APPLIED SCIENCES

Cardiac Autonomic Function and

High-Intensity Interval Training in
Middle-Age Men
ANTTI M. KIVINIEMI1, MIKKO P. TULPPO1,2, JOONAS J. ESKELINEN3, ANNA M. SAVOLAINEN3,
JUKKA KAPANEN4, ILKKA H. A. HEINONEN3,5, HEIKKI V. HUIKURI6, JARNA C. HANNUKAINEN3,
and KARI K. KALLIOKOSKI3
Department of Exercise and Medical Physiology, Verve Research, Oulu, FINLAND; 2Department of Applied Sciences,
London South Bank University, London, UNITED KINGDOM; 3Turku PET Centre, University of Turku and Turku University
Hospital, Turku, FINLAND; 4Paavo Nurmi Centre, Turku, FINLAND; 5Research Centre of Applied and Preventive
Cardiovascular Medicine, University of Turku, Turku, FINLAND; and 6Institute of Clinical Medicine, University Hospital
and University of Oulu, Oulu, FINLAND

ABSTRACT
KIVINIEMI, A. M., M. P. TULPPO, J. J. ESKELINEN, A. M. SAVOLAINEN, J. KAPANEN, I. H. A. HEINONEN, H. V. HUIKURI,
J. C. HANNUKAINEN, and K. K. KALLIOKOSKI. Cardiac Autonomic Function and High-Intensity Interval Training in MiddleAge Men. Med. Sci. Sports Exerc., Vol. 46, No. 10, pp. 19601967, 2014. Purpose: The effects of short-term high-intensity interval
training (HIT) on cardiac autonomic function are unclear. The present study assessed cardiac autonomic adaptations to short-term HIT
in comparison with aerobic endurance training (AET). Methods: Twenty-six healthy middle-age sedentary men were randomized into
HIT (n = 13, 46  30 s of all-out cycling efforts with 4-min recovery) and AET (n = 13, 4060 min at 60% of peak workload) groups,
performing six sessions within 2 wk. The participants underwent a 24-h ECG recording before and after the intervention and,
additionally, recorded R-R interval data in supine position (5 min) at home every morning during the intervention. Mean HR and lowfrequency (LF) and high-frequency (HF) power of R-R interval oscillation were analyzed from these recordings. Results: Peak
O2peak) increased in both groups (P G 0.001). Compared with AET (n = 11), HIT (n = 13) increased 24-h LF power
oxygen consumption (V
(P = 0.024), tended to increase 24-h HF power (P = 0.068), and increased daytime HF power (P = 0.038). In home-based measurements, supine HF power decreased on the days after HIT (P = 0.006, n = 12) but not AET (P = 0.80, n = 9) session. The acute response
of HF power to HIT session did not change during the intervention. Conclusions: In conclusion, HIT was more effective short-term
strategy to increase R-R interval variability than aerobic training, most probably by inducing larger increases in cardiac vagal activity.
The acute autonomic responses to the single HIT session were not modified by short-term training. Key Words: EXERCISE
TRAINING, HEART RATE VARIABILITY, VAGAL ACTIVITY, AUTONOMIC NERVOUS SYSTEM

at moderate intensity or Q75 min at vigorous intensity

weekly and two to three strength-training exercises per
week (14). In terms of cardiovascular health, some of the
health benefits of this type of aerobic-based exercise
training are manifested as improved cardiovascular autonomic regulation. This is indicated by a substantial increase
in cardiac vagal activity and a decrease in cardiovascular
sympathetic activity (6,25,26,32,43), which have important
antiarrhythmic effects (5,27).
Research for the past decade has documented the beneficial effects of various types of high-intensity interval training
(HIT) on fitness and health. One of its ultimate forms
short-term high-intensity anaerobic training, including 46 
30 s of all-out effortshas improved aerobic fitness within
2 wk, similarly to aerobic exercise training (11,15), and

large body of literature shows the beneficial effects

of exercise training on health outcomes in various
populations (14). Currently, recommendations for
health-enhancing physical activity from the American College of Sports Medicine include Q150 min of aerobic exercise

