{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T13:17:12Z","timestamp":1772284632174,"version":"3.50.1"},"reference-count":39,"publisher":"IOP Publishing","issue":"11","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":31,"URL":"https:\/\/publishingsupport.iopscience.iop.org\/iop-standard\/v1"},{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"tdm","delay-in-days":31,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"crossref","award":["304798\/2016-9"],"award-info":[{"award-number":["304798\/2016-9"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"crossref","award":["88881.132129\/2016-01"],"award-info":[{"award-number":["88881.132129\/2016-01"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"crossref","award":["E-26\/110.184\/2013"],"award-info":[{"award-number":["E-26\/110.184\/2013"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Physiol. Meas."],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    : Reduced vagal activity is often present in obese adolescents. Simple and practical strategies for the assessment of isolate parasympathetic outflow in this population are therefore useful.\n                    <jats:italic>Objectives<\/jats:italic>\n                    : To compare the methods derived from heart rate variability (HRV) analysis at rest and 4\u2009s exercise testing (T4S) for the assessment of cardiac parasympathetic modulation in adolescents classified as obese (OB) or with normal weight (NW). Additionally, associations between total and trunk fat versus autonomic modulation determined by the two methods were calculated.\n                    <jats:italic>Approach<\/jats:italic>\n                    : A cross-sectional study was conducted with 50 adolescents (26 OB and 24 NW, 14.7\u2009\u2009\u00b1\u2009\u20091.5 years), comparing autonomic indices provided by HRV and T4S. Body fractioning was determined employing dual-energy x-ray absorptiometry (DXA).\n                    <jats:italic>Main results<\/jats:italic>\n                    : The cardiac vagal index (CVI) obtained from T4S and standard time- and frequency-domain HRV measures were lower in OB versus NW (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009\u2009\u2a7d\u2009\u20090.05). Correlations between CVI and HRV indices of cardiac vagal modulation were as follows: CVI versus RMSSD (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009\u2009=\u2009\u20090.44;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009\u2009=\u2009\u20090.003); CVI versus pNN50 (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009\u2009=\u2009\u20090.32;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009\u2009=\u2009\u20090.04); CVI versus HF (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009\u2009=\u2009\u20090.35;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009\u2009=\u2009\u20090.02). Associations between body fat, android\/gynoid ratio, and percent trunk fat versus CVI were of similar magnitude and direction than versus HRV indices.\n                    <jats:italic>Significance<\/jats:italic>\n                    : The T4S proved to be adequate to detect cardiac parasympathetic impairment in obese adolescents. Moreover, vagal modulation assessed by HRV and T4S inversely correlated with visceral adipose tissue. These findings along with the simplicity and safety of the T4S should encourage its use in the assessment of cardiac parasympathetic modulation in obese pediatric populations.\n                  <\/jats:p>","DOI":"10.1088\/1361-6579\/ab4f1d","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T18:46:11Z","timestamp":1571424371000},"page":"115003","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Four-second dynamic exercise testing (T4S) for the assessment of cardiac vagal modulation in obese adolescents"],"prefix":"10.1088","volume":"40","author":[{"given":"Cristiano Q","family":"Oliveira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo B","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iedda A","family":"Brasil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauro Lopes","family":"Junior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enyo","family":"Mendes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walace D","family":"Monteiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2463-1280","authenticated-orcid":false,"given":"Paulo","family":"Farinatti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"266","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"pmeaab4f1dbib001","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1590\/S0066-782X2004001400007","type":"journal-article","article-title":"Validation of the 4\u2009s exercise test in the orthostatic position","volume":"83","author":"Almeida","year":"2004","journal-title":"Arq. Bras. Cardiol."