Influence of exercise training on cardiac baroreflex sensitivity in patients with COPD

Costes, Frédéric; Roche, Frédéric; Pichot, Vincent; Vergnon, Jean‐Michel; Garet, Martin; Barthélemy, Jean

doi:10.1183/09031936.04.00040304

Cited by 56 publications

(56 citation statements)

References 32 publications

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“…These range from a reduction in heart rate variability [25][26][27], a reduction in respiratory sinus arrhythmia [27] and a reduction in baroreflex sensitivity [28,29], together with a direct increase in muscle sympathetic nerve activity [30,31]. In the present study, the COPD patients had depressed baroreflex sensitivity, regardless of their history of smoking and of the current therapy.…”

Section: Autonomic Disturbances In Copd Patientsmentioning

confidence: 48%

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Bernardi¹,

Casucci²,

Haider³

et al. 2008

Eur Respir J

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Patients with chronic obstructive pulmonary disease (COPD) may develop hypercapnia and hypoxia, two main determinants of cerebral blood flow. The current authors tested whether cerebrovascular regulation was altered in mild COPD, modified by manoeuvres acutely improving autonomic cardiovascular modulation or influenced by smoking habit.In 15 eucapnic normoxic mild COPD patients (eight smokers) and 28 age-matched controls (14 smokers), midcerebral artery blood flow velocity (MCFV), end-tidal carbon dioxide tension (PET,CO 2 ), arterial oxygen saturation (Sa,O 2 ), ECG and blood pressure at rest were monitored during progressive hypercapnic hyperoxia, isocapnic hypoxia, slow breathing and oxygen administration. MCFV, arterial baroreflex and dynamic MCFV-blood pressure relationships were compared by phase analysis.COPD and control smokers showed higher MCFV (when corrected for PET,CO 2 ), lower cerebrovascular resistance index and lower sensitivity to hypercapnia than nonsmokers, with equal sensitivity to Sa,O 2 and similar phase analysis. Arterial baroreflex was depressed in all COPD patients. Slow breathing and oxygen administration improved baroreflex sensitivity and reduced MCFV in all COPD patients.Patients with mild chronic obstructive pulmonary disease show autonomic dysfunction. Chronic smoking induces cerebral vasodilation and impairs cerebrovascular control. All abnormalities can be partly corrected by improving the cardio-and cerebrovascular autonomic modulation, suggesting that functional autonomic abnormalities are already present at an early stage of disease.

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Section: Autonomic Disturbances In Copd Patientsmentioning

confidence: 48%

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Bernardi¹,

Casucci²,

Haider³

et al. 2008

Eur Respir J

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“…Several other studies also concluded that regular physical activity increases vagal influence on the HR and BRS, while the sympathetic tone may be decreased. 8,[11][12][13]17,19,25,27,32,34 However, Iellamo et al 25 found a reversal of these effects after a period of training at 100% training load. Very intensive training shifted the CV autonomic modulation from PNS toward SNS predominance.…”

Section: Discussionmentioning

confidence: 99%

“…4,8,[10][11][12][13]15,17,18,[19][20][21]25,27,[30][31][32][34][35][36]38,39,45,47 The results of 10 articles on ANS response measured during exercise are shown in Table I. Some authors expressed concern about the measurement of spectral analysis of HRV during exercise, while others reported increases (↑), decreases (↓) and no changes in variability indicators (↔) of sympathetic (SNS) and parasympathetic (PNS) influence.…”

