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

Schäfer, Daniela; Gjerdalen, G. F.; Solberg, Erik Ekker; Khokhlova, Maria; Badtieva, Vikoriya; Herzig, David; Trachsel, Lukas; Noack, Patrick; Karavirta, Laura; Eser, Prisca; Saner, Hugo Ernst; Wilhelm, Matthias (2015). Sex differences in heart rate variability: a longitudinal study in international elite cross-country skiers. European journal of applied physiology, 115(10), pp. 2107-2114. Springer 10.1007/s00421-015-3190-0

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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.

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:

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


600 Technology > 610 Medicine & health








Matthias Wilhelm

Date Deposited:

27 Apr 2016 07:53

Last Modified:

02 Mar 2023 23:27

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Athletes; Autonomic nervous system; Endurance; Heart rate variability; Orthostatic test; Training




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