},{"key":"pmeaab4f1dbib002","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1055\/s-2008-1025815","type":"journal-article","article-title":"Fast \u2018ON\u2019 and \u2018OFF\u2019 heart rate transients at different bicycle exercise levels","volume":"6","author":"Araujo","year":"1985","journal-title":"Int. J. Sports Med."},{"key":"pmeaab4f1dbib003","doi-asserted-by":"publisher","first-page":"366","DOI":"10.5935\/abc.20150026","type":"journal-article","article-title":"4\u2009s exercise test: reference values for ages 18\u201381 years","volume":"104","author":"Araujo","year":"2015","journal-title":"Arq. Bras. Cardiol."},{"key":"pmeaab4f1dbib004","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/BF01824209","type":"journal-article","article-title":"Heart rate responses to deep breathing and 4\u2009s of exercise before and after pharmacological blockade with atropine and propranolol","volume":"2","author":"Araujo","year":"1992","journal-title":"Clin. Auton. Res."},{"key":"pmeaab4f1dbib005","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3389\/fphys.2013.00026","type":"journal-article","article-title":"The LF\/HF ratio does not accurately measure cardiac sympatho-vagal balance","volume":"4","author":"Billman","year":"2013","journal-title":"Frontiers Physiol."},{"key":"pmeaab4f1dbib006","first-page":"795","type":"journal-article","article-title":"Peripheral and abdominal adiposity in childhood obesity","volume":"18","author":"Brambilla","year":"1994","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"pmeaab4f1dbib007","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1093\/pch\/14.3.177","type":"journal-article","article-title":"Childhood obesity and cardiovascular disease","volume":"14","author":"Bridger","year":"2009","journal-title":"Paediatr. Child Health"},{"key":"pmeaab4f1dbib008","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1111\/cob.12206","type":"journal-article","article-title":"Magnetic resonance imaging reveals elevated aortic pulse wave velocity in obese and overweight adolescents","volume":"7","author":"Caterini","year":"2017","journal-title":"Clin. Obes."},{"key":"pmeaab4f1dbib009","doi-asserted-by":"publisher","first-page":"660","DOI":"10.2471\/BLT.07.043497","type":"journal-article","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"de Onis","year":"2007","journal-title":"Bull. World Health Organ."},{"key":"pmeaab4f1dbib010","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1249\/MSS.0000000000000705","type":"journal-article","article-title":"Effects of resistance training on obese adolescents","volume":"47","author":"Dias","year":"2015","journal-title":"Med. Sci. Sports Exerc."},{"key":"pmeaab4f1dbib011","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1123\/pes.2015-0191","type":"journal-article","article-title":"Short-term resistance training attenuates cardiac autonomic dysfunction in obese adolescents","volume":"28","author":"Farinatti","year":"2016","journal-title":"Pediatr. Exerc. Sci."},{"key":"pmeaab4f1dbib012","doi-asserted-by":"publisher","first-page":"356","DOI":"10.3389\/fphys.2016.00356","type":"journal-article","article-title":"Heart rate and respiratory rate influence on heart rate variability repeatability: effects of the correction for the prevailing heart rate","volume":"7","author":"Gasior","year":"2016","journal-title":"Frontiers Physiol."},{"key":"pmeaab4f1dbib013","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1113\/expphysiol.2010.056259","type":"journal-article","article-title":"Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes","volume":"96","author":"Goldstein","year":"2011","journal-title":"Exp. Physiol."},{"key":"pmeaab4f1dbib014","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1038\/oby.2007.619","type":"journal-article","article-title":"Relationships of cardiac autonomic function with metabolic abnormalities in childhood obesity","volume":"15","author":"Kaufman","year":"2007","journal-title":"Obesity"},{"key":"pmeaab4f1dbib015","first-page":"RA1","type":"journal-article","article-title":"Arterial baroreceptors in the management of systemic hypertension","volume":"16","author":"Kougias","year":"2010","journal-title":"Med. Sci. Monit."},{"key":"pmeaab4f1dbib016","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.spen.2013.01.004","type":"journal-article","article-title":"Laboratory evaluation of pediatric autonomic disorders","volume":"20","author":"Kuntz","year":"2013","journal-title":"Semin. Pediatr. Neurol."