Relationship between linear and nonlinear dynamics of heart rate and impairment of lung function in COPD patients

Abstract

BackgroundIn chronic obstructive pulmonary disease (COPD), functional and structural impairment of lung function can negatively impact heart rate variability (HRV); however, it is unknown if static lung volumes and lung diffusion capacity negatively impacts HRV responses. We investigated whether impairment of static lung volumes and lung diffusion capacity could be related to HRV indices in patients with moderate to severe COPD.MethodsSixteen sedentary males with COPD were enrolled in this study. Resting blood gases, static lung volumes, and lung diffusion capacity for carbon monoxide (DLCO) were measured. The RR interval (RRi) was registered in the supine, standing, and seated positions (10 minutes each) and during 4 minutes of a respiratory sinus arrhythmia maneuver (M-RSA). Delta changes (Δsupine-standing and Δsupine-M-RSA) of the standard deviation of normal RRi, low frequency (LF, normalized units [nu]) and high frequency (HF [nu]), SD1, SD2, alpha1, alpha2, and approximate entropy (ApEn) indices were calculated.ResultsHF, LF, SD1, SD2, and alpha1 deltas significantly correlated with forced expiratory volume in 1 second, DLCO, airway resistance, residual volume, inspiratory capacity/total lung capacity ratio, and residual volume/total lung capacity ratio. Significant and moderate associations were also observed between LF/HF ratio versus total gas volume (%), r=0.53; LF/HF ratio versus residual volume, %, r=0.52; and HF versus total gas volume (%), r=−0.53 (P<0.05). Linear regression analysis revealed that ΔRRi supine-M-RSA was independently related to DLCO (r=−0.77, r2=0.43, P<0.05).ConclusionResponses of HRV indices were more prominent during M-RSA in moderate to severe COPD. Moreover, greater lung function impairment was related to poorer heart rate dynamics. Finally, impaired lung diffusion capacity was related to an altered parasympathetic response in these patients.

Is cardiac autonomic modulation during upper limb isometric contraction and Valsalva maneuver impaired in COPD patients?

“…These findings were previously reported by other authors in different autonomic tests, as postural change, and during dynamic exercise 2,3,12,13. It has been reported that increased cardiac parasympathetic modulation in COPD patients was directly associated with increased airway obstruction 15.…”

Variabilidade Da Frequência Cardíaca Em Diferentes Posições Corporais E Durante Masr Em Amputado Unilateral De Membro Inferior

“…Referente aos achados da mudança ativa de postura para ortostase, estes podem ocorrer devido à provocação do acúmulo de fluxo sanguíneo nos membros . 2019 jan-abr; 12(1): 77-84 -e-ISSN 2176-9206 Doença Pulmonar Obstrutiva Crônica (DPOC) 13,22,23 , Insuficiência Cardíaca Congestiva (ICC) 24 e sujeitos com asma 25 . Pacientes com DPOC, ICC e asma apresentam um incremento da atividade simpática e atenuação parassimpática durante a MARS e esse comportamento pode ser justificado devido às alterações de força muscular respiratória e comprometimento pulmonar, demonstrando maior 'turbulência' na função do SNA em comparação com a manobra ativa postural/simpática 13,[22][23][24][25] .…”

“…2019 jan-abr; 12(1): 77-84 -e-ISSN 2176-9206 Doença Pulmonar Obstrutiva Crônica (DPOC) 13,22,23 , Insuficiência Cardíaca Congestiva (ICC) 24 e sujeitos com asma 25 . Pacientes com DPOC, ICC e asma apresentam um incremento da atividade simpática e atenuação parassimpática durante a MARS e esse comportamento pode ser justificado devido às alterações de força muscular respiratória e comprometimento pulmonar, demonstrando maior 'turbulência' na função do SNA em comparação com a manobra ativa postural/simpática 13,[22][23][24][25] . Curiosamente, ao avaliar o efeito da pressão positiva expiratória das vias aéreas (EPAP) com 5 cmH 2 O sobre os índices de VFC em repouso e durante um teste de caminhada constante em pacientes com DPOC, Goulart et al 26 observaram melhora da modulação cardíaca e complexidade do SNA durante o repouso.…”

Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

“…When performing a symbolic analysis (Figure 2), a difference was found between the two groups: more severely affected patients had significantly lower levels of 0V% (20 ± 16 vs. 31 ± 15, p = 0.01) and higher levels of 2LV% (10 (7-18) vs. 5 (3)(4)(5)(6)(7)(8), p = 0.004).…”

“…A reduction of global HRV has been associated with poor prognosis in several cardiovascular diseases [4]. Although cardiac autonomic modulation seems impaired in pulmonary diseases [5][6][7], the interplay between cardiac autonomic modulation and severity of end-stage pulmonary disorders in patients waiting for LTx has not been studied yet.…”