BackgroundAutonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD) may increase the risks of arrhythmia and sudden death. We studied cardiac autonomic function in patients with acute exacerbation of COPD (AECOPD).MethodsPatients with AECOPD were classified into ventricular tachycardia (VT) and non-VT groups according to the presence or absence of VT. The following parameters derived from 24-h Holter monitoring were compared between groups: average heart rate, heart rate deceleration capacity (DC), heart rate acceleration capacity (AC), standard deviation of normal RR intervals (SDNN), standard deviation of average RR interval in 5-min segments (SDANN), root mean square of standard deviations of differences between adjacent normal RR intervals (rMSSD), low-frequency power (LF), high-frequency power (HF) and LF/HF ratio.ResultsSeventy patients were included, 22 in the VT group and 48 in the non-VT group. The groups had similar clinical characteristics (except for more common amiodarone use in the VT group, P < 0.05) and general ECG characteristics. DC, SDNN, SDANN and rMSSD were lower and AC higher in the VT group (P < 0.05). In the VT group, DC was correlated positively with SDNN (r = 0.716), SDANN (r = 0.595), rMSSD (r = 0.571) and HF (r = 0.486), and negatively with LF (r = -0.518) and LF/HF (r = -0.458) (P < 0.05). AC was correlated negatively with SDNN (r = -0.682), SDANN (r = -0.567) and rMSSD (r = -0.548) (P < 0.05).ConclusionsDC decreased and AC increased in patients with AECOPD and VT, reflecting an imbalance in autonomic regulation of the heart that might increase the risk of sudden death.

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Purpose: Chronic obstructive pulmonary disease (COPD) is associated with increased incidence of arrhythmias, which has been attributed to autonomic dysregulation. Detection of autonomic function may facilitate stratification of COPD patients with respect to their risk of development of arrhythmias. Patients and Methods: A total of 151 COPD patients and 45 non-COPD patients were included in this study. Heart rate deceleration runs (DRs) were detected by dynamic electrocardiogram (ECG); DRs successively occurring in 2, 4, or 8 cardiac cycles were denoted as DR 2 , DR 4 , and DR 8 , respectively. Indicators of arrhythmias including isolated premature atrial contractions (PAC), supraventricular tachycardia (SVT), isolated premature ventricular contractions (PVC), and ventricular tachycardia (VT) were recorded. Occurrence of SVT or PAC ≥70/day was considered positive for supraventricular arrhythmias, while positive ventricular arrhythmias category (PVAC) was defined as occurrence of VT or PVC ≥10/hour. Results: Compared with non-COPD individuals, COPD patients were associated with increased number of PAC, PVC, higher incidence of PAC >70/d, SVT, PVAC, and decreased DRs (DR2, DR4, DR8) (P<0.05). In COPD patients, DRs showed a negative correlation with the incidence of PAC, PVC, SVT, and PVAC (P<0.05). In receiver operating characteristic curve analysis, all the DRs were found to be significant predictors of PAC >70/d, SVT, and PVAC. The predictive power of DRs was significantly different from one another with the order ranged as DR4>DR8>DR2 for PAC >70/d, DR8>DR4>DR2 for SVT, and DR8>DR4>DR2 for PVAC. Conclusion: Our study provides evidence of significant autonomic dysregulation in COPD patients. DRs may serve as a marker of the risk of arrhythmias in COPD patients.

Objectives: To explore the characteristics of road traffic accident casualties and time distribution characteristics of road traffic crashes in Guilin. Methods: We analyzed the data of road traffic crashes in 2007-2014 of Guilin to explore the casualty's features of road traffic injuries and time distribution characteristics of road traffic crashes. Results: A total of 3162 road traffic accident casualties were studied. The majority of the study subjects were males (63.23%) who suffered almost twice as females. The casualties' ages ranged from 5 to 78 years with the mean age 33.65 ± 16.76 years. The mortality rate of RTCs was significantly higher in males than in females (61.39 versus 38.61, P < 0.05). RTIs disproportionately affected adult people, with the majority of those fatalities occurred among people aged 15-59 years. The mortality rates of RTCs varied greatly by educational status, more than one-third occurred in people of secondary school. Approximately 40.25% of fatalities of road traffic crashes occurred in daily laborer showed that mortality rate was significantly higher than other occupations (P < 0.05). The distribution of season from road traffic deaths involved Spring (24.72%), Summer (15.56%), Autumn (30.56%), and Winter (29.17%). The proportion of road traffic deaths varied from the lowest 6.02% in 9:00-12:00 to the highest 16.78% in 0:00-3:0; midnight (0:00-3:00) shows a significantly higher proportion of reported road traffic deaths (P < 0.05). The upper limbs and lower limbs were the most common body region injured accounting for 16.57% and 17.84% of cases respectively; the highest fatality rate of head was 20.77% and followed by abdomen of 15.75%. Conclusions: This study showed diverse morbidity and mortality characteristics among the casualties and varied the road traffic accident rate and fatality rate from season and time. Corresponding measures to reduce the occurrence of traffic injuries should be formulated according to different population and time.