},{"key":"pmeaab4f1dbib017","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1139\/Y09-041","type":"journal-article","article-title":"Baroreflex sensitivity is reduced in obese normotensive children and adolescents","volume":"87","author":"Lazarova","year":"2009","journal-title":"Can. J. Physiol. Pharmacol."},{"key":"pmeaab4f1dbib018","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1038\/ejcn.2014.26","type":"journal-article","article-title":"Prediction of basal metabolic rate in obese children and adolescents considering pubertal stages and anthropometric characteristics or body composition","volume":"68","author":"Lazzer","year":"2014","journal-title":"Eur. J. Clin. Nutrition"},{"key":"pmeaab4f1dbib019","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/S0167-5273(02)00330-3","type":"journal-article","article-title":"Electrocardiographic criteria for vagotonia-validation with pharmacological parasympathetic blockade in healthy subjects","volume":"87","author":"Lazzoli","year":"2003","journal-title":"Int. J. Cardiol."},{"key":"pmeaab4f1dbib020","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1007\/s11936-014-0342-1","type":"journal-article","article-title":"Childhood obesity and autonomic dysfunction: risk for cardiac morbidity and mortality","volume":"16","author":"Liao","year":"2014","journal-title":"Curr. Treat. Opt. Cardiovasc Med."},{"key":"pmeaab4f1dbib021","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S0022-3476(98)70175-1","type":"journal-article","article-title":"Visceral adipose tissue and cardiovascular risk factors in obese children","volume":"133","author":"Owens","year":"1998","journal-title":"J. Pediatr."},{"key":"pmeaab4f1dbib022","doi-asserted-by":"publisher","first-page":"70","DOI":"10.4103\/2230-8210.126565","type":"journal-article","article-title":"Arterial stiffness in obese children: Role of adiposity and physical activity","volume":"18","author":"Pandit","year":"2014","journal-title":"Indian J. Endocrinol. Metab."},{"key":"pmeaab4f1dbib023","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1038\/oby.2003.76","type":"journal-article","article-title":"Assessment of cardiac autonomic modulation during adolescent obesity","volume":"11","author":"Rabbia","year":"2003","journal-title":"Obes. Res."},{"key":"pmeaab4f1dbib024","doi-asserted-by":"publisher","first-page":"13","DOI":"10.4103\/2230-8210.91176","type":"journal-article","article-title":"Obesity and cardiovascular risk in children and adolescents","volume":"16","author":"Raj","year":"2012","journal-title":"Indian J. Endocrinol. Metab."},{"key":"pmeaab4f1dbib025","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1590\/S1807-59322010000100008","type":"journal-article","article-title":"Lower cardiac vagal tone in non-obese healthy men with unfavorable anthropometric characteristics","volume":"65","author":"Ramos","year":"2010a","journal-title":"Clinics"},{"key":"pmeaab4f1dbib026","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1590\/S0066-782X2010005000078","type":"journal-article","article-title":"Normotensive individuals with exaggerated exercise blood pressure response have increased cardiac vagal tone","volume":"95","author":"Ramos","year":"2010b","journal-title":"Arq. Bras. Cardiol."},{"key":"pmeaab4f1dbib027","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1378\/chest.127.1.318","type":"journal-article","article-title":"Initial and final exercise heart rate transients: influence of gender, aerobic fitness, and clinical status","volume":"127","author":"Ricardo","year":"2005","journal-title":"Chest"},{"key":"pmeaab4f1dbib028","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1081\/CEH-100001197","type":"journal-article","article-title":"Obesity and autonomic function in adolescence","volume":"23","author":"Riva","year":"2001","journal-title":"Clin. Exp. Hypertens."},{"key":"pmeaab4f1dbib029","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/846578","type":"journal-article","article-title":"Importance of android\/gynoid fat ratio in predicting metabolic and cardiovascular disease risk in normal weight as well as overweight and obese children","volume":"2014","author":"Samsell","year":"2014","journal-title":"J. Obes."},{"key":"pmeaab4f1dbib030","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1046\/j.1467-789x.2000.00001.x","type":"journal-article","article-title":"The sympathetic nervous system and obesity: role in aetiology and treatment","volume":"1","author":"Snitker","year":"2000","journal-title":"Obes. Rev."