Herz
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Review Comparative Study
[Heart rate variability and physical exercise. Current status].
Heart rate variability (HRV) has long been used in risk stratification for sudden cardiac death and diabetic autonomic neuropathy. In recent years, both time and frequency domain indices of HRV also gained increasing interest in sports and training sciences. In these fields, HRV is currently used for the noninvasive assessment of autonomic changes associated with short-term and long-term endurance exercise training in both leisure sports activity and high-performance training. ⋯ Preliminary results, though promising, need to be confirmed in larger cohorts. A basic problem in HRV analysis is nonstationarity of the heart rate signal, which holds particularly true for exercise conditions. Whether, in these conditions, more robust nonlinear HRV methods offer a benefit has to be established in further work.
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The prevalence of overweight and obesity in children and adolescents is increasing. In Germany, 10-20% of children and youth are overweight and obese. Childhood obesity is associated with cardiovascular and other comorbidities. 25% suffer from arterial hypertension and/or hypercholesterolemia, 1% from diabetes mellitus type 2. ⋯ Results, however, are inconsistent and depend on several factors such as socioeconomic status, parental integration, etc. To counteract the epidemic of obesity, national and international data should be collected, results and recommendations adapted to individual necessities of different settings. The implementation of such strategies is only possible with a combined and qualified procedure by a concerted and qualified action of all health care employees based on adequate political structures.
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Preconditioning is the most effective form of cardioprotection that can be induced via different interventions before a longer-lasting ischemia (= index ischemia). Preconditioning can be induced by short bouts of ischemia, several pharmaceuticals (e.g., adenosine), and volatile anesthetics. ⋯ Such a postconditioning can also be elicited at a distant organ, termed remote postconditioning. It is the aim of this short review to characterize preconditioning and in particular postconditioning, describe possible mechanisms, and call attention to the clinical relevance.