Ischemic preconditioning boosts post-exercise but not resting cardiac vagal control in endurance runners

  • Jeann L. Sabino-Carvalho
  • Tiago Obeid-Freitas
  • Marcelle Paula-Ribeiro
  • Thiago R. Lopes
  • Thiago H. N. Ferreira
  • José E. Succi
  • Antônio C. Silva
  • Bruno Moreira SilvaEmail author
Original Article



High cardiac vagal control in endurance athletes has been generally associated with adequate recovery from training and readiness to cope high-intensity training. A method that improves cardiac vagal control in endurance athletes could therefore be advantageous. Accordingly, we sought to test whether ischemic preconditioning (IPC) could enhance cardiac vagal control in endurance runners.


Fifteen subjects underwent IPC, sham ultrasound (SHAM) or control (CT), in random order. Subjects were informed both IPC and SHAM would be beneficial vs. CT (i.e., similar placebo induction), and IPC would be harmless despite ischemia sensations (i.e., nocebo avoidance). Resting cardiac vagal control was assessed via respiratory sinus arrhythmia (RSA) and heart rate variability (HRV) indexes. Post-exercise cardiac vagal control was assessed via heart rate recovery [HR time constant decay (T30) and absolute HR decay (HRR30s)] during 30-s breaks of a discontinuous incremental test. Capillary blood samples were collected for lactate threshold identification.


RSA and HRV were similar among interventions at pre- and post-intervention assessments. Lactate threshold occurred at 85 ± 4% of maximal effort. T30 was similar among interventions, but IPC increased HRR30s at 70% and 75% of maximal effort vs. SHAM and CT (70%: IPC = 31 ± 2 vs. SHAM = 26 ± 3 vs. CT = 26 ± 2 bpm, mean ± SEM, P < 0.01; 75%: IPC = 29 ± 2 vs. SHAM = 25 ± 2 vs. CT = 24 ± 2 bpm, P < 0.01).


IPC did not change resting cardiac vagal control, but boosted fast post-exercise cardiac vagal reactivation at exercise intensities below lactate threshold in endurance runners.


Ischemic preconditioning Parasympathetic nervous system Heart rate Placebo effect Exercise 



Analysis of variance


Resting control


Coefficient of variation


Ratio between the longest R–R interval among all expirations and the shortest R–R interval among all inspirations


Ratio between the mean of the longest R–R interval of each expiration and the mean of the shortest R–R interval of each inspiration


High frequency


Heart rate


Heart rate at the end of a given stage of the discontinuous incremental


Heart rate recovery


Heart rate recovery at 30 s post-exercise


Heart rate recovery at 60 s post-exercise


Heart rate variability


Intra-class correlation coefficient


Ischemic preconditioning


Low frequency


Ratio between low- and high-frequency powers of heart rate variability


Natural logarithm of the RMSSD was divided by the mean R–R interval


Square root of the mean squared differences between consecutive R–R intervals


R–R intervals


Respiratory sinus arrhythmia


Standard error of the mean


Sham ultrasound


Smallest worthwhile change


Total power


Time constant of heart rate decay


Very low frequency

\(\dot {V}{{\text{O}}_{{\text{2max}}}}\)

Maximal oxygen consumption



The time and effort expended by all the volunteer subjects is greatly appreciated.

Author contributions

JLS, TRL and BMS conceived and designed research. JLS, TO, TRL and THNF conducted experiments. JLS, TO, MP and TRL analyzed data. All authors interpreted the results of experiments. JLS and BMS prepared the figures and tables. JLS, BMS drafted the manuscript. All authors edited, revised and approved the manuscript.


J.L.S. and M.P. received scholarship from the Coordination for Improvement of Higher Education Personnel (CAPES). J.L.S., M.P. and T.O. received scholarship from the São Paulo Research Foundation (FAPESP; grants: 2014/15877-8, 2015/22198-2 and 2015/03572-0, respectively). B.M.S received funding from FAPESP (Grant: 2014/25683-6) and CNPq (Grant: 461516/2014-4) to conduct the study.

Compliance with ethical standards

Conflict of interest

None of the authors declares a conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Post-graduate Program in Translational MedicineFederal University of São PauloSão PauloBrazil
  2. 2.Laboratory of Exercise PhysiologyOlympic Center of Training and ResearchSão PauloBrazil
  3. 3.Department of PhysiologyFederal University of São PauloSão PauloBrazil
  4. 4.São Paulo Association for Medicine DevelopmentSão PauloBrazil
  5. 5.Department of SurgeryFederal University of São PauloSão PauloBrazil

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