Martin Garet | Universite Jean Monnet - Saint-Etienne (original) (raw)
Papers by Martin Garet
Circulation, Nov 23, 2010
European Respiratory Journal, Sep 1, 2014
Revue de Pneumologie Clinique
Assessment of daily physical activity (DPA) is a major element in the development of respiratory ... more Assessment of daily physical activity (DPA) is a major element in the development of respiratory rehabilitation. The aim of this study was to evaluate the DPA and the daily energy expenditure (DEE) in adult patients with cystic fibrosis. Thirty adult patients (16 women, 14 men, mean age 27.1±8.4 years) with cystic fibrosis (FVC: 69.2±19%, FEV1: 55.1±24%, BMI: 20.5±3.6kg/m(2)), in stable condition were included in the study. The questionnaire allowed DPA to estimate DEE from the intensity and type of activity. This tool divides the DEE into four intensity levels: less than 1 Metabolic Equivalent Task (MET), greater than 1 and less than 3 METs, 3-5 METs, and greater than 5 METs. A shuttle test for estimating VO(2) peak was performed in all patients. The DEE reached 9478.4±3224.3kJ24h(-1) and was significantly and highly correlated with calculated peak VO(2) (l/min) (r=0.876, P=<0.001); 22% DEE was less than 3 METs, 10% between 3 and 5 METs et 2,5% greater than 5 METs; 65% DEE was l...
Clinical Nutrition, 2015
A severe weakness of peripheral muscles occurs in half of the persons aged 80 years or older. The... more A severe weakness of peripheral muscles occurs in half of the persons aged 80 years or older. The common factors between muscle depletion and reduced respiratory strength have not yet been established. In the subjects of the Proof cohort, we aimed to identify, among body composition, pulmonary function and energy expenditure parameters, the predictors of maximal inspiratory pressure (MIP) as an index of respiratory muscle strength and handgrip (HG) as an index of peripheral muscle strength. In 375 healthy elderly subjects aged 72 ± 1 years, fat mass (FM) and fat free mass (FFM) were assessed by DEXA, the last being also indexed to height (FFMI). Spirometry was performed and daily energy expenditure (DEE) was estimated by a questionnaire. After three years, MIP and HG of the dominant arm were determined and the predicting value of pulmonary function tests, body composition and DEE on these parameters was tested. Mean MIP and HG were 77 ± 26% and 106 ± 19% of the predicted value (%pred) with 90 (24%) and 30 (8%) subjects below standards, respectively. There was a significant but weak correlation between MIP%pred and HG%pred (r = 0.175, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Logistic regression showed that low MIP was predicted by trunk FFM and FFMI in women, and DEE in men. Low HG was predicted by trunk FM in men only. The predictors of a reduction of MIP in the elderly differ from those of HG, suggesting a differential regulation of respiratory muscle and arm strength.
International journal of sports medicine, 2002
The objective of this study was to evaluate the variability of maximal heart rate in three differ... more The objective of this study was to evaluate the variability of maximal heart rate in three different conditions: laboratory tests, field tests, and competitions. Sixteen male endurance volunteers were tested in five exhaustive tests for each condition. All exhaustive events were heart rate monitored (Accurex plus, Polar Electro, Finland) and true maximal heart rates were assessed and compared with each other and with predicted maximal heart rates. Results show that under the three conditions HR(peaks) were not statistically different (p = 0.62, NS, Friedman test). Mean HR(peaks) (SD) were: laboratory = 194.3 (7.8), field = 193.8 (11.8), competition = 192.3 (10.1) beats x min(-1). Conditions for reaching individual heart rate peak were in the laboratory (treadmill VO(2)max protocol) for 5 subjects, in field tests for 7 subjects and in competitions for 6 subjects (two circumstances for two subjects). A large intra-individual variation existed in the three circumstances (+/- 6 beats x ...
Revue de Pneumologie Clinique, 2013
Assessment of daily physical activity (DPA) is a major element in the development of respiratory ... more Assessment of daily physical activity (DPA) is a major element in the development of respiratory rehabilitation. The aim of this study was to evaluate the DPA and the daily energy expenditure (DEE) in adult patients with cystic fibrosis. Thirty adult patients (16 women, 14 men, mean age 27.1±8.4 years) with cystic fibrosis (FVC: 69.2±19%, FEV1: 55.1±24%, BMI: 20.5±3.6kg/m(2)), in stable condition were included in the study. The questionnaire allowed DPA to estimate DEE from the intensity and type of activity. This tool divides the DEE into four intensity levels: less than 1 Metabolic Equivalent Task (MET), greater than 1 and less than 3 METs, 3-5 METs, and greater than 5 METs. A shuttle test for estimating VO(2) peak was performed in all patients. The DEE reached 9478.4±3224.3kJ24h(-1) and was significantly and highly correlated with calculated peak VO(2) (l/min) (r=0.876, P=<0.001); 22% DEE was less than 3 METs, 10% between 3 and 5 METs et 2,5% greater than 5 METs; 65% DEE was less than 1 MET. There was a strong correlation between DEE and BMI (r=0.860, P=<0.001), a low correlation with FVC (r=0.423, P=0.02). This questionnaire is relevant for estimating DPA and DEE in patients with cystic fibrosis and is an interesting test to be used to evaluate changes in patients after pulmonary rehabilitation.
