Fractal correlation property of heart rate variability in chronic obstructive pulmonary disease

Carvalho, Tatiana Dias de; Pastre, Carlos Marcelo; Godoy, Moacir Fernandes de; Fereira, Celso; Pitta, Fábio; Abreu, Luíz Carlos de; Ramos, Ercy Mara Cípulo; Valenti, Vítor Engrácia; Vanderlei, Luiz Carlos Marques

doi:10.2147/copd.s15099

Cited by 51 publications

(54 citation statements)

References 32 publications

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“…DFA can detect abnormal regularity in heart rate in patients with severe congestive heart failure [10,28] and differentiate between fluctuations in the plasma glucose of healthy and diabetic patients [29]. However, it is not always obvious whether a high or low a indicates the pathological condition.…”

Section: Discussionmentioning

confidence: 99%

Detrended fluctuation analysis of peak expiratory flow and exacerbation frequency in COPD

Donaldson¹,

Seemungal²,

Hurst³

et al. 2012

Eur Respir J

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We investigated whether exacerbation frequency in chronic obstructive pulmonary disease (COPD) was related to an exponent a which quantifies self-similarity in daily peak expiratory flow (PEF) and is calculated using detrended fluctuation analysis (DFA).We examined data from COPD patients who recorded an increase in respiratory symptoms and post-bronchodilator PEF on daily diary cards. We also investigated PEF data from a double-blind, placebo-controlled trial of the anti-cholinergic agent, tiotropium.In the observational study there were 308 patients with COPD (195 males; mean¡SD age 68.3¡8.4 yrs, forced expiratory volume in 1 s (FEV1) 1.12¡0.46 L, FEV1 % predicted 44.5¡ 16.4%). The mean¡SD a over the first year was 0.944¡0.19 and it was positively related to the frequency of exacerbations per year (p50.009). In the clinical trial, a was lower in COPD patients randomised to tiotropium, mean¡SD 0.87¡0.21 (n548) than on placebo, mean¡SD 0.95¡0.19 (n552; p50.035). Power analysis showed that fewer patients would be required for clinical studies with a as the outcome measure than exacerbation frequency.DFA shows that daily PEF in COPD has long-term correlations which are related to exacerbation frequency. Monitoring of PEF and use of a may result in smaller COPD patient sample sizes in trials.KEYWORDS: Anti-cholinergic agent, chronic obstructive pulmonary disease, detrended fluctuation analysis, exacerbations, peak expiratory flow Thus factors associated with frequent exacerbations are important and several longitudinal studies have shown that within an individual patient exacerbation frequency is similar from one year to the next [3,4,[7][8][9]. A number of therapeutic interventions reduce exacerbations, but clinical trials require a large number of randomised patients to be monitored to capture these relatively infrequent events. Thus, a measure of exacerbation risk that is responsive to therapy would be useful both for clinical purposes and also for testing interventions in COPD.There is growing evidence that signals from complex biological systems can have fluctuations that exhibit long-range correlations [10,11]. In other words, the signal is correlated with itself over a longer time scale [12]. This is referred to as self-similarity [13]. It can be quantified using a technique called detrended fluctuation analysis (DFA) [14,15]. The technique has been applied by FREY and colleagues to peak expiratory flow (PEF) in asthma [16][17][18]. DFA has also been used in the study of respiratory impedance in asthma and COPD [19] and inter-breath intervals [15]. If the exponent a from DFA is equal to 0.5 then successive points in a time series have no relationship to each other. However, if a .0.5 then the time series has long-range correlations and points in the time series are related to previous values. This has been described as the system having a memory which translates as the current situation being dictated by past events. A time series of daily PEF which has a high value of a has a smooth appearance whe...

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Section: Discussionmentioning

confidence: 99%

Detrended fluctuation analysis of peak expiratory flow and exacerbation frequency in COPD

Donaldson¹,

Seemungal²,

Hurst³

et al. 2012

Eur Respir J

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“…To analyse the linear indices in the time and frequency we used HRV analysis software (HRV Kubios v.1.1 for Windows, Biomedical Signal Analysis Group, University of Kuopio, Finland) [14,15].…”

Section: Methodsmentioning

confidence: 99%

Acute Effects of Auditory Stimulation With Heavy Metal Music on Heart Rate Responses

et al. 2016

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The relationship between music and medicine is a fast growing area that in the past has been largely focused on the use of music as an alternative and complementary therapy [1]. Relaxant music has been reported to present positive influence on stress reduction, relaxation, pain management, neural cognition and cardiac function [2,3]. Auditory stimulation with music is known to induce several psychological responses, leading to changes in the autonomic nervous system [4,5].In this context, the heart rate variability (HRV) is a non-invasive method that evaluates the cardiac autonomic control in humans, it is a conventionally accepted term to describe the fluctuations in the intervals between consecutive heart beats (RR intervals), which are related to the influences of the ANS on the sinus node [6].Great part of studies has observed the relaxing effect of classical music. On the other hand, genres such as heavy metal, hip hop and techno music are commonly associated with physiologic excitement [7].Although two recent studies showed reduced HRV during exposure to heavy metal musical auditory stimulation in healthy women [8,9], others found absence of cardiac Aim. Investigate the acute effects of heavy metal musical auditory stimulation on cardiac autonomic regulation. Material and methods. this is a prospective study conducted on 22 healthy women between 18 and 30 years old. All procedures were performed in the same soundproof room. the volunteers remained at rest for 20 minutes and subsequently were exposed to heavy metal (75-84 dB) music for 20 minutes. We analysed the following HRV indices: SdNN, RMSSd, pNN50, LF, HF and LF/HF ratio, RRtri, tINN, Sd1, Sd2 and Sd1/Sd2 ratio. Results. during exposure to heavy metal music auditory stimulation we observed that the LF (ms 2 ) tended to increase (p=0,06) and reduce HF (nu) (p=0,07) and the LF/HF ratio increased (p=0,05). No significant changes were found for SdNN, pNN50, RMSSd, SdNN/RMSSd ratio, tINN, RRtri, Sd1, Sd2 and Sd1/Sd2 ratio. Conclusion. Auditory stimulation with the selected heavy metal musical style acutely decreased HRV. Keywords: cardiovascular system, autonomic nervous system, hearing, music. ACUTE EFFECTS OF AUDITORY STIMULATION WITH HEAVY METAL MUSIC ON HEART RATE RESPONSES

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“…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.…”

Section: Evidence For Autonomic Function In Subjectsmentioning

confidence: 99%

“…1 Patients with COPD have features that encompass several body systems, such as inflammation of the airways, cachexia or obesity, structural and functional changes in respiratory and peripheral muscles, arrhythmias, fatigue, dyspnea, poor quality of life (QOL), reduced exercise capacity, depression, anxiety, and sleep disturbances. [1][2][3][4][5][6][7][8] More recently, COPD has been reported to adversely affect the autonomic nervous system. 2,5,6 Consequently, autonomic function in patients with COPD has received a considerable amount of attention in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…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%

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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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Fractal correlation property of heart rate variability in chronic obstructive pulmonary disease

Cited by 51 publications

References 32 publications

Detrended fluctuation analysis of peak expiratory flow and exacerbation frequency in COPD

Detrended fluctuation analysis of peak expiratory flow and exacerbation frequency in COPD

Acute Effects of Auditory Stimulation With Heavy Metal Music on Heart Rate Responses

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

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