Complexity analysis of heart rate variability in chronic obstructive pulmonary disease: relationship with severity and symptoms

Serrão, Nelson Francisco; Porta, Alberto; Minatel, Vinícius; Castro, Antônio Adolfo Mattos de; Catai, Aparecida Maria; Sampaio, Luciana Maria Malosá; Arena, Ross; Borghi‐Silva, Audrey

doi:10.1007/s10286-019-00659-z

Cited by 12 publications

(8 citation statements)

References 40 publications

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“…It has been used to evaluate the balance of the sympathetic and parasympathetic nervous systems by analyzing the variation in the beat-to-beat timing of the heart rate using portable electrocardiogram equipment or a Holter machine (11,12). HRV has also been used as a prognostic tool for many diseases such as cardiovascular, respiratory, kidney, and neurological diseases (13)(14)(15)(16)(17). In addition, it can be used to monitor health status and adaptability as well as functionality related health status (5,18).…”

Section: Introductionmentioning

confidence: 99%

Polyunsaturated Fatty Acid EAB-277® Supplementation Improved Heart Rate Variability and Clinical Signs in Tracheal Collapse Dogs

et al. 2022

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Canine tracheal collapse is a progressive disease in small breed dogs resulting from chronic inflammation of the tracheal mucosal lining. Polyunsaturated fatty acid EAB-277® is one of the nutraceuticals that can alleviate inflammation and oxidative stress. Heart rate variability (HRV) is a prognostic tool related to sympathovagal balance and oxidative stress level, which is widely used with cardiorespiratory diseases. However, the effect of EAB-277® on HRV in tracheal collapse dogs has rarely been investigated. In this study, 26 tracheal collapse dogs were divided into two groups. In the control group, the dogs received the standard treatment, whereas the dogs in the EAB-277® group received standard treatment combined with EAB-277®. After being treated for 5 weeks, changes in radiographic findings, blood profiles, serum malondialdehyde, inflammatory markers, and HRV were evaluated. This study found that clinical signs were improved in both groups (p < 0.05). However, serum malondialdehyde (MDA), Interleukin-6 (IL-6), and Tumor necrosis factor-alpha (TNF-α) were decreased only in the EAB-277® group after treatment for five weeks (p < 0.05) and the mean percent change of MDA, IL-6, and TNF-α at week five compared to baseline in the EAB-277® group was greater than in the control group (p < 0.05). Additionally, greater sympathovagal imbalance indicated by decreased standard deviation of all normal R-R intervals (SDNN) and standard deviation of the averaged R-R intervals for all 5-minutes segments (SDANN) was found in the control group at week five compared to baseline (P < 0.05), whereas EAB-277® improved SDNN and SDANN and decreased low frequency/high-frequency component (LF/HF ratio) after being treated for five weeks (P < 0.05). This study demonstrates that EAB-277® improves clinical signs and attenuates HRV impairment by reducing oxidative stress and inflammation in tracheal collapse dogs.

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Section: Introductionmentioning

confidence: 99%

Polyunsaturated Fatty Acid EAB-277® Supplementation Improved Heart Rate Variability and Clinical Signs in Tracheal Collapse Dogs

et al. 2022

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“…As far as heart rate variability analysis is concerned it should be kept in mind that the newer non-linear analyses (symbolic, dynamic and complexity) could be useful in these patients ( Serrão et al, 2020 ).…”

Section: Testing Baroreceptor Function To Obtain a Comprehensive Pict...mentioning

confidence: 99%

Sympathetic and Vagal Nerve Activity in COPD: Pathophysiology, Presumed Determinants and Underappreciated Therapeutic Potential