Section: Resultsmentioning

confidence: 99%

Autonomic response to exercise as measured by cardiovascular variability

Grant¹,

Ker²

2008

S. Afr. j. sports med.

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Heart rate variability (HRV), blood pressure variability (BPV) and baroreceptor sensitivity (BRS) are often used as measures of autonomic activity, even though reported results are not always comparable or as expected. It is known that endurance athletes have lower average resting heart rates than non-exercising individuals. 33,50 However, other exercise-induced autonomic influences on cardiac control are far more controversial.Autonomic control via sympathetic and parasympathetic modulation of the heart has been assessed by power spectral analysis of HRV 1,7,33,41,46,48,50 and BPV. 44,52 Different frequency peaks reflect specific physiological stimuli and it is possible to estimate the involvement of the autonomic nervous system (ANS) influence and balance in heart rate (HR) regulation. Method. An Ovid MEDLINE Database search for the period 1950 -March 2008 produced 46 articles for review. The published articles that evaluate the effect of exercise on the autonomic nervous system (ANS) are summarised in three categories: the response of the ANS during a bout of exercise, directly after exercise (recovery measurements), and after a long-term exercise programme. Results.Articles on the effect of training on the ANS as measured by cardiovascular variability indicators show increased variability, decreased variability, and no change in variability. Conclusion.Findings in this review emphasise that standardisation and refinement of these measuring tools are essential to produce results that can be repeated and used as reference. Standardisation is essential as these measurements are increasingly employed in studies regarding investigations of central autonomic regulation, those exploring the link between psychological pro cesses and physiological functioning, and those indicating ANS activity in response to exercise, training and overtraining. This review shows that important aspects are inter-individual differences, duration and intensity of the exercise programme, and choice and specific implementation of variability analysis techniques. CoRREspondEnCE:Mrs C C Grant Section Sports Medicine University of Pretoria Tel: 27 12 3624496 Fax: 27 12 3623369 E-mail: Rina.Grant@up.ac.za and also gives an indication of respiratory sinus arrhythmia (RSA). 1,48During measurement of systolic BPV the LF peak corresponds with sympathetic activity while the HF peak is determined by mechanical effects of respiration on intrathoracic pressure and cardiac filling. 44,52 The variability in blood pressure and identification of the corresponding physiological stimuli are difficult to identify. Indications are that the very low frequencies (≤0.04 Hz) are influenced by vascular tone, endothelium factors and thermoregulation, and the LF peak (0.07 -0.15 Hz) relates to sympathetic activity and represents vasomotor tone.2 BRS reflects mainly vagal modulation of the HR by the arterial baroreceptors and the magnitude of response in heart beat interval to a change in blood pressure (ms/mmHg). 6Physical exercise requires rapid and complex physio...

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“…2,5,6 Consequently, autonomic function in patients with COPD has received a considerable amount of attention in the literature. [2][3][4][5][6][7][9][10][11] The autonomic nervous system controls and regulates the internal physiology of the body and plays a very important role in the pathophysiology of COPD. It consists of 2 branches (sympathetic and parasympathetic), both of which exert antagonistic effects on most bodily functions and also contribute to homeostasis in the body.…”

Section: Introductionmentioning

confidence: 99%

Evidence for Autonomic Function and Its Influencing Factors in Subjects With COPD: A Systematic Review

et al. 2015

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SummaryCardiovascular autonomic neuropathy is one of the factors implicated in the high morbidity and mortality rate in patients with COPD. Thus, several studies and nonsystematic reviews have increasingly reported autonomic function impairment in these subjects. For a better understanding, this systematic review was performed to evaluate not only the evidence for autonomic function impairment, but also factors influencing it. The results of the studies reviewed showed a strong level of evidence to support the impairment of heart rate variability in the time domain. A similar evidence level was also found to support impairment in baroreceptor sensitivity and muscle sympathetic nerve activity. Furthermore, this review identified physical activity level, muscle function, and circadian rhythm as the major influencing factors (strong evidence) of autonomic function in subjects with COPD. However, no definite conclusion could be reached for factors such as dyspnea, anxiety, body composition, pulmonary function, age, breathing frequency, ventilatory effort, quality of life, and disease severity due to limited, conflicting, or lack of existing evidence. The results of this review highlight relevant clinical messages for clinicians and other health-care providers regarding the role autonomic function can play as an important physiological marker for prognostication and stratification. Hence, autonomic function outcomes should be identified and considered during management of patients with COPD. Moreover, this review can serve as basis for future research aimed at assessing the interventions for autonomic function abnormalities in these patients.

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Influence of exercise training on cardiac baroreflex sensitivity in patients with COPD

Cited by 56 publications

References 32 publications

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Autonomic response to exercise as measured by cardiovascular variability

Evidence for Autonomic Function and Its Influencing Factors in Subjects With COPD: A Systematic Review

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