Address for correspondence: Antti M. Kiviniemi, Ph.D., Verve, Kasarmintie

13, PO Box 404, FI-90101 Oulu, Finland; E-mail: Antti.Kiviniemi@verve.fi.
J.C.H. and K.K.K. contributed equally to this article.
Submitted for publication October 2013.
Accepted for publication February 2014.
0195-9131/14/4610-1960/0
MEDICINE & SCIENCE IN SPORTS & EXERCISE
Copyright 2014 by the American College of Sports Medicine
DOI: 10.1249/MSS.0000000000000307

1960

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METHODS
The present study was a part of a larger study titled The
Effects of Short-Term High-Intensity Interval Training on
Tissue Glucose and Fat Metabolism in Healthy Subjects and
in Patients with Type 2 Diabetes (NCT01344928), which
was conducted at the Turku PET Centre, University of
Turku and Turku University Hospital (Turku, Finland). The

HEART RATE VARIABILITY AND INTERVAL TRAINING

study was performed according to the Declaration of Helsinki,

the protocol was approved by the ethical committee of the
Hospital District of Southwest Finland, Turku, Finland
(decision 95/180/2010 I228), and all the participants gave their
written informed consent.
Subjects. The participants were recruited with newspaper advertisements, through personal contacts, and using
electronic and traditional bulletin boards. The candidates
were interviewed with a standardized scheme to ascertain
their health status. The inclusion criteria were as follows:
male sex, age 4055 yr, body mass index 18.530 kgImj2,
and normal glycemic control verified by an oral glucose
tolerance test (3). The exclusion criteria were blood pressure 9140/90 mm Hg; any chronic disease, medical defect,
or injury interfering with everyday life; a history of eating
disorders; a history of asthma; previous use of anabolic
steroids, additives, or any other substrates; use of tobacco
products during past year; use of narcotics; significant use of
alcohol; any other condition that in the opinion of the investigator could create a hazard to the participants safety,
endanger the study procedures, or interfere with the interpretation of the study results; presence of any ferromagnetic
objects that would make magnetic resonance imaging contraindicated; current or a history of regular and systematic
O2peak)
exercise training; and peak oxygen consumption (V
j1
j1
940 mLIkg Imin to complement the information about
training status. Twenty-eight participants fulfilled these criteria
and were randomized into HIT (n = 14) and AET groups
(n = 14). This sample size was determined to obtain statistical
O2peak (from
power of 980% for the expected change in V
j1
2.8 T 0.6 to 3.0 T 0.6 LImin , alpha G5%, n 9 12) (10). During
the intervention, one participant from the HIT group dropped
out due to training-induced hip pain and one from the AET
group due to personal reasons; thus, 13 participants in both
groups finalized the intervention.
Training interventions. The training interventions consisted of six supervised exercise sessions within 2 wk, performed in controlled laboratory conditions. The progressive
HIT training included 46  30 s of all-out cycling efforts
with 4 min of recovery where the participants were allowed
to remain still or do unloaded cycling (Monark Ergomedic
828E; Monark, Vansbro, Sweden). The initial number of bouts
was 4, and it increased by one after every other session. The
participants were familiarized with the HIT training approximately 1 wk before the intervention (2  30-s bouts). Each
bout started with 5-s acceleration to maximal cadence without any resistance, followed by a sudden increase of the load
(7.5% of whole body weight in kg) and maximal cycling
for 30 s. The AET group did traditional aerobic training that
included cycling exercises (Tunturi E85; Tunturi Fitness,
Almere, The Netherlands) for 4060 min at moderate intensity
(60% of peak workload). The duration of cycling was initially
40 min, and it increased by 10 min after every other session
until 60 min was reached during the second week.
Maximal exercise test. The participants performed a
maximal exercise test on a bicycle ergometer (Ergoline 800s;