Background: Metabolic syndrome is associated with higher C-reactive protein (CRP) serum levels, a... more Background: Metabolic syndrome is associated with higher C-reactive protein (CRP) serum levels, a common biological marker of inflammation. However, the respective contribution of each component of metabolic syndrome to the inflammation has not been established. The aim of the present study was to assess the strength of the association between metabolic syndrome components and CRP in elderly subjects. Methods: This was an observational, cross-sectional study on 921 volunteers (65.6 -0.8 years old) from the PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events) Study. Anthropometric, biological, and clinical parameters were evaluated. Subjects with a CRP value less than 10 mg/L were considered. The relationships between the metabolic syndrome components and CRP tertiles were evaluated using logistic regression analysis. Results: After adjustment for gender and for body mass index, metabolic syndrome and high-CRP tertile were significantly associated [odds ratio (OR) = 2.37, 95% confidence interval (CI) 1.46-3.87, P < 0.001]. Waist circumference demonstrated the strongest association with the high-CRP tertile (OR = 1.75, 95% CI 1.05-2.91, P < 0.05). In addition, CRP levels significantly increased with the number of metabolic syndrome components. Conclusions: Among metabolic syndrome components, waist circumference showed the strongest association with the high-CRP tertile in elderly subjects. These findings help to explain the strong association between waist circumference and cardiovascular morbidity.
The purpose of this study is to measure the impact of an educational program to raise awareness o... more The purpose of this study is to measure the impact of an educational program to raise awareness of the increased spending energy in two different population of patients with breast cancer by using the questionnaire POPAQ (Population Physical Activity Questionnaire). This is a prospective study including two groups of 15 consecutive breast cancer patients (≤ 50 years Group 1 and Group 2 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 50 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 70 years) followed in the department of radiotherapy at the Institute of Cancer of the Loire from January to July 2011. A questionnaire of physical activity assessment was used at two different times before the diagnosis/treatment of breast cancer (t0) and at 6 months (t6) to measure the impact of the awareness method. Comparison of different measures of daily energy expenditure (t0) between groups 1 and 2 was statistically significant (1,1803 and 9434 kJ/24 h, respectively, p = 0.0005). Daily energy expenditure of professional activity was statistically different between the two groups (1437 and 457 kJ/24 h, in groups 1 and 2, respectively; p = 0.003). Between t0 and t6, we observed a significant decrease in total energy consumption in group 1 (1,1803 to 1,0876 kJ/24 h) while there was no significant change between the group 2, except energy expended at rest (basal metabolism). There were differences in daily energy expenditure based on age may influence behavioral patterns deal with energy expenditure in physical activities. Tomorrow&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s challenges are to provide re-entrainment programs tailored to targeted populations.
The purpose is to assess the physical activity of breast cancer patients using a questionnaire, t... more The purpose is to assess the physical activity of breast cancer patients using a questionnaire, the Population Physical Activity Questionnaire (POPAQ) and to compare the data with those from two female populations: one healthy population and one with a previous history of cardiovascular disease. This prospective study included 104 consecutive breast cancer patients who were addressed at the radiation oncology department, Institut de cancérologie de la Loire from March to July 2010. A questionnaire using factorial method was used for assessment of physical activity. In the study population, the rest energetic expenditures of physical energy related to both rest activity and low intensity activity were higher than in the healthy patients (5,292±1,376 versus 5,520±1,248 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 and 2,583±681 versus 2,494±558 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05, respectively). Conversely, the energetic expenditures of physical energy related to both high physical activity and intensive physical activity were lower than in the healthy population (882±441 versus 1,560±868 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 et 210±274 versus 340±621 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05, respectively). The POPAQ allows quantifying the daily physical activity and seems feasible in clinical routine in breast cancer patients. In our study, it was found that the physical activity of those patients was significantly different from that of a healthy population. Further investigations are necessary for better defining the true impact of such differences in terms of incidence and prognostic for mammary carcinoma.
European journal of applied physiology, Jan 31, 2014
Our aim was to assess whether we can predict satisfactorily performance in swimming and high freq... more Our aim was to assess whether we can predict satisfactorily performance in swimming and high frequency power (HF power) of heart rate variability from the responses to previous training. We have tested predictions using the model of Banister and the variable dose-response model. Data came from ten swimmers followed during 30 weeks of training with performance and HF power measured each week. The first 15-week training period was used to estimate the parameters of each model for both performance and HF power. Both were then predicted in response to the training done during the second 15-week training period. The bias and precision were estimated from the mean and SD of the difference between prediction and actual value expressed as a percentage of performance or HF power at the first week. With the variable-dose response model, the bias for performance prediction was -0.24 ± 0.06 and the precision 0.69 ± 0.24 % (mean ± between-subject SD). For HF power, the bias was 0 ± 21 and the pr...
