Physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease: A cross-sectional analysis

Delgado-Ortiz, Laura; Arbillaga-Etxarri, Ane; Rodríguez-Chiaradia, Diego A.; Gimeno‐Santos, Elena; Barberán-García, Anael; Balcells, Eva; Rodríguez-Roisín, Robert; Garcia‐Aymerich, Judith

doi:10.1016/j.rehab.2021.101501

Cited by 8 publications

(6 citation statements)

References 34 publications

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“…Consistent with previous studies, cardiac AD exists regardless of the severity of COPD [39]. Considering its predictive value for quality of life and mortality [40,41], we suggest that physicians pay attention to exercise tolerance during the clinical management of patients with AD.…”

Section: Discussionsupporting

confidence: 87%

Chronotropic Incompetence and Abnormal Heart Rate Recovery in COPD: Relationship with Pulmonary Vascular Volume and Ventilatory Efficiency

Peng

Qumu

Huang

et al. 2023

Preprint

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Background: Cardiac automatic dysfunction (AD) is an established predictor of long-term mortality in patients with cardiopulmonary disease. It has been closely linked to lung blood perfusion abnormalities in pulmonary hypertension, a phenomenon that has been poorly studied in chronic obstructive pulmonary disease (COPD). This study aimed to 1) characterize computed tomography (CT), spirometry, and cardiopulmonary exercise test (CPET) features of COPD patients with cardiac AD; and 2) estimate the association of AD with CT-derived vascular and CPET-derived ventilatory efficiency metrics. Methods: Patients were randomly recruited and underwent clinical evaluation, spirometry, CPET, and CT. Cardiac AD was determined based on chronotropic incompetence (CI) or delayed heart rate recovery (HRR) during CPET. Results: Among 46 patients included in the study, CI was observed in 59% and delayed HRR was present in 35%. According to multivariate analyses, patients with CI were more likely to have reduced vascular volume (VV; VV < median; odds ratio [5–95% confidence interval], 4.82 [1.17–19.80]) and low ventilatory efficiency (nadir VE/VCO2 > median ; odds ratio [5–95% confidence interval], 6.89 [1.57–30.20]). Similar results were found for delayed HRR (VV < median; odds ratio [5–95% confidence intervals], 13.45 [1.95–92.85], nadir VE/VCO2 > median; odds ratio [5–95% confidence interval], 12.33 [1.56–97.30]). Conclusions: Cardiac AD is associated with increased pulmonary vascular volume and ventilatory efficiency. Findings suggest that lung blood perfusion abnormalities may occur in these patients, a result that requires confirmation via the assessment of a large population-based cohort.

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Section: Discussionsupporting

confidence: 87%

Chronotropic Incompetence and Abnormal Heart Rate Recovery in COPD: Relationship with Pulmonary Vascular Volume and Ventilatory Efficiency

Peng

Qumu

Huang

et al. 2023

Preprint

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Section: Discussionmentioning

confidence: 99%

Abnormal heart rate responses to exercise in non-severe COPD: relationship with pulmonary vascular volume and ventilatory efficiency

Shi,

Qumu,

Wang

et al. 2024

BMC Pulm Med

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Background Despite being a prognostic predictor, cardiac autonomic dysfunction (AD) has not been well investigated in chronic obstructive pulmonary disease (COPD). We aimed to characterise computed tomography (CT), spirometry, and cardiopulmonary exercise test (CPET) features of COPD patients with cardiac AD and the association of AD with CT-derived vascular and CPET-derived ventilatory efficiency metrics. Methods This observational cohort study included stable, non-severe COPD patients. They underwent clinical evaluation, spirometry, CPET, and CT. Cardiac AD was determined based on abnormal heart rate responses to exercise, including chronotropic incompetence (CI) or delayed heart rate recovery (HRR) during CPET. Results We included 49 patients with FEV1 of 1.2–5.0 L (51.1–129.7%), 24 (49%) had CI, and 15 (31%) had delayed HRR. According to multivariate analyses, CI was independently related to reduced vascular volume (VV; VV ≤ median; OR [95% CI], 7.26 [1.56–33.91]) and low ventilatory efficiency (nadir VE/VCO2 ≥ median; OR [95% CI], 10.67 [2.23–51.05]). Similar results were observed for delayed HRR (VV ≤ median; OR [95% CI], 11.46 [2.03–64.89], nadir VE/VCO2 ≥ median; OR [95% CI], 6.36 [1.18–34.42]). Conclusions Cardiac AD is associated with impaired pulmonary vascular volume and ventilatory efficiency. This suggests that lung blood perfusion abnormalities may occur in these patients. Further confirmation is required in a large population-based cohort.

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“…Cardiac AD exists regardless of the severity of COPD and has predictive value for quality of life and mortality; we suggest physicians pay attention to it during clinical management. [34] , [35,36] These patients may not experience su cient symptom relief from typical COPD treatment. Thus, prospective studies should determine whether patients bene t from rehabilitative interventions, such as exercise training, which have been shown to be effective in those with CVDs.…”

Section: Discussionmentioning

confidence: 99%

Abnormal heart rate responses to exercise in non-severe COPD: Relationship with pulmonary vascular volume and ventilatory efficiency

Shi,

Qumu,

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Despite being a prognostic predictor, cardiac autonomic dysfunction (AD) has not been well investigated in chronic obstructive pulmonary disease (COPD). We aimed to characterise computed tomography (CT), spirometry, and cardiopulmonary exercise test (CPET) features of COPD patients with cardiac AD and the association of AD with CT-derived vascular and CPET-derived ventilatory efficiency metrics. Methods This observational cohort study included stable, non-severe COPD patients. They underwent clinical evaluation, spirometry, CPET, and CT. Cardiac AD was determined based on abnormal heart rate responses to exercise, including chronotropic incompetence (CI) or delayed heart rate recovery (HRR) during CPET. Results Out of 49 patients, 24 (49%) had CI, and 15 (31%) had delayed HRR. According to multivariate analyses, CI was independently related to reduced vascular volume (VV; VV ≤ median; OR [5–95% CI], 7.26 [1.56–33.91]) and low ventilatory efficiency (nadir VE/VCO2 ≥ median; OR [5–95% CI], 10.67 [2.23–51.05]). Similar results were observed for delayed HRR (VV ≤ median; OR [5–95% CI], 11.46 [2.03–64.89], nadir VE/VCO2 ≥ median; OR [5–95% CI], 6.36 [1.18–34.42]). Conclusions Cardiac AD is associated with impaired pulmonary vascular volume and ventilatory efficiency. This suggests that lung blood perfusion abnormalities may occur in these patients. Further confirmation is required in a large population-based cohort.

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Physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease: A cross-sectional analysis

Cited by 8 publications

References 34 publications

Chronotropic Incompetence and Abnormal Heart Rate Recovery in COPD: Relationship with Pulmonary Vascular Volume and Ventilatory Efficiency

Chronotropic Incompetence and Abnormal Heart Rate Recovery in COPD: Relationship with Pulmonary Vascular Volume and Ventilatory Efficiency

Abnormal heart rate responses to exercise in non-severe COPD: relationship with pulmonary vascular volume and ventilatory efficiency

Abnormal heart rate responses to exercise in non-severe COPD: Relationship with pulmonary vascular volume and ventilatory efficiency

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