Medicine & Science in Sports & Exercised

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1961

APPLIED SCIENCES

resulted in even better outcomes in glucose metabolism than

aerobic endurance training (AET) (4). Therefore, this type
of HIT has become very popular training scheme in practice and research. Although, the autonomic adaptations in
various types of interval training have been investigated extensively, the effectiveness of all-out HIT scheme, introduced
by Burgomaster et al. (11), to improve cardiac autonomic function is unclear. Typically, aerobic exercise training increases
cardiac vagal modulation via functional and structural
adaptations in cardiovascular system, including improved
stroke volume (29). A recent study by MacPherson et al.
(30) suggested that adaptations of fitness in response to
HIT are mainly peripheral, accompanied by no central cardiovascular adaptations, such as maximal cardiac output.
Therefore, limited autonomic adaptations may occur with
HIT. However, different types of interval training (work
recovery ratio: 30:60 s, 10:20 s, or 8:12 s for 2040 min;
work: 120% maximal aerobic work rate or 80%90% of
maximal HR) have been effective to increase cardiac vagal
activity in young healthy participants (21,37). Nevertheless,
although the exercise training with higher metabolic strain
is more effective in improving aerobic fitness, it does not
alter sympathovagal balance toward vagal predominance as
do the training with less metabolic strain (37). Furthermore,
Buchheit et al. (9) reported that, among adolescents, shortterm interval training within aerobic capacity is a more effective training regimen for increasing cardiac vagal activity than
interval training with a larger anaerobic component. However,
these training protocols differ saliently from commonly investigated HIT (46  30 s of all-out efforts). Also, as the
recovery of cardiac autonomic function from a single exercise
session seems to be strongly dependent on training intensity
via amount anaerobic strain of exercise and chemoreflex
(7,3840), it is important to investigate how all-out anaerobic
HIT (200% of maximal aerobic work rate) exercise acutely
perturbs cardiac autonomic function and if this response is
modified by short-term training.
The aim of the present study was to assess adaptation of
cardiac autonomic regulation to short-term HIT intervention
in comparison with moderate-intensity higher-volume aerobic training in healthy sedentary middle-age men. We hypothesized that cardiac autonomic adaptations to HIT intervention
may be larger than those induced by short-term aerobic training
and adaptation to HIT may decrease the acute disturbances in
cardiac autonomic function induced by a single HIT session in
previously untrained individuals.