Rejuvenation Research, 2011
Physical activity has a pleiotropic effect and is a significant factor in successful aging. This ... more Physical activity has a pleiotropic effect and is a significant factor in successful aging. This study aims to quantify the relationship between the physical activity of a 65-year-old cohort and the level of life satisfaction and self-rated health 7 years later. A total of 988 questionnaires were sent by mail to a representative sample of healthy pensioners. Life satisfaction and health status were estimated on two visual analogical scales in answer to the following questions: (1) How would you estimate your state of health? and (2) Are you generally satisfied with your life? The level of physical activity was estimated using a questionnaire which enabled us to calculate: (1) Daily energy expenditure (DEE), (2) physical activity energy expenditure (PAEE), (3) daily energy expenditure higher than 5 metabolic equivalents (METs) (DEQisa), (4) Activity index (PAEE/DEE), (5) VO(2) peak. In all, 686 responses were validated. The average age was 72.9 ± 1.2 years old with 59.5% of women (n = 408). Amongst the sample, 98.8% (n = 676) lived in their own homes and 25.2% (n = 172) lived alone. Mean DEE was 10.365 ± 1.964 kJ/24 h, mean PAEE was 4.479 ± 1.170 kJ/24 h, mean activity index was 0.42 ± 0.05, and mean estimated oxygen uptake (VO(2)) peak was 22.5 ± 1.6 mL/min per kg. Activity index and VO(2) peak were the variables most significantly correlated with self-rated health (p = 0.0032 and p = 0.0011, respectively) and life satisfaction (p = 0.0117 and p = 0.0053). Energy spent in activity and VO(2) peak estimated from DEE, measured at the age of 65, appear to be strong predictors of well-being 7 years later.
PLoS ONE, 2012
Competitive swimming as a physical activity results in changes to the activity level of the auton... more Competitive swimming as a physical activity results in changes to the activity level of the autonomic nervous system (ANS). However, the precise relationship between ANS activity, fatigue and sports performance remains contentious. To address this problem and build a model to support a consistent relationship, data were gathered from national and regional swimmers during two 30 consecutive-week training periods. Nocturnal ANS activity was measured weekly and quantified through wavelet transform analysis of the recorded heart rate variability. Performance was then measured through a subsequent morning 400 meters freestyle time-trial. A model was proposed where indices of fatigue were computed using Banister's two antagonistic component model of fatigue and adaptation applied to both the ANS activity and the performance. This demonstrated that a logarithmic relationship existed between performance and ANS activity for each subject. There was a high degree of model fit between the measured and calculated performance (R 2 = 0.8460.14,p,0.01) and the measured and calculated High Frequency (HF) power of the ANS activity (R 2 = 0.7960.07, p,0.01). During the taper periods, improvements in measured performance and measured HF were strongly related. In the model, variations in performance were related to significant reductions in the level of 'Negative Influences' rather than increases in 'Positive Influences'. Furthermore, the delay needed to return to the initial performance level was highly correlated to the delay required to return to the initial HF power level (p,0.01). The delay required to reach peak performance was highly correlated to the delay required to reach the maximal level of HF power (p = 0.02). Building the ANS/performance identity of a subject, including the time to peak HF, may help predict the maximal performance that could be obtained at a given time. Citation: Chalencon S, Busso T, Lacour J-R, Garet M, Pichot V, et al. (2012) A Model for the Training Effects in Swimming Demonstrates a Strong Relationship between Parasympathetic Activity, Performance and Index of Fatigue. PLoS ONE 7(12): e52636.
Pfl�gers Archiv European Journal of Physiology, 2002
Quantification of physical fatigue remains a challenge. We hypothesized that its effects on centr... more Quantification of physical fatigue remains a challenge. We hypothesized that its effects on central autonomic nervous system activity could be explored for such a quantification. To test this relationship, we prospectively measured central autonomic nervous activity through nocturnal heart rate variability (HRV) in six French garbage collectors, aged 32.1€4.3 years, twice a week during 3 consecutive weeks of work, and during the following week of rest. Eight healthy sedentary males formed a control group. HRV indices were calculated by applying standard temporal domain and wavelet transform analyses to standard ECG recordings. During the 3 consecutive weeks of work, there was a significantly progressive decrease in HRV indices, particularly pNN50 (-34.2%, P<0.05), as well as the high (-33.3%, P<0.05) and low (-22.2%, P<0.01) frequency components of wavelet transform, while there was an increase, although non-significant, of the ratio of low to high frequencies (9.1%). During the resting period, there was a significant recovery of HRV indices, notably of its high (50.0%, P<0.05) and low (28.6%, P<0.05) frequency components. No such changes occurred in the control group. A central signature of cumulated physical fatigue can thus be detected and quantified through nocturnal autonomic nervous system activity. Its characteristics are those of a progressive parasympathetic withdrawal.
Pacing and Clinical Electrophysiology, 2005
Medicine & Science in Sports & Exercise, 2004
Variations in autonomic nervous system activity (ANS) and variations in performances have been sh... more Variations in autonomic nervous system activity (ANS) and variations in performances have been shown to be correlated at the group level in swimmers. The aim of the study was to investigate the strength of that relationship at the individual level. Seven regional-level swimmers (four male, age 16.6 +/- 05 yr, 6.4 +/- 0.9 yr of practice) were included in the study. They performed maximal aerobic performance on a 400-m freestyle race before and after a 3-wk intensive training period, and following a 2-wk tapering period. ANS activity was assessed through heart rate variability (HRV) indices measured the night before each race and twice a week along the protocol. All HRV indices were altered, with global and parasympathetic indices decreasing from W1 to W3 in the whole group, while they increased until W5 in five swimmers, and continuously decreased in two. Best performances were respectively realized when global and parasympathetic indices of HRV were highest. Importantly, the relationship between the changes in performances and the changes in HRV indices was strong (DeltaPerf = -1.232 to 1.625.DeltaHF(wavelet), R(2) = 0.5); the greater the rebound in ANS activity after W3, the greater the performance improvement, and reciprocally. Performance is correlated with nocturnal ANS activity at an individual level. The decrease in ANS activity during intensive training is correlated with the loss in performance, and the rebound in ANS activity during tapering tracks with the gain in performance. Interestingly, the speed of the rebound during the tapering period was quite different between swimmers. ANS activity measurement may be useful to design and control individual training periods and to optimize the duration of tapering.
