Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease

Abstract

BACKGROUNDA synchronism exists between the respiratory and cardiac cycles. However, the influence of the inspiratory muscle weakness in chronic obstructive pulmonary disease (COPD) on cardiac autonomic control is unknown. The purpose of the present investigation was to evaluate the influence of respiratory muscle strength on autonomic control in these patients.METHODSTen chronic obstructive pulmonary disease patients (69±9 years; FEV1/FVC 59±12% and FEV1 41±11% predicted) and nine age-matched healthy volunteers (64±5 years) participated in this study. Heart-rate variability (HRV) was obtained at rest and during respiratory sinusal arrhythmia maneuver (RSA-M) by electrocardiograph.RESULTSChronic obstructive pulmonary disease patients demonstrated impaired cardiac autonomic modulation at rest and during RSA-M when compared with healthy subjects (p<0.05). Moreover, significant and positive correlations between maximal inspiratory pressure (MIP) and the inspiratory-expiratory difference (ΔIE) (r = 0.60, p<0.01) were found.CONCLUSIONPatients with chronic obstructive pulmonary disease presented impaired sympathetic-vagal balance at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in chronic obstructive pulmonary disease. Based on this evidence, future research applications of respiratory muscle training may bring to light a potentially valuable target for rehabilitation.

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

“…37 However, 3 studies reported comparable time-domain parameters between subjects with COPD and healthy controls. 36,39,41 The frequency-domain values for heart rate variability showed more variation across the studies. Lower frequencydomain values were reported in some studies for LF, 3 10,34,38,44 and HFnu in subjects with COPD compared with their healthy counterparts.…”

“…Fifteen studies of high methodological quality investigated the differences in heart rate variability values between subjects with COPD and healthy controls. 3,10,13,19,[34][35][36][37][38][39][40][41][42][43][44] Most of these studies reported significantly lower heart rate variability in subjects with COPD. Specifically, the time-domain parameters in most of the studies (12 of 15) showed that subjects with COPD had lower heart rate variability compared with healthy controls.…”

Heart rate variability in patients with chronic heart failure and chronic obstructive pulmonary disease: clinical parallels

“…Reis (2010) исследуя пациентов с ХОБЛ и здоровых добровольцев, нашёл снижение RMSSD (18,3±15,6 мс) и SDNN (32,1±21,2 мс) при пато-логии бронхолёгочной системы в сравнении со здоровыми людьми (RMSSD 43,5±27,9 мс, SDNN 63,8±29,1 мс). В этой же работе при ХОБЛ отме-чено снижение высокочастотных (0,1±0,03 мс 2 ) и низкочастотных (0,9±0,03 мс 2 ) компонентов спек-тра [25].…”

Pesquisas em pneumologia recentemente publicadas em revistas brasileiras

“…Reis et al (54) found that patients with COPD present impaired sympathetic-vagal balance at rest. Those authors also found that autonomic control of HR is associated with inspiratory muscle weakness in COPD.…”