The Association Between Endurance Training and Heart Rate Variability: The Confounding Role of Heart Rate.

Herzig, David; Asatryan, Babken; Brugger, Nicolas Jacques; Eser, Prisca; Wilhelm, Matthias (2018). The Association Between Endurance Training and Heart Rate Variability: The Confounding Role of Heart Rate. Frontiers in physiology, 9(756), p. 756. Frontiers Research Foundation 10.3389/fphys.2018.00756

fphys-09-00756.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (587kB) | Preview

Heart rate variability (HRV) is a widely used marker of cardiac autonomic nervous activity (CANA). Changes in HRV with exercise training have often been interpreted as increases in vagal activity. HRV is strongly associated with heart rate, which in turn, is associated with heart size. There is strong evidence from basic studies that lower heart rate in response to exercise training is caused by morphological and electrical remodeling of the heart. In a cross-sectional study in participants of a 10 mile race, we investigated the influence of endurance exercise on HRV parameters independently of heart size and heart rate. One-hundred-and-seventy-two runners (52 females and 120 males) ranging from novice runners with a first participation to an endurance event to highly trained runners, with up to 15 h of training per week, were included in the analysis. R-R intervals were recorded by electrocardiography over 24 h. Left ventricular end diastolic volume indexed to body surface area (LVEDVI) was assessed by transthoracic echocardiography and peak oxygen consumption (VOpeak) by cardiopulmonary exercise testing. Exercise was quantified by VOpeak, training volume, and race performance. HRV was determined during deep sleep. HRV markers of vagal activity were moderately associated with exercise variables (standardized β = 0.28-0.40, all < 0.01). These associations disappeared when controlling for heart rate and LVEDVI. Due to the intrinsic association between heart rate and HRV, conclusions based on HRV parameters do not necessarily reflect differences in CANA. Based on current evidence, we discourage the use of HRV as a marker of CANA when measuring the effect of chronic exercise.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Herzig, David, Asatryan, Babken, Brugger, Nicolas Jacques, Eser, Prisca Christina, Wilhelm, Matthias


600 Technology > 610 Medicine & health




Frontiers Research Foundation




Michelle Dysli

Date Deposited:

08 Feb 2019 15:04

Last Modified:

02 Mar 2023 23:31

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

autonomic nervous system bradycardia endurance training heart rate heart rate variability




Actions (login required)

Edit item Edit item
Provide Feedback