Int J Sports Med 2018; 39(01): 73-78
DOI: 10.1055/s-0043-118033
Immunology
© Georg Thieme Verlag KG Stuttgart · New York

Resting Autonomic Function in Active and Insufficiently Active People Living with HIV

Norberto Quiles
1   Queens College, Family, Nutrition and Exercise Science, Flushing, United States
,
Carol Garber
2   Biobehavioral Sciences, Teachers College of Columbia University, New York, United States
,
Joseph Ciccolo
2   Biobehavioral Sciences, Teachers College of Columbia University, New York, United States
› Author Affiliations
Further Information

Publication History



accepted after revision 24 July 2017

Publication Date:
21 November 2017 (online)

Abstract

Autonomic dysfunction appears to be prevalent in people living with HIV/AIDS (PLWHA). However, there are limited data on the resting autonomic responses to exercise in active and insufficiently active PLWHA. We aimed to determine whether active PLWHA have better autonomic responses compared with insufficiently active PLWHA. Active PLWHA receiving anti-retroviral therapy (n=13) and insufficiently active PLWHA (n=10) were recruited. A 10-min recording of the supine electrocardiogram was taken. Resting heart rate variability was analyzed from this electrocardiogram. Parasympathetic modulation, as measured by high frequency power in normalized units, was greater in active PLWHA when compared to insufficiently active PLWHA (41.0±15.6 vs. 25.2±9.7; p<0.05). Sympathetic modulation as measured by low frequency power in normalized units was greater in insufficiently active PLWHA when compared to active PLWHA (55.6±15.8 vs 79.3±17.5; p<0.05). Sympathovagal balance as measured by low frequency/high frequency ratio was greater in insufficiently active PLWHA when compared to active PLWHA (3.4±1.8 vs 1.6±0.9; p<0.05), indicating greater parasympathetic dominance in the active group. In conclusion, PLWHA who regularly exercised demonstrated enhanced autonomic function compared with insufficiently active PLWHA. These results suggest that exercise is associated with enhanced autonomic function, and may improve cardiovascular risk.