APPLIED SCIENCES

VIASYS Healthcare, Germany), starting at 50 W and followed

by an increase of 30 W every 2 min until volitional exhaustion.
The participants were asked to abstain from eating and drinking for 2 h before the testing. The test was performed for each
participant before the intervention and 4 d after the last training session at approximately the same time of day at the Paavo
Nurmi Centre (Turku, Finland). Ventilation and gas exchange
(Jaeger Oxycon Pro; VIASYS Healthcare) were measured and
reported as the mean value per minute. The peak respiratory
exchange ratio was Q1.15, and the peak blood lactate concentration, measured from capillary samples obtained immediately and 1 min after exhaustion (YSI 2300 Stat Plus; YSI
Incorporated Life Sciences, Yellow Springs, OH), was
Q8.0 mmolILj1 for all the tests. A peak HR (RS800CX;
Polar Electro Ltd., Kempele, Finland) within 10 beats of the
age-appropriate reference value (220 j age) was true in all
except one participant in the both groups and in both pre- and
posttraining tests. Therefore, the highest 1-min mean value of
O2peak. Peak workoxygen consumption was expressed as V
load (Loadpeak) was calculated as average workload during
the last 2 min of the test (weighted average was used if
the final stage was stopped prior completion) and used as a
measure of maximal performance.
R-R interval recordings. A 24-h ECG was recorded
before the intervention and 3 d after the last exercise with
a digital Holter device with the sampling frequency set to
1 kHz (Medilog AR 12 Plus; Schiller AG, Switzerland).
Strenuous physical activity was prohibited on the day of measurement and the day before and the participants were asked
to keep their daily routines during the recording (e.g., work,
sleep, and meals). R-R intervals were extracted from the
ECG recordings for further analysis. In addition, the participants recorded R-R intervals with an HR monitor at an
accuracy of 1 ms (RS800CX; Polar Electro Ltd.) in a supine
position (5 min) at home every morning during the intervention. These measurements started immediately after awakening
and emptying the urinary bladder. The R-R interval data
were stored in the HR monitor and extracted to a computer
for further analysis. One participant from the AET group
was excluded from all the analyses because of technical
problems in both the 24-h and the home-based recordings.
In addition, one participant in the HIT group and three in the
AET group had insufficient data in the home-based measurements, covering less than two exercises per week. Thus,
the final numbers of participants were 13 and 11 in the 24-h
analyses and 12 and 9 in the home recordings for the HIT
and AET groups, respectively.
HR variability analyses. The R-R interval data were
edited based on visual inspection of the tachogram and ECG
when available (24-h ECG). All ectopic beats and artifacts
were deleted from the data. Mean HR, low-frequency (LF,
0.04G0.15 Hz) and high-frequency (HF, 0.150.40 Hz)
components of HRV, and their ratio (LF/HF) were analyzed
by autoregressive spectral analysis in 1-h segments (42).
The analyses were performed for the whole 24-h R-R interval data set, daytime (9:00 a.m.6:00 p.m.), nighttime

1962

Official Journal of the American College of Sports Medicine

(1:00 a.m.5:00 a.m.) and the final 3-min periods of 5-min

supine resting measurements at home. The values of absolute spectral powers and LF/HF ratio were not normally
distributed and, thus, were transformed into natural logarithm (ln) before the statistical tests. The 24-h recording was
used to assess autonomic adaptations to the training. The
acute effects of exercise were assessed on a weekly basis
(first and second weeks). Daily HRV values were averaged
separately for the preexercise (morning on a training day)
and postexercise (morning after a training day) conditions
in this approach.
Statistical methods. The training adaptations were
assessed by two-way repeated-measures ANOVA with training (pre- vs postintervention) as the within-subject factor
and group (HIT vs AET) as the between-subjects factor. A
two-way ANOVA was also used to test the acute effects of
the exercise session on HRV separately for the study groups
using acute exercise (morning before vs after exercise)
and first versus second week (indicating training adaptations between the first week and the second week) as withinsubject factors. The t-test with Bonferronis correction was
used appropriately as post hoc when significant interaction
was observed. Standardized effects sizes (ES) were also
calculated with following threshold values: e0.2 trivial,
90.2 small, 90.6 moderate, and 91.2 large (22). The data were
analyzed using SPSS software (IBM SPSS Statistics 21; IBM
Corp., Armonk, NY). A P value G 0.05 was considered statistically significant.

RESULTS
O2peak and Loadpeak in the
The intervention increased V
study groups without significant traininggroup interaction
O2peak and Loadpeak
(Table 1). The training responses in V
j1
were 0.14 T 0.15 LImin (ES = 0.93, moderate) and 20 T
16 W (ES = 1.3, large) among the HIT group and 0.09 T
0.17 LIminj1 (ES = 0.53, small) and 14 T 11 W (ES = 1.3,
large) among the AET group, respectively.
Training adaptations in ambulatory 24-h HR variability. In the 24-h recording measured before and after the
intervention, LF power of HRV increased in the HIT group
(ES = 1.1, moderate), but not in the AET (P = 0.024 for the
traininggroup interaction; Fig. 1b). Also, the 24-h HF
power of HRV tended to increase more in HIT (ES = 0.56,
small) than that in AET during the intervention (P = 0.068;
Fig. 1c). No significant training effects or traininggroup
interactions were observed in the mean 24-h HR or LF/HF
ratio. However, the AET group had a significantly higher
mean 24-h HR compared with the HIT group without significant interaction with training (Fig. 1a).
In daytime and nighttime HRV analyses, the training
group interaction was significant only in the daytime HF power
and LF/HF ratio (Table 2). The intervention decreased daytime
LF/HF ratio in the HIT group (ES = 0.67, moderate; P = 0.032)
and tended to increase HF power (ES = 0.56, small; P = 0.067),

