{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T20:04:30Z","timestamp":1777320270014,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Endurance exercise is associated with increased life duration and improved life quality. Paradoxically, high exercise intensity is also associated with increased coronary artery calcification (CAC) and a small but significant increased risk of adverse cardiac events during exercise. The mechanisms underlying the development of CAC during prolonged high\u2010intensity endurance exercise are unknown. This study aims to determine if there are differences in cardiovascular haemodynamic measures and heart rate variability (HRV) in individuals with (CAC<jats:sup>+<\/jats:sup>) and without CAC (CAC<jats:sup>\u2212<\/jats:sup>). Hemodynamic measures from 56 healthy, middle\u2010aged (median [interquartile range] 51 [43\u201358] years) individuals (41 men\/15 women) participating in a 91\u00a0km [251.2 [217.2\u2010271.6] min] leisure sport mountain bike race were included in this study. Twenty\u2010five participants (20 men\/5 women) were classified as CAC<jats:sup>+<\/jats:sup> based on coronary computed tomographic assessment. Haemodynamic measures and HRV were quantified at the top of the hardest hill (THH) during the last quarter of the race. At the top of THH, CAC<jats:sup>+<\/jats:sup> individuals had significantly higher systolic blood pressure (SBP) (235 [225\u2013245] mmHg vs. 220 [193\u2013238] mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008), higher diastolic blood pressure (DBP) (105 [95\u2013110] mmHg vs. 95 [85\u2013110] mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.006), higher pulse pressure (130 [125\u2013140] mmHg vs. 123 [110\u2013130] mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.039), higher mean rate pressure product (33,882 [30,872\u201335,053] bpm \u00d7 mmHg vs. 31,028 [27,392\u201333,047] bpm \u00d7 mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.028), and larger increase in DBP from baseline (20 [20\u201330] mmHg vs. 10 [0\u201320] mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), compared with CAC<jats:sup>\u2212<\/jats:sup> individuals. Further, CAC<jats:sup>+<\/jats:sup> participants showed a significant reduction in the low\u2010frequency component of HRV (HRV<jats:sub>LF<\/jats:sub>) (6.3 [2.4\u201311.5] ms<jats:sup>2<\/jats:sup> vs. 12.4 [6.8\u201320.2] ms<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.044). In multivariable analysis, HRV<jats:sub>LF<\/jats:sub> was an independent predictor of the presence of CAC even after adjusting for established risk factors of atherosclerosis: age, sex, body mass index, maximum heart rate, , smoking, resting SBP and resting DBP. CAC<jats:sup>+<\/jats:sup> individuals had significant alterations in haemodynamic measures and HRV<jats:sub>LF<\/jats:sub> following prolonged high\u2010intensity endurance exercise compared with individuals without CAC. HRV<jats:sub>LF<\/jats:sub> was an independent predictor of CAC, suggesting an adverse autonomic response to high\u2010intensity endurance exercise in individuals with CAC.<\/jats:p>","DOI":"10.1113\/ep092201","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T09:40:44Z","timestamp":1735638044000},"page":"454-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Alterations in the autonomic and haemodynamic response to prolonged high\u2010intensity endurance exercise in individuals with coronary artery calcification"],"prefix":"10.1113","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3818-2251","authenticated-orcid":false,"given":"Jakob","family":"Svane","sequence":"first","affiliation":[{"name":"Department of Electrical Engineering and Computer Science University of Stavanger  Stavanger Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Wiktorski","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Computer Science University of Stavanger  Stavanger Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trygve","family":"Eftest\u00f8l","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Computer Science University of Stavanger  Stavanger Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stein","family":"\u00d8rn","sequence":"additional","affiliation":[{"name":"Division of Cardiology Stavanger University Hospital  Stavanger Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.061173"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.6166045"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2014.0104"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/s22155774"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.11.034"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53491-0.00013-4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000001800"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1113\/expphysiol.2010.056259"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1590\/1414-431x2023e12364"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.06.006"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjh.0000222758.54111.e2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2017.1292044"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.13643"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2019.02.044"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000048892.83521.58"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.1996.tb00275.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/10641963.2020.1806292"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13102-022-00411-7"},{"key":"e_1_2_9_20_1","unstructured":"Python Software Foundation. (2020).Python Language Reference version 3.8. Available athttps:\/\/www.python.org"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-010-0098-y"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.12027"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00927.2016"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.17987\/icfj.v6i0.242"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00443-9"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10020291"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.914721"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht508"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2018.01.033"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mex.2023.102381"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.181485"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41592-019-0686-2"},{"issue":"5","key":"e_1_2_9_33_1","first-page":"759","article-title":"Subclinical atherosclerosis and risk factors in relation to autonomic indices in the general population","volume":"41","author":"Zambach C.","year":"2023","journal-title":"Journal of Hypertension"},{"issue":"2","key":"e_1_2_9_34_1","first-page":"254","article-title":"Cardiovagal baroreflex sensitivity, blood pressure and blood pressure variability\u2013the Maastricht study","volume":"41","author":"Zhou T. L.","year":"2023","journal-title":"Journal of Hypertension"}],"container-title":["Experimental Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/EP092201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T02:50:12Z","timestamp":1741747812000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/EP092201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,31]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1113\/EP092201"],"URL":"https:\/\/doi.org\/10.1113\/ep092201","archive":["Portico"],"relation":{},"ISSN":["0958-0670","1469-445X"],"issn-type":[{"value":"0958-0670","type":"print"},{"value":"1469-445X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,31]]},"assertion":[{"value":"2024-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}