Control of heart rate during exercise in health and disease

The authors present a review of their contributions over the last decade to the study of the autonomic control of heart rate during dynamic exercise under physiological and pathological conditions. These studies included the development of new methods for the evaluation of autonomic control of heart rate during dynamic exercise in man. Pharmacological blockade of sympathetic (propranolol) and parasympathetic (atropine) efferent nerves was used to demonstrate differences in time constants and power-dependent relative participation of each division of the autonomic nervous system, as predominant mechanisms responsible for the tachycardia occurring during dynamic exercise. These findings have permitted the use of properly standardized dynamic exercise (discontinuous protocol: step powers, seated position on a bicycle ergometer, 4-min duration), as a simple and noninvasive test for the evaluation of autonomic control of the sinus node. This test has proved to be useful for detecting physiological autonomic adaptations induced by aerobic training, as well as dysfunctions occurring in pathologic conditions such as Chagas' disease and hyperthyroidism.