},{"key":"pmeaab4f1dbib031","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1007\/s00246-011-0015-8","type":"journal-article","article-title":"Central fat influences cardiac autonomic function in obese and overweight girls","volume":"32","author":"Soares-Miranda","year":"2011","journal-title":"Pediatr. Cardiol."},{"key":"pmeaab4f1dbib032","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1111\/j.1540-8167.2005.50157.x","type":"journal-article","article-title":"Vagal tone: myths and realities","volume":"16","author":"Stein","year":"2005","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"pmeaab4f1dbib033","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1161\/01.CIR.93.5.1043","type":"journal-article","article-title":"Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology","volume":"93","author":"Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology","year":"1996","journal-title":"Circulation"},{"key":"pmeaab4f1dbib034","first-page":"709","type":"journal-article","article-title":"Cardio-respiratory interaction and autonomic dysfunction in obesity","volume":"59","author":"Tonhajzerova","year":"2008","journal-title":"J. Physiol. Pharmacol."},{"key":"pmeaab4f1dbib035","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1590\/S1807-59322010000800008","type":"journal-article","article-title":"Analysis of cardiac autonomic modulation in obese and eutrophic children","volume":"65","author":"Vanderlei","year":"2010","journal-title":"Clinics"},{"key":"pmeaab4f1dbib036","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1080\/02640414.2015.1064150","type":"journal-article","article-title":"Health markers in obese adolescents improved by a 12-week recreational soccer program: a randomised controlled trial","volume":"34","author":"Vasconcellos","year":"2016","journal-title":"J. Sports Sci."},{"key":"pmeaab4f1dbib037","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1007\/s40279-014-0193-7","type":"journal-article","article-title":"Physical activity in overweight and obese adolescents: systematic review of the effects on physical fitness components and cardiovascular risk factors","volume":"44","author":"Vasconcellos","year":"2014","journal-title":"Sports Med."},{"key":"pmeaab4f1dbib038","doi-asserted-by":"publisher","first-page":"57","DOI":"10.2147\/DMSO.S123935","type":"journal-article","article-title":"Association between obesity and heart rate variability indices: an intuition toward cardiac autonomic alteration\u2014a risk of CVD","volume":"10","author":"Yadav","year":"2017","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"pmeaab4f1dbib039","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1152\/jappl.1991.71.3.1136","type":"journal-article","article-title":"Autonomic control of heart rate during exercise studied by heart rate variability spectral analysis","volume":"71","author":"Yamamoto","year":"1991","journal-title":"J. Appl. Physiol."}],"container-title":["Physiological Measurement"],"original-title":[],"link":[{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d","content-type":"text\/html","content-version":"am","intended-application":"text-mining"},{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d","content-type":"text\/html","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T12:32:59Z","timestamp":1772281979000},"score":1,"resource":{"primary":{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ab4f1d"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,1]]},"references-count":39,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,12,2]]},"published-print":{"date-parts":[[2019,11,1]]}},"URL":"https:\/\/doi.org\/10.1088\/1361-6579\/ab4f1d","relation":{},"ISSN":["0967-3334","1361-6579"],"issn-type":[{"value":"0967-3334","type":"print"},{"value":"1361-6579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,1]]},"assertion":[{"value":"Four-second dynamic exercise testing (T4S) for the assessment of cardiac vagal modulation in obese adolescents","name":"article_title","label":"Article Title"},{"value":"Physiological Measurement","name":"journal_title","label":"Journal Title"},{"value":"paper","name":"article_type","label":"Article Type"},{"value":"\u00a9 2019 Institute of Physics and Engineering in Medicine. All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2019-06-10","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2019-10-18","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2019-12-02","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}