4-Second Exercise Test: Reference Values for Ages 18–81 Years

Background: Physiological reflexes modulated primarily by the vagus nerve allow the heart to decelerate and accelerate rapidly after a deep inspiration followed by rapid movement of the limbs. This is the physiological and pharmacologically validated basis for the 4-s exercise test (4sET) used to assess the vagal modulation of cardiac chronotropism. Objective: To present reference data for 4sET in healthy adults. Methods: After applying strict clinical inclusion/exclusion criteria, 1,605 healthy adults (61% men) aged between 18 and 81 years subjected to 4sET were evaluated between 1994 and 2014. Using 4sET, the cardiac vagal index (CVI) was obtained by calculating the ratio between the duration of two RR intervals in the electrocardiogram: 1) after a 4-s rapid and deep breath and immediately before pedaling and 2) at the end of a rapid and resistance-free 4-s pedaling exercise. Results: CVI varied inversely with age (r = -0.33, p < 0.01), and the intercepts and slopes of the linear regressions between CVI and age were similar for men and women (p > 0.05). Considering the heteroscedasticity and the asymmetry of the distribution of the CVI values according to age, we chose to express the reference values in percentiles for eight age groups (years): 18–30, 31–40, 41–45, 46–50, 51–55, 56–60, 61–65, and 66+, obtaining progressively lower median CVI values ranging from 1.63 to 1.24. Conclusion: The availability of CVI percentiles for different age groups should promote the clinical use of 4sET, which is a simple and safe procedure for the evaluation of vagal modulation of cardiac chronotropism.

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Magdeburg, Univ., Fak. für Naturwiss., Diss., 2008

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Magdeburg, Univ., Fak. für Naturwiss., Diss., 2009

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Magdeburg, Univ., Fak. für Naturwiss., Diss., 2010

Modulation of the activity of the mitochondrial BK-channel and the permeability transition pore by hypoxia and apoptotic factors

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2010

Modulation of [My]-opioid receptor signal transduction and endocytosis by ADP-ribosylation factor proteins

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2010

Modulation funktioneller Plastizität in der hippokampalen CA1 Region der frei beweglichen Ratte

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2011

Untersuchung mit fMRT zu hämodynamischen Veränderungen im Gehirn von Katatonen bei der Verarbeitung von emotionalen Reizen und ihre Modulation mit Lorazepam

Magdeburg, Univ., Medizin. Fakultät, Diss., 2007

Modulation der physiologischen Zellfunktion in intestinalen porcinen Epithelzellen (IPEC) durch das Mykotoxin Deoxynivalenol (DON)

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2012

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Magdeburg, Univ., Med. Fak., Diss., 2013

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Magdeburg, Univ., Fak. für Naturwiss., Diss., 2013

Modulation of social and emotional behaviors by glutamic acid decarboxylase (GAD) and phytoestrogens

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2014

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Magdeburg, Univ., Fak. für Naturwiss., Diss., 2015

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Magdeburg, Univ., Med. Fak., Habil.-Schr., 2014

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