Heart Rate Variability and Disease Characteristics in Patients with COPD

Abstract

Heart rate variability (HRV) is reduced in patients with chronic obstructive pulmonary disease (COPD). However, the relationships among HRV and characteristics of COPD are unknown. The aim of this study was to characterize HRV in patients with COPD and to verify the correlation of HRV measured during rest with disease severity and pulmonary, muscular, and functional impairment. Thirty-one patients with COPD (16 male; 66 +/- 8 years; BMI = 24 +/- 6 kg/m(2); FEV(1) = 46 +/- 16% predicted) without severe cardiac dysfunction were included. HRV assessment was performed by the head-up tilt test (HUTT), and the main variables used for analysis were SDNN index, LF/HF ratio, and R-R intervals. Other tests included spirometry, bioelectrical impedance, cardiopulmonary exercise test, 6-minute walk test, respiratory and peripheral muscle force, health-related quality of life and functional status questionnaires, and objective quantification of physical activity level in daily life with the DynaPort and SenseWear armband activity monitors, besides calculation of the BODE index. There was a statistical difference in all variables of HRV between the HUTT positions (lying and standing). There was no correlation of HRV with BODE index or FEV(1). Out of the BODE index, just the BMI was correlated with SDNN and R-R intervals (r = 0.44; p < 0.05 and r = 0.37; p < 0.05, respectively). There was correlation between HRV reduction and a lower level of physical activity in daily life, besides worse health-related quality of life, functional status, and respiratory and peripheral muscle force. Cardiac autonomic function of patients with COPD is not related to disease severity but mainly to the level of physical activity in daily life.

Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD)

“…This would lead to increased end-inspiratory lung volume, which is somewhat independent of tidal volume 4 . Although Camillo et al 33 showed that COPD severity was not significantly related to HRV indices, the limited number of subjects classified as GOLD stage II in the current sample might be considered a limitation of the present study. In addition, the inclusion of a healthy control group (without COPD) may elucidate whether the results shown for the COPD group were effectively caused by the PLB maneuver or whether they were partially affected by the disease itself.…”

Analysis of cardiovascular system responses to forced vital capacity in COPD

“…Additionally, the inclusion of patients whose COPD severity varied widely could be considered another limiting factor, although most of our patients (63%) were classified according to GOLD as stage II and III. Some studies have indicated an association between low FEV1 and a high risk of cardiovascular disease 51,52 , although Camillo et al 53 observed no association between the degree of bronchial obstruction and the values of HRV indices.…”

Implantable Cardiac Devices and the Acute Care Management of Decompensated Heart Failure

“…Other illnesses and comorbidities that manifest with a ramping up of sympathetic tone also present with a decrease in heart rate variability, such as seen in exacerbation of chronic obstructive pulmonary disease [34] or various infectious states [35]. Examination of all parameters captured by the implantable device will give a more complete understanding of the patient's clinical picture.…”