et al. 2022

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This article explains the comprehensive state of the art assessment of sympathetic (SNA) and vagal nerve activity recordings in humans and highlights the precise mechanisms mediating increased SNA and its corresponding presumed clinical determinants and therapeutic potential in the context of chronic obstructive pulmonary disease (COPD). It is known that patients with COPD exhibit increased muscle sympathetic nerve activity (MSNA), as measured directly using intraneural microelectrodes—the gold standard for evaluation of sympathetic outflow. However, the underlying physiological mechanisms responsible for the sympathoexcitation in COPD and its clinical relevance are less well understood. This may be related to the absence of a systematic approach to measure the increase in sympathetic activity and the lack of a comprehensive approach to assess the underlying mechanisms by which MSNA increases. The nature of sympathoexcitation can be dissected by distinguishing the heart rate increasing properties (heart rate and blood pressure variability) from the vasoconstrictive drive to the peripheral vasculature (measurement of catecholamines and MSNA) (Graphical Abstract Figure 1). Invasive assessment of MSNA to the point of single unit recordings with analysis of single postganglionic sympathetic firing, and hence SNA drive to the peripheral vasculature, is the gold standard for quantification of SNA in humans but is only available in a few centres worldwide because it is costly, time consuming and requires a high level of training. A broad picture of the underlying pathophysiological determinants of the increase in sympathetic outflow in COPD can only be determined if a combination of these tools are used. Various factors potentially determine SNA in COPD (Graphical Abstract Figure 1): Obstructive sleep apnoea (OSA) is highly prevalent in COPD, and leads to repeated bouts of upper airway obstructions with hypoxemia, causing repetitive arousals. This probably produces ongoing sympathoexcitation in the awake state, likely in the “blue bloater” phenotype, resulting in persistent vasoconstriction. Other variables likely describe a subset of COPD patients with increase of sympathetic drive to the heart, clinically likely in the “pink puffer” phenotype. Pharmacological treatment options of increased SNA in COPD could comprise beta blocker therapy. However, as opposed to systolic heart failure a similar beneficial effect of beta blocker therapy in COPD patients has not been shown. The point is made that although MSNA is undoubtedly increased in COPD (probably independently from concomitant cardiovascular disease), studies designed to determine clinical improvements during specific treatment will only be successful if they include adequate patient selection and translational state of the art assessment of SNA. This would ideally include intraneural recordings of MSNA and—as a future perspective—vagal nerve activity all of which should ideally be assessed both in the upright and in the supine position to also determine baroreflex function.

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“…HR variability (HRV) in a cardiac autonomic nervous marker is defined as one of the factors contributing to pathophysiology in COPD. The literature suggests that patients with COPD have el-evated resting HR, reduced baroreflex sensitivity, altered autonomic nervous control involvement, decreased parasympathetic activity, and/or increased sympathetic activity relative to healthy subjects (Huertas and Palange, 2011;Mohammed et al, 2015;Serrao et al, 2020;Tseng et al, 2018), all of which may be linked to morbidity and mortality (Stein et al, 1998). In addition, depression of cardio autonomic control has been reported to have a positive association with the severity stage of COPD (Haider et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Oxidative stress associated with impaired autonomic control and severity of lung function in chronic obstructive pulmonary disease patients

Promsrisuk¹,

Boonla²,

Kongsui³

et al. 2023

J Exerc Rehabil

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Oxidative stress has been suggested to play a role in the pathogenesis of chronic obstructive pulmonary disease (COPD). This study aimed to investigate a link between malondialdehyde (MDA) levels, pulmonary function, and cardiac autonomic control in patients with COPD. Plasma levels of MDA, heart rate variability, and pulmonary function were measured in 50 clinically stable COPD patients and 50 normal male controls. COPD patients exhibited lower means of the standard deviations of all normal to normal (NN) intervals (SDNN), the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD), and high frequency (HF). Nevertheless, they presented greater low frequency (LF) and low frequency/high frequency ratio (LF/HF ratio) in supine and head-up tilt positions than controls (P< 0.001). Moreover, a negative correlation between MDA levels with SDNN (P< 0.001) and a positive correlation with LF (P< 0.01) and LF/HF ratio (P< 0.05) were observed in both positions. In COPD patients, plasma MDA levels were 2.3 times greater than controls (4.33± 2.03 µM vs. 1.89± 0.39 µM, P< 0.001), and they were inversely correlated with forced vital capacity, forced expiratory volume in 1 sec, midexpiratory flow, and peak expiratory flow (P< 0.001). Our findings suggest a potential role for oxidative stress in impaired cardiac autonomic control and clinical relevance of plasma MDA levels as a predictor of severity of COPD in COPD patients.

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Complexity analysis of heart rate variability in chronic obstructive pulmonary disease: relationship with severity and symptoms

Cited by 12 publications

References 40 publications

Polyunsaturated Fatty Acid EAB-277® Supplementation Improved Heart Rate Variability and Clinical Signs in Tracheal Collapse Dogs

Polyunsaturated Fatty Acid EAB-277® Supplementation Improved Heart Rate Variability and Clinical Signs in Tracheal Collapse Dogs

Sympathetic and Vagal Nerve Activity in COPD: Pathophysiology, Presumed Determinants and Underappreciated Therapeutic Potential

Oxidative stress associated with impaired autonomic control and severity of lung function in chronic obstructive pulmonary disease patients

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