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TABLE 1. Characteristics and training adaptations in the high-intensity interval training (HIT) and aerobic endurance training (AET) study groups.
HIT, n = 13
Age, yr
Height, cm
Weight, kg
BMI
Loadpeak, W
Loadpeak, WIkgj1
VO2peak, LIminj1
VO2peak, mLIkgj1Iminj1
HRpeak, bpm
Lapeak, mmolILj1
RERpeak

AET, n = 13

ANOVA Results (P)

Pretraining

Posttraining

Pretraining

Posttraining

Training

Group

TrainingGroup

T
T
T
T
T
T
T
T
T
T
T

81.9 T 9.5
25.4 T 2.8
245 T 32
3.00 T 0.36
2.99 T 0.35
36.7 T 4.5
184 T 12
14.2 T 2.9
1.27 T 0.06

48
179
83.5
26.1
224
2.70
2.82
33.9
183
10.9
1.23

T
T
T
T
T
T
T
T
T
T
T

83.5 T 7.9
26.1 T 1.9
238 T 29
2.86 T 0.41
2.91 T 0.36
35.0 T 4.6
183 T 16
12.7 T 1.6
1.23 T 0.06

0.16
0.16
G0.001
G0.001
0.002
0.001
0.11
G0.001
0.37

0.78
0.61
0.70
0.55
0.73
0.56
0.69
0.45
0.98
0.30
0.14

0.17
0.19
0.28
0.18
0.44
0.26
0.15
0.090
0.78

48
180
82.5
25.6
225
2.74
2.85
34.7
181
11.1
1.26

5
5
9.6
2.7
36
0.34
0.41
3.9
12
2.0
0.06

5
4
8.2
2.0
29
0.43
0.35
4.6
17
2.1
0.06

Values are presented as mean T SD.

BMI, body mass index; Load, workload; VO2, oxygen consumption; La, blood lactate concentration; RER, respiratory exchange ratio; peak, the peak value during the exercise test.

whereas no such changes occurred in the AET group. The

training effect without significant traininggroup interaction was observed in the nighttime LF power (Table 2).
Acute effects of exercise on HR variability in daily
home-based measurements. Acute exercise effect of
HIT session was observed in the supine resting HF power of
HRV, which was lower in the mornings after HIT session than
that in the mornings before HIT session (P = 0.006, ES = 0.64,
moderate; Fig. 2b). In addition, the HF power of HRV was
significantly higher during the second week of the HIT
intervention than the first week (first vs second week: P =
0.007, ES = 0.66, moderate; Fig. 2b), indicating training
adaptations during HIT intervention. However, no acute
exercise first versus second week interaction was observed,
meaning that the acute exercise effects of HIT session on
HF power occurred similarly between the first week and the
second week of intervention. The AET exercise had acute
exercise effect on supine resting HR that was higher in the
mornings after exercise than before (Fig. 2d). No other significant main effects were observed in any other HR and
HRV variable with HIT and AET exercise.

acute autonomic response to HIT exercise was not altered

within a short-term HIT intervention, despite the cardiac
autonomic adaptations observed after the training period
of 2 wk.
Autonomic adaptations to interventions. Short-term
high-intensity anaerobic training for 2 wk increased the
power of LF oscillation in R-R interval during 24-h ambulatory measurement, whereas such change was absent with
AET. This was accompanied with an apparent tendency for
the larger increase in the 24-h HF power and a significant

DISCUSSION

HEART RATE VARIABILITY AND INTERVAL TRAINING

FIGURE 1Effects of short-term high-intensity interval training

(HIT) and aerobic endurance training (AET) on 24-h HR (A) and HR
variability. In the 24-h recording, there was a significant training
group interaction, such that the low-frequency (LF, 0.04G0.15 Hz)
power of HRV increased during the 2-wk HIT, but not during the 2-wk
AET intervention (B). A similar tendency for traininggroup interaction was observed in high-frequency power (HF, 0.150.4 Hz) (C),
whereas no significant main effects were observed in the LF/HF ratio
(D). *P G 0.001 between pre- and postintervention.