Medicine & Science in Sports & Exercise, 2002
Looking for practical and reliable markers of fatigue is of particular interest in elite sports. ... more Looking for practical and reliable markers of fatigue is of particular interest in elite sports. One possible marker might be the autonomic nervous system activity, known to be well affected by physical exercise and that can be easily assessed by heart rate variability. We designed a laboratory study to follow six sedentary subjects (32.7 +/- 5.0 yr) going successively through 2 months of intensive physical training and 1 month of overload training on cycloergometer followed by 2 wk of recovery. Maximal power output over 5 min (Plim5&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;), VO(2) and standard indices of heart rate variability were monitored all along the protocol. During the intensive training period, physical performance increased significantly VO(2peak) : +20.2%, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01; Plim5&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;: +26.4%, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) as well as most of the indices of heart rate variability (mean RR, Ptot, HF, rMSSD, pNN50, SDNNIDX, SDNN, all &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) with a significant shift in the autonomic nervous system toward a predominance of its parasympathetic arm (LF/HF, LFnu, HFnu, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). During the overload training period, there was a stagnation of the parasympathetic indices associated to a progressive increase in sympathetic activity (LF/HF, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). During the week of recovery, there was a sudden significant rebound of the parasympathetic activity (mean RR, HF, pNN50, rMSSD, all &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). After 7 wk of recovery, all heart rate variability indices tended to return to the prestudy values. Autonomic nervous system status depends on cumulated physical fatigue due to increased training loads. Therefore, heart rate variability analysis appears to be an appropriate tool to monitor the effects of physical training loads on performance and fitness, and could eventually be used to prevent overtraining states.
Medicine & Science in Sports & Exercise, 2004
To assess the validity, reliability, and sensitivity of a new self-administered physical activity... more To assess the validity, reliability, and sensitivity of a new self-administered physical activity questionnaire estimating daily energy expenditure (DEE) in patients with congestive heart failure (CHF). There is a need to develop a low cost, practical, and accurate tool increasing the knowledge of the type and dose of physical activity in patients with CHF for clinical and epidemiological aims. One hundred five participants with stable CHF performed an incremental symptom-limited VO2(peak) test and completed the questionnaire. For DEE calculation, time spent in each activity was multiplied by its energy cost corrected for weight, age, sex, autonomy, and the total was calculated over 24 h. Reproducibility and sensitivity of the questionnaire as well as interrater reliability were tested. Concurrent validity was assessed against VO2(peak), anthropometric characteristics and data from the literature. Test-retest correlation coefficients used to measure reproducibility ranged from 0.82 for activities ranging from 3 to 5 METs to 0.98 for DEE and a paired Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test didn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;t reach statistical significance for any activity score studied. Interrater reliability was high with an error in DEE estimation of 1.37% (t value = -1.064; P = NS). Sensitivity (changes in VO2(peak) concurrent to changes in DEE) was high (r = 0.88, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). DEE was in line with the literature in patients with CHF and relationships between DEE and VO2(peak) (r = 0.71, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), and DEE and anthropometric characteristics (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001) were significant. Activity level above 3 METs was the best intensity criteria related to VO2(peak) (r = 0.62, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and DEE (r = 0.80, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The questionnaire seems reliable, sensitive and valid for the estimation of DEE. VO2(peak) appears related to global DEE and more particularly to activities above 3 METs in patients with CHF.
Medicine & Science in Sports & Exercise, 2005
Purpose: Heart rate variability (HRV) indices are powerful independent prognostic factors of card... more Purpose: Heart rate variability (HRV) indices are powerful independent prognostic factors of cardiovascular events and all cause mortality in patients with chronic heart failure (CHF). This study evaluates the influence of lifestyle on HRV in CHF patients. Methods: Thirty-nine CHF patients (33 men, ischemic/dilated cardiomyopathy (18/21), 52.4 Ϯ 11.2 yr, NYHA I to III, LVEF 33.4 Ϯ 5.1%) filled out a physical activity questionnaire providing an individual complete qualitative and quantitative picture of their physical activity and daily energy expenditure (PAEE/DEE) corrected for age, weight, severity of the condition and autonomy. Frequency and time domain indices of HRV were calculated from ECG Holter recordings on a typical weekday. Nighttime indices were calculated in order to avoid the confounding factor of physical activity that might alter 24-h frequency analysis of HRV. Results: DEE was significantly different between classes I and II and classes I and III (P ϭ 0.01 both) patients. Time spent in activities above 3 METs decreased significantly with the severity of the condition. Global and parasympathetic indices of 24-h HRV analysis were correlated to DEE and PAEE (P tot 24 h ϭ 78.80*PAEE (J ⅐ min Ϫ1 ⅐ kg Ϫ1 ) Ϫ1061.80, R ϭ 0.72, P Ͻ 0.0001). Multiple regression analysis revealed that PAEE was the sole independent factor on established HRV prognostic indices (P Ͻ 0.05) and especially within PAEE dimensions, only activities above 3 METs were correlated with established prognostic HRV indices (P Ͻ 0.05). Conclusion: These results indicate that rather than total DEE, moderate to intensive physical activity may counteract the decline in HRV with chronic heart disease. This may be linked to longer time spent in higher intensity activities, and not to total activity time.
