 2003; 36 Suppl: 75-81
  • 29 Rance M, Boussuge PY, Lazaar N, Bedu M, Van Praagh E, Dabonneville M, Duche P. Validity of a V.O2 max prediction equation of the 2-km walk test in female seniors. Int J Sports Med 2005; 26: 453-456
  • 30 Richter S, Duray G, Hohnloser SH. How to analyze T-wave alternans. Heart Rhythm 2005; 2: 1268-1271
  • 31 Rosenbaum DS, Jackson LE, Smith JM, Garan H, Ruskin JN, Cohen RJ. Electrical alternans and vulnerability to ventricular arrhythmias. N Engl J Med 1994; 330: 235-241
  • 32 Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN, Paffenbarger Jr RS. Physical activity assessment methodology in the Five-City Project. Am J Epidemiol 1985; 121: 91-106
  • 33 Scharff-Olson M, Williford HN, Blessing DL, Moses R, Wang T. Vertical impact forces during bench-step aerobics: exercise rate and experience. Percept Mot Skills 1997; 84: 267-274
  • 34 Schuit AJ, van Amelsvoort LG, Verheij TC, Rijneke RD, Maan AC, Swenne CA, Schouten EG. Exercise training and heart rate variability in older people. Med Sci Sports Exerc 1999; 31: 816-821
  • 35 Sourander L, Rajala T, Raiha I, Makinen J, Erkkola R, Helenius H. Cardiovascular and cancer morbidity and mortality and sudden cardiac death in postmenopausal women on oestrogen replacement therapy (ERT). Lancet 1998; 352: 1965-1969
  • 36 Sundquist K, Qvist J, Johansson SE, Sundquist J. The long-term effect of physical activity on incidence of coronary heart disease: a 12-year follow-up study. Prev Med 2005; 41: 219-225
  • 37 Tsuji H, Larson MG, Venditti Jr FJ, Manders ES, Evans JC, Feldman CL, Levy D. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 1996; 94: 2850-2855
  • 38 Zabel M, Malik M, Hnatkova K, Papademetriou V, Pittaras A, Fletcher RD, Franz MR. Analysis of T-wave morphology from the 12-lead electrocardiogram for prediction of long-term prognosis in male US veterans. Circulation 2002; 105: 1066-1070