Medicine & Science in Sports & Exercised

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1963

APPLIED SCIENCES

The present study documented that HIT, but not AET, for
2 wk increased the power of LF oscillations in the R-R
interval during 24-h ambulatory measurement. HIT also
tended to increase the 24-h HF power and significantly
increased the daytime HF power compared with AET. Furthermore, HIT also increased the supine HF power in the
home-based measurements from the first week to the second
week of intervention. These findings suggest that HIT was
a more effective short-term strategy to increase HRV than
AET, most probably by inducing larger increases in cardiac
vagal activity. In addition, the home-based measurements of
supine HF power of R-R interval oscillation, in the mornings
before and after the exercise, revealed that the acute decrease
in cardiac vagal activity after HIT exercise was observed similarly during the first and the second weeks of intervention.
This suggests that HIT exercise acutely constituted a substantial stress to the autonomic nervous system, and this

TABLE 2. Daytime and nighttime mean HR and HR variability in the high-intensity interval training (HIT) and aerobic endurance training (AET) study groups.
HIT, n = 13
Pretraining
Day, 9:00 a.m.6:00 p.m.
HR, bpm
LF, ln ms2
HF, ln ms2
LF/HF-ratio, ln
Night, 1:00 a.m.5:00 a.m.
HR, bpm
LF, ln ms2
HF, ln ms2
LF/HF ratio, ln

AET, n = 11

Posttraining

Pretraining

ANOVA Results (P)

Posttraining

Training

Group

TrainingGroup

79
7.0
5.2
1.8

T
T
T
T

10
0.6
0.6
0.3

77
7.0
5.4
1.6

T
T
T
T

9
0.5
0.6
0.4*

83
6.6
5.2
1.5

T
T
T
T

9
0.5
0.5
0.4

85
6.6
5.0
1.6

T
T
T
T

9
0.6
0.8
0.3

0.95
0.76
0.70
0.78

0.093
0.15
0.37
0.38

0.31
0.65
0.038
0.010

56
7.3
6.3
1.0

T
T
T
T

5
0.7
0.5
0.6

56
7.6
6.5
1.1

T
T
T
T

5
0.5
0.8
0.7

63
7.2
5.9
1.2

T
T
T
T

7
0.5
0.8
0.8

63
7.2
5.8
1.4

T
T
T
T

5
0.7
0.7
0.6

0.76
0.044
0.65
0.39

0.002
0.24
0.050
0.30

0.87
0.15
0.28
0.87

APPLIED SCIENCES

Values are presented as mean T SD. LF, HF and LF/HF ratio were transformed into natural logarithm (ln).
*P G 0.05 between pre- and postintervention.
LF, low frequency (0.04G0.15 Hz); HF, high frequency (0.150.40 Hz).