Circulation, Nov 23, 2010
European Respiratory Journal, Sep 1, 2014
Revue de Pneumologie Clinique
Assessment of daily physical activity (DPA) is a major element in the development of respiratory ... more Assessment of daily physical activity (DPA) is a major element in the development of respiratory rehabilitation. The aim of this study was to evaluate the DPA and the daily energy expenditure (DEE) in adult patients with cystic fibrosis. Thirty adult patients (16 women, 14 men, mean age 27.1±8.4 years) with cystic fibrosis (FVC: 69.2±19%, FEV1: 55.1±24%, BMI: 20.5±3.6kg/m(2)), in stable condition were included in the study. The questionnaire allowed DPA to estimate DEE from the intensity and type of activity. This tool divides the DEE into four intensity levels: less than 1 Metabolic Equivalent Task (MET), greater than 1 and less than 3 METs, 3-5 METs, and greater than 5 METs. A shuttle test for estimating VO(2) peak was performed in all patients. The DEE reached 9478.4±3224.3kJ24h(-1) and was significantly and highly correlated with calculated peak VO(2) (l/min) (r=0.876, P=<0.001); 22% DEE was less than 3 METs, 10% between 3 and 5 METs et 2,5% greater than 5 METs; 65% DEE was l...
Clinical Nutrition, 2015
A severe weakness of peripheral muscles occurs in half of the persons aged 80 years or older. The... more A severe weakness of peripheral muscles occurs in half of the persons aged 80 years or older. The common factors between muscle depletion and reduced respiratory strength have not yet been established. In the subjects of the Proof cohort, we aimed to identify, among body composition, pulmonary function and energy expenditure parameters, the predictors of maximal inspiratory pressure (MIP) as an index of respiratory muscle strength and handgrip (HG) as an index of peripheral muscle strength. In 375 healthy elderly subjects aged 72 ± 1 years, fat mass (FM) and fat free mass (FFM) were assessed by DEXA, the last being also indexed to height (FFMI). Spirometry was performed and daily energy expenditure (DEE) was estimated by a questionnaire. After three years, MIP and HG of the dominant arm were determined and the predicting value of pulmonary function tests, body composition and DEE on these parameters was tested. Mean MIP and HG were 77 ± 26% and 106 ± 19% of the predicted value (%pred) with 90 (24%) and 30 (8%) subjects below standards, respectively. There was a significant but weak correlation between MIP%pred and HG%pred (r = 0.175, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Logistic regression showed that low MIP was predicted by trunk FFM and FFMI in women, and DEE in men. Low HG was predicted by trunk FM in men only. The predictors of a reduction of MIP in the elderly differ from those of HG, suggesting a differential regulation of respiratory muscle and arm strength.
International journal of sports medicine, 2002
The objective of this study was to evaluate the variability of maximal heart rate in three differ... more The objective of this study was to evaluate the variability of maximal heart rate in three different conditions: laboratory tests, field tests, and competitions. Sixteen male endurance volunteers were tested in five exhaustive tests for each condition. All exhaustive events were heart rate monitored (Accurex plus, Polar Electro, Finland) and true maximal heart rates were assessed and compared with each other and with predicted maximal heart rates. Results show that under the three conditions HR(peaks) were not statistically different (p = 0.62, NS, Friedman test). Mean HR(peaks) (SD) were: laboratory = 194.3 (7.8), field = 193.8 (11.8), competition = 192.3 (10.1) beats x min(-1). Conditions for reaching individual heart rate peak were in the laboratory (treadmill VO(2)max protocol) for 5 subjects, in field tests for 7 subjects and in competitions for 6 subjects (two circumstances for two subjects). A large intra-individual variation existed in the three circumstances (+/- 6 beats x ...
Revue de Pneumologie Clinique, 2013
Assessment of daily physical activity (DPA) is a major element in the development of respiratory ... more Assessment of daily physical activity (DPA) is a major element in the development of respiratory rehabilitation. The aim of this study was to evaluate the DPA and the daily energy expenditure (DEE) in adult patients with cystic fibrosis. Thirty adult patients (16 women, 14 men, mean age 27.1±8.4 years) with cystic fibrosis (FVC: 69.2±19%, FEV1: 55.1±24%, BMI: 20.5±3.6kg/m(2)), in stable condition were included in the study. The questionnaire allowed DPA to estimate DEE from the intensity and type of activity. This tool divides the DEE into four intensity levels: less than 1 Metabolic Equivalent Task (MET), greater than 1 and less than 3 METs, 3-5 METs, and greater than 5 METs. A shuttle test for estimating VO(2) peak was performed in all patients. The DEE reached 9478.4±3224.3kJ24h(-1) and was significantly and highly correlated with calculated peak VO(2) (l/min) (r=0.876, P=<0.001); 22% DEE was less than 3 METs, 10% between 3 and 5 METs et 2,5% greater than 5 METs; 65% DEE was less than 1 MET. There was a strong correlation between DEE and BMI (r=0.860, P=<0.001), a low correlation with FVC (r=0.423, P=0.02). This questionnaire is relevant for estimating DPA and DEE in patients with cystic fibrosis and is an interesting test to be used to evaluate changes in patients after pulmonary rehabilitation.
