Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study

Abstract Background Assessing lactate (LT) or anaerobic thresholds (AT) in athletes is an important tool to control training intensities and to estimate individual performance levels. Previously we demonstrated that ECG-based assessment of cardiac repolarization instability during exercise testing a...

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Main Authors: Dominik Schüttler, Simone Krammer, Lukas von Stülpnagel, Lauren Sams, Axel Bauer, Wolfgang Hamm, Stefan Brunner
Format: Article
Language:English
Published: BMC 2021-08-01
Series:BMC Sports Science, Medicine and Rehabilitation
Subjects:
Online Access:https://doi.org/10.1186/s13102-021-00312-1
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spelling doaj-935ab4a25e0b4f49881f633fd0caa0842021-08-08T11:41:12ZengBMCBMC Sports Science, Medicine and Rehabilitation2052-18472021-08-011311810.1186/s13102-021-00312-1Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation studyDominik Schüttler0Simone Krammer1Lukas von Stülpnagel2Lauren Sams3Axel Bauer4Wolfgang Hamm5Stefan Brunner6Department of Medicine I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU)Department of Medicine I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU)Department of Medicine I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU)Department of Medicine I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU)Department of Medicine I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU)Department of Medicine I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU)Department of Medicine I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU)Abstract Background Assessing lactate (LT) or anaerobic thresholds (AT) in athletes is an important tool to control training intensities and to estimate individual performance levels. Previously we demonstrated that ECG-based assessment of cardiac repolarization instability during exercise testing allows non-invasive estimation of AT in recreational athletes. Here, we validate this method in professional and amateur team sports athletes. Methods We included 65 team sports athletes (32 professionals and 33 amateur athletes; 51 men, 14 women, mean age 22.3 ± 5.2 years) undergoing a standardized incremental cycle exercise test. During exercise testing a high-resolution ECG (1000 Hz) was recorded in Frank-leads configuration and beat-to-beat vector changes of cardiac repolarization (dT°) were assessed by previously established technologies. Repolarization-based AT (ATdT°) was estimated by its typical dT°-signal pattern. Additionally, LT was detected in accordance to methods established by Mader (LTMader) and Dickhuth (LTDickhuth). Results All athletes performed exercise testing until exhaustion with a mean maximum workload of 262.3 ± 60.8 W (241.8 ± 64.4 W for amateur athletes and 283.4 ± 49.5 W for professional athletes). Athletes showed ATdT° at 187.6 ± 44.4 W, LTDickhuth at 181.1 ± 45.6 W and LTMader at 184.3 ± 52.4 W. ATdT° correlated highly significantly with LTDickhuth (r = 0.96, p < 0.001) and LTMader (r = 0.98, p < 0.001) in the entire cohort of athletes as well as in the subgroups of professional and amateur athletes (p < 0.001 for all). Conclusions ATdT°, defined by the maximal discordance between dT° and heart rate, can be assessed reliably and non-invasively via the use of a high-resolution ECG in professional and amateur athletes.https://doi.org/10.1186/s13102-021-00312-1Cardiac repolarizationAutonomic nervous systemAnaerobic thresholdProfessional athlete
collection DOAJ
language English
format Article
sources DOAJ
author Dominik Schüttler
Simone Krammer
Lukas von Stülpnagel
Lauren Sams
Axel Bauer
Wolfgang Hamm
Stefan Brunner
spellingShingle Dominik Schüttler
Simone Krammer
Lukas von Stülpnagel
Lauren Sams
Axel Bauer
Wolfgang Hamm
Stefan Brunner
Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
BMC Sports Science, Medicine and Rehabilitation
Cardiac repolarization
Autonomic nervous system
Anaerobic threshold
Professional athlete
author_facet Dominik Schüttler
Simone Krammer
Lukas von Stülpnagel
Lauren Sams
Axel Bauer
Wolfgang Hamm
Stefan Brunner
author_sort Dominik Schüttler
title Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
title_short Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
title_full Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
title_fullStr Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
title_full_unstemmed Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
title_sort estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
publisher BMC
series BMC Sports Science, Medicine and Rehabilitation
issn 2052-1847
publishDate 2021-08-01
description Abstract Background Assessing lactate (LT) or anaerobic thresholds (AT) in athletes is an important tool to control training intensities and to estimate individual performance levels. Previously we demonstrated that ECG-based assessment of cardiac repolarization instability during exercise testing allows non-invasive estimation of AT in recreational athletes. Here, we validate this method in professional and amateur team sports athletes. Methods We included 65 team sports athletes (32 professionals and 33 amateur athletes; 51 men, 14 women, mean age 22.3 ± 5.2 years) undergoing a standardized incremental cycle exercise test. During exercise testing a high-resolution ECG (1000 Hz) was recorded in Frank-leads configuration and beat-to-beat vector changes of cardiac repolarization (dT°) were assessed by previously established technologies. Repolarization-based AT (ATdT°) was estimated by its typical dT°-signal pattern. Additionally, LT was detected in accordance to methods established by Mader (LTMader) and Dickhuth (LTDickhuth). Results All athletes performed exercise testing until exhaustion with a mean maximum workload of 262.3 ± 60.8 W (241.8 ± 64.4 W for amateur athletes and 283.4 ± 49.5 W for professional athletes). Athletes showed ATdT° at 187.6 ± 44.4 W, LTDickhuth at 181.1 ± 45.6 W and LTMader at 184.3 ± 52.4 W. ATdT° correlated highly significantly with LTDickhuth (r = 0.96, p < 0.001) and LTMader (r = 0.98, p < 0.001) in the entire cohort of athletes as well as in the subgroups of professional and amateur athletes (p < 0.001 for all). Conclusions ATdT°, defined by the maximal discordance between dT° and heart rate, can be assessed reliably and non-invasively via the use of a high-resolution ECG in professional and amateur athletes.
topic Cardiac repolarization
Autonomic nervous system
Anaerobic threshold
Professional athlete
url https://doi.org/10.1186/s13102-021-00312-1
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