increase in daytime HF power of R-R interval oscillation

with HIT than AET. As it is known, the HF power of R-R
interval oscillation is an established marker for cardiac vagal
activity (1,20,36). However, the LF power includes both cardiac sympathetic and vagal effects (36), and a major part of it
is determined by vagal modulation (2) and baroreflex (16,33).
This suggests that the increase in the power of LF oscillations
in the R-R interval is due to the increased vagal and/or baroreflexmediated modulation of sinoatrial node without major changes
in sympathovagal balance, which is supported by the findings of
Rakobowchuk et al. (37) with supramaximal interval training
with high metabolic strain. Also, the home-based measurements of HRV showed an evident increase in the resting HF
power (but not in LF power) from the first week to the second
week of intervention in the HIT group. The LF/HF ratio, an
estimatealthough controversialof sympathovagal balance
(13,31), did not reveal any significant training effects when
analyzed during whole 24-h recording. However, daytime LF/HF
ratio decreased in the HIT group. Taken together, the present
observations are most likely explained by larger increase in
vagal or baroreflex-mediated modulation of sinoatrial node
with HIT compared with AET. Both the LF and the HF power
of R-R interval oscillations are significant predictors of cardiac morbidities cardiac patients (27). Therefore, HIT might
be efficient short-term strategy to improve cardiac autonomic
function and have important antiarrhythmic effect (18).
It is important to note that despite significant improvement in aerobic fitness, the present aerobic training regimen
did not induce as evident changes in cardiac autonomic regulation as HIT. Several previous studies have documented increased cardiac vagal activity after aerobic training (6,25,26,43),
the findings during short-term aerobic training (2 wk), however,
being inconsistent (19,28). In addition to the length of the
training intervention, a larger training volume may be needed
to increase cardiac vagal activity, for example, the present three
times per week for 2 wk versus four to six times per week for
28 wk (6,25,26,28,43). Nonetheless, HIT seems to be an
effective strategy for inducing cardiac autonomic adaptations even in short-term training.
It is noteworthy that differences in training responses of
circadian HRV between HIT and AET occurred specifically
in the daytime but not nighttime analyses. Longer-term

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Official Journal of the American College of Sports Medicine

aerobic training has consistent increased both daytime and

nighttime HRV (43). Larger increase in the HF power of
R-R interval oscillation and larger decrease in LF/HF ratio
in the HIT compared with the AET group indicate larger
increase in daytime cardiac vagal activity. Although both
analyses are similarly reproducible (41), it seems that HIT
induces positive adaptations that manifest as lesser vagal
withdrawal during daily routines. Whether this is related to
autonomic adaptations per se or lesser physiological strain
of daily routines because of improved aerobic fitness remains to be established.
The detailed mechanisms for the current observation
cannot be confirmed by the present data, but increased blood
volume may be the fastest contributor to training-induced
increase in cardiac vagal modulation at rest (8), presumably
via baroreflex activation, which is an important determinant
of LF oscillations in the R-R interval (16,33). However, it
has been established that improved aerobic capacity with
HIT is mainly due to the improved muscle oxidative capacity rather than changes in cardiac function and blood
volume (23,30), and that is why the exact mechanisms for
the present findings remains to be established by the future
studies.
Acute autonomic responses to the exercise sessions over the interventions. Unlike aerobic endurance
exercise with moderate intensity, HIT exercise acutely decreased cardiac vagal activity, as documented by the decreased supine HF power of R-R interval oscillations in the
home-based measurements on the days after training sessions (Fig. 2). This underscores the well-documented importance of exercise intensity, that is, metabolic strain, in the
autonomic recovery from acute physical exercise (7,38 40).
Importantly, the acute decrease in cardiac vagal activity by
HIT exercise was not modified by training, meaning that the
acute decrease in HF power of R-R interval oscillations was
observed similarly between the first week and the second
week of intervention. Presumably, this lack of adaptations
in autonomic recovery from HIT exercise may have been
masked by the increased number of all-out bouts during HIT
exercise between the first week and the second week and the
increased power output in the HIT bouts (e.g., ~10% in the
third and fourth bouts) during the training. It has been

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clearly shown that better aerobic fitness enables faster recovery from aerobic exercise (39), but our results suggest
that similar adaptation to all-out exercise is not observed, at
least in short term. Longer training period and larger improvement in aerobic fitness might be needed to improve the
autonomic recovery from the acute HIT exercise. Buchheit
et al. (9) have reported that interval training, although within
the aerobic capacity, improves rapid cardiac vagal reactivation immediately after exercise. This type of adaptation