Background: Metabolic syndrome is associated with higher C-reactive protein (CRP) serum levels, a... more Background: Metabolic syndrome is associated with higher C-reactive protein (CRP) serum levels, a common biological marker of inflammation. However, the respective contribution of each component of metabolic syndrome to the inflammation has not been established. The aim of the present study was to assess the strength of the association between metabolic syndrome components and CRP in elderly subjects. Methods: This was an observational, cross-sectional study on 921 volunteers (65.6 -0.8 years old) from the PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events) Study. Anthropometric, biological, and clinical parameters were evaluated. Subjects with a CRP value less than 10 mg/L were considered. The relationships between the metabolic syndrome components and CRP tertiles were evaluated using logistic regression analysis. Results: After adjustment for gender and for body mass index, metabolic syndrome and high-CRP tertile were significantly associated [odds ratio (OR) = 2.37, 95% confidence interval (CI) 1.46-3.87, P < 0.001]. Waist circumference demonstrated the strongest association with the high-CRP tertile (OR = 1.75, 95% CI 1.05-2.91, P < 0.05). In addition, CRP levels significantly increased with the number of metabolic syndrome components. Conclusions: Among metabolic syndrome components, waist circumference showed the strongest association with the high-CRP tertile in elderly subjects. These findings help to explain the strong association between waist circumference and cardiovascular morbidity.
The purpose of this study is to measure the impact of an educational program to raise awareness o... more The purpose of this study is to measure the impact of an educational program to raise awareness of the increased spending energy in two different population of patients with breast cancer by using the questionnaire POPAQ (Population Physical Activity Questionnaire). This is a prospective study including two groups of 15 consecutive breast cancer patients (≤ 50 years Group 1 and Group 2 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 50 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 70 years) followed in the department of radiotherapy at the Institute of Cancer of the Loire from January to July 2011. A questionnaire of physical activity assessment was used at two different times before the diagnosis/treatment of breast cancer (t0) and at 6 months (t6) to measure the impact of the awareness method. Comparison of different measures of daily energy expenditure (t0) between groups 1 and 2 was statistically significant (1,1803 and 9434 kJ/24 h, respectively, p = 0.0005). Daily energy expenditure of professional activity was statistically different between the two groups (1437 and 457 kJ/24 h, in groups 1 and 2, respectively; p = 0.003). Between t0 and t6, we observed a significant decrease in total energy consumption in group 1 (1,1803 to 1,0876 kJ/24 h) while there was no significant change between the group 2, except energy expended at rest (basal metabolism). There were differences in daily energy expenditure based on age may influence behavioral patterns deal with energy expenditure in physical activities. Tomorrow&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s challenges are to provide re-entrainment programs tailored to targeted populations.
The purpose is to assess the physical activity of breast cancer patients using a questionnaire, t... more The purpose is to assess the physical activity of breast cancer patients using a questionnaire, the Population Physical Activity Questionnaire (POPAQ) and to compare the data with those from two female populations: one healthy population and one with a previous history of cardiovascular disease. This prospective study included 104 consecutive breast cancer patients who were addressed at the radiation oncology department, Institut de cancérologie de la Loire from March to July 2010. A questionnaire using factorial method was used for assessment of physical activity. In the study population, the rest energetic expenditures of physical energy related to both rest activity and low intensity activity were higher than in the healthy patients (5,292±1,376 versus 5,520±1,248 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 and 2,583±681 versus 2,494±558 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05, respectively). Conversely, the energetic expenditures of physical energy related to both high physical activity and intensive physical activity were lower than in the healthy population (882±441 versus 1,560±868 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 et 210±274 versus 340±621 kJ/24 h, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05, respectively). The POPAQ allows quantifying the daily physical activity and seems feasible in clinical routine in breast cancer patients. In our study, it was found that the physical activity of those patients was significantly different from that of a healthy population. Further investigations are necessary for better defining the true impact of such differences in terms of incidence and prognostic for mammary carcinoma.
European journal of applied physiology, Jan 31, 2014
Our aim was to assess whether we can predict satisfactorily performance in swimming and high freq... more Our aim was to assess whether we can predict satisfactorily performance in swimming and high frequency power (HF power) of heart rate variability from the responses to previous training. We have tested predictions using the model of Banister and the variable dose-response model. Data came from ten swimmers followed during 30 weeks of training with performance and HF power measured each week. The first 15-week training period was used to estimate the parameters of each model for both performance and HF power. Both were then predicted in response to the training done during the second 15-week training period. The bias and precision were estimated from the mean and SD of the difference between prediction and actual value expressed as a percentage of performance or HF power at the first week. With the variable-dose response model, the bias for performance prediction was -0.24 ± 0.06 and the precision 0.69 ± 0.24 % (mean ± between-subject SD). For HF power, the bias was 0 ± 21 and the pr...