 
  • References

  • 1 Akay C, Cooper M, Odeleye A, Jensen BK, White MG, Vassoler F, Gannon PJ, Mankowski J, Doersey JL, Buch AM. Antiretroviral drugs induce oxidative stress and neuronal damage in the central nervous system. J. Neurovirol 2014; 20: 39-53
  • 2 Askgaard G, Kristoffersen US, Mehlsen J, Kronborg G, Kjaer A, Lebech AM. Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol. PloS one 2011; 6: e20196
  • 3 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381
  • 4 Borges J, Soares P, Farinatti P. Autonomic modulation following exercise is impaired in HIV patients. Int J Sports Med 2012; 33: 320-324
  • 5 Correia D, De Resende R, Pertilli LA, Molina RJ, Ferreira BDC, Colombari F. Barbosa CJDG Da Silva VJD, Prata A. Power spectral analysis of heart rate variability in HIV-Infected and AIDS patients. Pacing Clin Electrophysiol 2006; 29: 53-58
  • 6 De Meersman RE. Heart rate variability and aerobic fitness. Am Heart J 1993; 125: 726-731
  • 7 Freeman R, Roberts MS, Friedman LS, Broadbridge C. Autonomic function and human immunodeficiency virus infection. Neurology 1990; 40: 575
  • 8 Hand GA, Phillips KD, Dudgeon WD, Lyerly WG, Durstine LJ, Burgess SE. Moderate intensity exercise training reverses functional aerobic impairment in HIV-infected individuals. AIDS care 2008; 20: 1066-1074
  • 9 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2016 update. Int J Sports Med 2015; 36: 1121-1124
  • 10 Haugaard SB, Andersen O, Pedersen SB, Dela F, Richelsen B, Nielsen JO, Madsbad S, Iversen J. Depleted skeletal muscle mitochondrial DNA, hyperlactatemia, and decreased oxidative capacity in HIV-infected patients on highly active antiretroviral therapy. J Med Virol 2005; 77: 29-38
  • 11 Hemkens LG, Bucher HC. HIV infection and cardiovascular disease. Eur Heart J 2014; 35: 1373-1381
  • 12 Hull 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
  • 13 Islam FM, Wu J, Jansson J, Wilson DP. Relative risk of cardiovascular disease among people living with HIV: A systematic review and meta-analysis. HIV medicine 2012; 13: 453-468
  • 14 Kaminsky L, Arena R, Myers J. Reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing. Mayo Clin Proc 2015; 90: 1515-1523
  • 15 Lahiri MK, Kannankeril PJ, Goldberger JJ. Assessment of autonomic function in cardiovascular disease: physiological basis and prognostic implications. J Am Coll Cardiol 2008; 51: 1725-1733
  • 16 Lebech AM, Kristoffersen US, Mehlsen J, Wiinberg N, Petersen CL, Hesse B, Gerstoft J, Kjaer A. Autonomic dysfunction in HIV patients on antiretroviral therapy: studies of heart rate variability. Clin Physiol Funct Imaging 2007; 27: 363-367
  • 17 Lombardi F. Chaos theory, heart rate variability, and arrhythmic mortality. Circulation 2000; 101: 8-10
  • 18 Mbada CE, Onayemi O, Ogunmoyole Y, Johnson OE, Akosile CO. Health-related quality of life and physical functioning in people living with HIV/AIDS: A case–control design. Health Qual Life Outcomes 2013; 11: 106
  • 19 Melli G, Keswani SC, Fischer A, Chen W, Höke A. Spatially distinct and functionally independent mechanisms of axonal degeneration in a model of HIV-associated sensory neuropathy. Brain 2006; 129: 1330-1338
  • 20 Mittal CM, Wig N, Mishra S, Deepak KK. Heart rate variability in human immunodeficiency virus-positive individuals. Int J Cardiol 2004; 94: 1-6
  • 21 Nakagawa F, May M, Phillips A. Life expectancy living with HIV: Recent estimates and future implications. Curr Opin Infect Dis 2013; 26: 17-25
  • 22 National Center for Health Statistics. NHANES III anthropometric procedures. 2015;
  • 23 Payne BA, Hateley CL, Ong EL, Price DA. HIV-associated fatigue in the era of highly active antiretroviral therapy: novel biological mechanisms?. HIV medicine 2013; 14: 247-251
  • 24 Pescatello L. (ed) ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins; 2013
  • 25 Physical Activity Guidelines Advisory Committee. Physical activity guidelines advisory committee report, 2008. Washington, DC: US Department of Health and Human Services; 2008. A1-H14
  • 26 Robinson-Papp J, Sharma S, Simpson DM, Morgello S. Autonomic dysfunction is common in HIV and associated with distal symmetric polyneuropathy. J Neurovirol 2013; 19: 172-180
  • 27 Roos R, Myezwa H, van Aswegen H, Musenge E. Effects of an education and home-based pedometer walking program on ischemic heart disease risk factors in people infected with HIV: a randomized trial. JAIDS 2014; 67: 268-276
  • 28 Routledge FS, Campbell TS, McFetridge-Durdle JA, Bacon SL. Improvements in heart rate variability with exercise therapy. Can J Cardiol 2010; 26: 303-312
  • 29 Sakhuja A, Goyal A, Jaryal AK, Wig N, Vajpayee M, Kumar A, Deepak KK. Heart rate variability and autonomic function tests in HIV positive individuals in India. Clin Auton Res 2007; 17: 193-196
  • 30 Sandercock GR, Bromley PD, Brodie DA. Effects of exercise on heart rate variability: inferences from meta-analysis. Med Sci Sports Exerc 2005; 37: 433-439
  • 31 Santos-Hiss MDB, Melo RC, Neves VR, Hiss FC, Verzola RMM, Silva E, Navarro AM. Effects of progressive exercise during phase I cardiac rehabilitation on the heart rate variability of patients with acute myocardial infarction. Disabil Rehabil 2011; 33: 835-842
  • 32 Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P. et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 2014; 384: 241-248
  • 33 Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes Metab Rev 2011; 27: 639-653
  • 34 Spierer DK, DeMeersman RE, Kleinfeld J, McPherson E, Fullilove RE, Alba A, Zion AS. Exercise training improves cardiovascular and autonomic profiles in HIV. Clin Auton Res 2007; 17: 341-348
  • 35 Task Force of the European Society of Cardiology. the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 1996; 93: 1043-1065
  • 36 Thoni GJ, Schuster I, Walther G, Nottin S, Vinet A, Boccara F, Mauboussin JM, Rouanet I, Ederhy S, Dauzat M, Messner PP, Obert P. Silent cardiac dysfunction and exercise intolerance in HIV+ men receiving combined antiretroviral therapies. AIDS 2008; 22: 2537-2540
  • 37 Tsuji H, Venditti FJ, Manders ES, Evans JC, Larson MG, Feldman CL, Levy D. Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation 1994; 90: 878-883
  • 38 Tulppo MP, Hautala AJ, Mäkikallio TH, Laukkanen RT, Nissilä S, Hughson RL, Huikuri HV. Effects of aerobic training on heart rate dynamics in sedentary subjects. J Appl Physiol 2003; 95: 364-372
  • 39 Vanoli E, De Ferrari GM, Stramba-Badiale M, Hull SS, Foreman RD, Schwartz PJ. Vagal stimulation and prevention of sudden death in conscious dogs with a healed myocardial infarction. Circ Res 1991; 68: 1471-1481
  • 40 Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger Jr RS, Blair S. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 1999; 282: 1547-1553
  • 41 Zoppini G, Cacciatori V, Gemma ML, Moghetti P, Targher G, Zamboni C, Thomaseth K, Bellaver F, Muggeo M. Effect of moderate aerobic exercise on sympatho-vagal balance in type 2 diabetic patients. Diabet Med 2007; 24: 370-376