HEART RATE VARIABILITY AND INTERVAL TRAINING

CONCLUSIONS
High-intensity interval training (46  30 s of all-out
cycling efforts) was more effective in increasing cardiac
vagal activity than aerobic training in short-term. Despite
these adaptations in cardiac autonomic function, the acute
decrease in cardiac vagal activity after single HIT exercise
was observed similarly during the first and second weeks
of intervention. Therefore, a short-term HIT intervention did
not decrease the acute autonomic disturbances induced by an
HIT exercise.
The authors want to thank the personnel of the Turku PET Centre
for their excellent assistance.
This study was conducted within the Centre of Excellence in
Molecular Imaging in Cardiovascular and Metabolic Research
supported by the Academy of Finland, the University of Turku, Turku
University Hospital, and Abo Akademi University.

Medicine & Science in Sports & Exercised

Copyright 2014 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.

1965

APPLIED SCIENCES

FIGURE 2Acute effects of short-term high-intensity interval training

(HIT, n = 12) and aerobic exercises (n = 9) on supine HR (A, D), highfrequency (HF, 0.150.4 Hz) (B, E), and low-frequency power of R-R
interval oscillation (LF, 0.04G0.15 Hz) (C, F), measured in the mornings before and after exercise sessions. HIT session did not have an
acute exercise effect on mean HR (A), but it decreased HF power (B).
This decrease in HF power was observed similarly during the first week
and the second week, although the average HF power during the second
week was higher than during the first week of intervention. Acute
aerobic exercise did not induce such changes in HF power, but it increased the mean resting HR (D). *P G 0.05 between the first week and
the second week.

may have also occurred in the present study, but we aimed

to focus on autonomic recovery on the day after exercise as
this approach has been proven to provide a potent tool for
periodization of high-intensity training sessions (24,25,35).
In terms of cardiac autonomic regulation, our findings suggest that moderate-intensity aerobic exercises could be repeated daily, but more than 1 d is needed to fully recover from
heavy HIT exercise.
Limitations. Measurements performed at home may not
be as highly standardized as those performed in laboratory
conditions. For instance, HRV obtained during paced and
spontaneous breathing has provided divergent results on
cardiac autonomic responses to short-term aerobic training
(28). However, this was the most convenient method, without a white-coat effect (17), for the participants to obtain
real-life information on cardiac autonomic function, having
direct implications in practice (24,25). The 24-h ambulatory
recording and home-based measurements did not provide
fully consistent results on HRV responses to training interventions. One potential reason may be the better reproducibility of 24-h recording compared with short-term
recordings (12). Averaging of home-based measurements
for 3 d may have diminished (34) but not completely abolished
the problem related to larger day-to-day variation in shortterm HRV. The present study is also limited by its relatively small sample size because HRV analyses could not
be performed for the all participants due to the technical
problems. The aerobic training intervention did not fully
meet the guidelines for health-enhancing physical activity
based on recommendations from the American College of
Sports Medicine, especially in terms of frequency of aerobic training. In this regard, the study was however purposefully designed in a way that both training groups had equal
numbers of exercise sessions (although AET had a larger total
volume). This enabled the present evaluation of autonomic
responses to acute exercises, which would not have been possible with a higher frequency of aerobic exercises.

The study was financially supported by the Ministry of Education

of the State of Finland, the Academy of Finland (grant nos. 251399
and 256470), and Centre of Excellence funding, the European Foundation for the Study of Diabetes, the Hospital District of Southwest
Finland, Orion Foundation, the Finnish Diabetes Foundation, and

the Finnish Technology Development Centre (Tekes, Helsinki,

Finland).
The authors declare no conflict of interest.
The results of the present study do not constitute endorsement
by the American College of Sports Medicine.

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HEART RATE VARIABILITY AND INTERVAL TRAINING

Medicine & Science in Sports & Exercised

Copyright 2014 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.

1967