Rejuvenation Research, 2011
Physical activity has a pleiotropic effect and is a significant factor in successful aging. This ... more Physical activity has a pleiotropic effect and is a significant factor in successful aging. This study aims to quantify the relationship between the physical activity of a 65-year-old cohort and the level of life satisfaction and self-rated health 7 years later. A total of 988 questionnaires were sent by mail to a representative sample of healthy pensioners. Life satisfaction and health status were estimated on two visual analogical scales in answer to the following questions: (1) How would you estimate your state of health? and (2) Are you generally satisfied with your life? The level of physical activity was estimated using a questionnaire which enabled us to calculate: (1) Daily energy expenditure (DEE), (2) physical activity energy expenditure (PAEE), (3) daily energy expenditure higher than 5 metabolic equivalents (METs) (DEQisa), (4) Activity index (PAEE/DEE), (5) VO(2) peak. In all, 686 responses were validated. The average age was 72.9 ± 1.2 years old with 59.5% of women (n = 408). Amongst the sample, 98.8% (n = 676) lived in their own homes and 25.2% (n = 172) lived alone. Mean DEE was 10.365 ± 1.964 kJ/24 h, mean PAEE was 4.479 ± 1.170 kJ/24 h, mean activity index was 0.42 ± 0.05, and mean estimated oxygen uptake (VO(2)) peak was 22.5 ± 1.6 mL/min per kg. Activity index and VO(2) peak were the variables most significantly correlated with self-rated health (p = 0.0032 and p = 0.0011, respectively) and life satisfaction (p = 0.0117 and p = 0.0053). Energy spent in activity and VO(2) peak estimated from DEE, measured at the age of 65, appear to be strong predictors of well-being 7 years later.
PLoS ONE, 2012
Competitive swimming as a physical activity results in changes to the activity level of the auton... more Competitive swimming as a physical activity results in changes to the activity level of the autonomic nervous system (ANS). However, the precise relationship between ANS activity, fatigue and sports performance remains contentious. To address this problem and build a model to support a consistent relationship, data were gathered from national and regional swimmers during two 30 consecutive-week training periods. Nocturnal ANS activity was measured weekly and quantified through wavelet transform analysis of the recorded heart rate variability. Performance was then measured through a subsequent morning 400 meters freestyle time-trial. A model was proposed where indices of fatigue were computed using Banister's two antagonistic component model of fatigue and adaptation applied to both the ANS activity and the performance. This demonstrated that a logarithmic relationship existed between performance and ANS activity for each subject. There was a high degree of model fit between the measured and calculated performance (R 2 = 0.8460.14,p,0.01) and the measured and calculated High Frequency (HF) power of the ANS activity (R 2 = 0.7960.07, p,0.01). During the taper periods, improvements in measured performance and measured HF were strongly related. In the model, variations in performance were related to significant reductions in the level of 'Negative Influences' rather than increases in 'Positive Influences'. Furthermore, the delay needed to return to the initial performance level was highly correlated to the delay required to return to the initial HF power level (p,0.01). The delay required to reach peak performance was highly correlated to the delay required to reach the maximal level of HF power (p = 0.02). Building the ANS/performance identity of a subject, including the time to peak HF, may help predict the maximal performance that could be obtained at a given time. Citation: Chalencon S, Busso T, Lacour J-R, Garet M, Pichot V, et al. (2012) A Model for the Training Effects in Swimming Demonstrates a Strong Relationship between Parasympathetic Activity, Performance and Index of Fatigue. PLoS ONE 7(12): e52636.
Pfl�gers Archiv European Journal of Physiology, 2002
Quantification of physical fatigue remains a challenge. We hypothesized that its effects on centr... more Quantification of physical fatigue remains a challenge. We hypothesized that its effects on central autonomic nervous system activity could be explored for such a quantification. To test this relationship, we prospectively measured central autonomic nervous activity through nocturnal heart rate variability (HRV) in six French garbage collectors, aged 32.1€4.3 years, twice a week during 3 consecutive weeks of work, and during the following week of rest. Eight healthy sedentary males formed a control group. HRV indices were calculated by applying standard temporal domain and wavelet transform analyses to standard ECG recordings. During the 3 consecutive weeks of work, there was a significantly progressive decrease in HRV indices, particularly pNN50 (-34.2%, P<0.05), as well as the high (-33.3%, P<0.05) and low (-22.2%, P<0.01) frequency components of wavelet transform, while there was an increase, although non-significant, of the ratio of low to high frequencies (9.1%). During the resting period, there was a significant recovery of HRV indices, notably of its high (50.0%, P<0.05) and low (28.6%, P<0.05) frequency components. No such changes occurred in the control group. A central signature of cumulated physical fatigue can thus be detected and quantified through nocturnal autonomic nervous system activity. Its characteristics are those of a progressive parasympathetic withdrawal.
Pacing and Clinical Electrophysiology, 2005
Medicine & Science in Sports & Exercise, 2004
Variations in autonomic nervous system activity (ANS) and variations in performances have been sh... more Variations in autonomic nervous system activity (ANS) and variations in performances have been shown to be correlated at the group level in swimmers. The aim of the study was to investigate the strength of that relationship at the individual level. Seven regional-level swimmers (four male, age 16.6 +/- 05 yr, 6.4 +/- 0.9 yr of practice) were included in the study. They performed maximal aerobic performance on a 400-m freestyle race before and after a 3-wk intensive training period, and following a 2-wk tapering period. ANS activity was assessed through heart rate variability (HRV) indices measured the night before each race and twice a week along the protocol. All HRV indices were altered, with global and parasympathetic indices decreasing from W1 to W3 in the whole group, while they increased until W5 in five swimmers, and continuously decreased in two. Best performances were respectively realized when global and parasympathetic indices of HRV were highest. Importantly, the relationship between the changes in performances and the changes in HRV indices was strong (DeltaPerf = -1.232 to 1.625.DeltaHF(wavelet), R(2) = 0.5); the greater the rebound in ANS activity after W3, the greater the performance improvement, and reciprocally. Performance is correlated with nocturnal ANS activity at an individual level. The decrease in ANS activity during intensive training is correlated with the loss in performance, and the rebound in ANS activity during tapering tracks with the gain in performance. Interestingly, the speed of the rebound during the tapering period was quite different between swimmers. ANS activity measurement may be useful to design and control individual training periods and to optimize the duration of tapering.
Medicine & Science in Sports & Exercise, 2002
Looking for practical and reliable markers of fatigue is of particular interest in elite sports. ... more Looking for practical and reliable markers of fatigue is of particular interest in elite sports. One possible marker might be the autonomic nervous system activity, known to be well affected by physical exercise and that can be easily assessed by heart rate variability. We designed a laboratory study to follow six sedentary subjects (32.7 +/- 5.0 yr) going successively through 2 months of intensive physical training and 1 month of overload training on cycloergometer followed by 2 wk of recovery. Maximal power output over 5 min (Plim5&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;), VO(2) and standard indices of heart rate variability were monitored all along the protocol. During the intensive training period, physical performance increased significantly VO(2peak) : +20.2%, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01; Plim5&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;: +26.4%, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) as well as most of the indices of heart rate variability (mean RR, Ptot, HF, rMSSD, pNN50, SDNNIDX, SDNN, all &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) with a significant shift in the autonomic nervous system toward a predominance of its parasympathetic arm (LF/HF, LFnu, HFnu, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). During the overload training period, there was a stagnation of the parasympathetic indices associated to a progressive increase in sympathetic activity (LF/HF, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). During the week of recovery, there was a sudden significant rebound of the parasympathetic activity (mean RR, HF, pNN50, rMSSD, all &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). After 7 wk of recovery, all heart rate variability indices tended to return to the prestudy values. Autonomic nervous system status depends on cumulated physical fatigue due to increased training loads. Therefore, heart rate variability analysis appears to be an appropriate tool to monitor the effects of physical training loads on performance and fitness, and could eventually be used to prevent overtraining states.
Medicine & Science in Sports & Exercise, 2004
To assess the validity, reliability, and sensitivity of a new self-administered physical activity... more To assess the validity, reliability, and sensitivity of a new self-administered physical activity questionnaire estimating daily energy expenditure (DEE) in patients with congestive heart failure (CHF). There is a need to develop a low cost, practical, and accurate tool increasing the knowledge of the type and dose of physical activity in patients with CHF for clinical and epidemiological aims. One hundred five participants with stable CHF performed an incremental symptom-limited VO2(peak) test and completed the questionnaire. For DEE calculation, time spent in each activity was multiplied by its energy cost corrected for weight, age, sex, autonomy, and the total was calculated over 24 h. Reproducibility and sensitivity of the questionnaire as well as interrater reliability were tested. Concurrent validity was assessed against VO2(peak), anthropometric characteristics and data from the literature. Test-retest correlation coefficients used to measure reproducibility ranged from 0.82 for activities ranging from 3 to 5 METs to 0.98 for DEE and a paired Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test didn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;t reach statistical significance for any activity score studied. Interrater reliability was high with an error in DEE estimation of 1.37% (t value = -1.064; P = NS). Sensitivity (changes in VO2(peak) concurrent to changes in DEE) was high (r = 0.88, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). DEE was in line with the literature in patients with CHF and relationships between DEE and VO2(peak) (r = 0.71, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), and DEE and anthropometric characteristics (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001) were significant. Activity level above 3 METs was the best intensity criteria related to VO2(peak) (r = 0.62, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and DEE (r = 0.80, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The questionnaire seems reliable, sensitive and valid for the estimation of DEE. VO2(peak) appears related to global DEE and more particularly to activities above 3 METs in patients with CHF.
Medicine & Science in Sports & Exercise, 2005
Purpose: Heart rate variability (HRV) indices are powerful independent prognostic factors of card... more Purpose: Heart rate variability (HRV) indices are powerful independent prognostic factors of cardiovascular events and all cause mortality in patients with chronic heart failure (CHF). This study evaluates the influence of lifestyle on HRV in CHF patients. Methods: Thirty-nine CHF patients (33 men, ischemic/dilated cardiomyopathy (18/21), 52.4 Ϯ 11.2 yr, NYHA I to III, LVEF 33.4 Ϯ 5.1%) filled out a physical activity questionnaire providing an individual complete qualitative and quantitative picture of their physical activity and daily energy expenditure (PAEE/DEE) corrected for age, weight, severity of the condition and autonomy. Frequency and time domain indices of HRV were calculated from ECG Holter recordings on a typical weekday. Nighttime indices were calculated in order to avoid the confounding factor of physical activity that might alter 24-h frequency analysis of HRV. Results: DEE was significantly different between classes I and II and classes I and III (P ϭ 0.01 both) patients. Time spent in activities above 3 METs decreased significantly with the severity of the condition. Global and parasympathetic indices of 24-h HRV analysis were correlated to DEE and PAEE (P tot 24 h ϭ 78.80*PAEE (J ⅐ min Ϫ1 ⅐ kg Ϫ1 ) Ϫ1061.80, R ϭ 0.72, P Ͻ 0.0001). Multiple regression analysis revealed that PAEE was the sole independent factor on established HRV prognostic indices (P Ͻ 0.05) and especially within PAEE dimensions, only activities above 3 METs were correlated with established prognostic HRV indices (P Ͻ 0.05). Conclusion: These results indicate that rather than total DEE, moderate to intensive physical activity may counteract the decline in HRV with chronic heart disease. This may be linked to longer time spent in higher intensity activities, and not to total activity time.