Shih-Tsung Cheng1, Yao-Kuang Wu2, Mei-Chen Yang2, Chun-Yao Huang2, Hui-Chuan Huang3, Wen-Hua Chu4, Chou-Chin Lan5. 1. Department of Cardiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan. 2. School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan. 3. Department of Nursing, Cardinal Tien College of Healthcare & Management, Taipei, Taiwan. 4. Department of Respiratory Therapy, Hsiao Chung Cheng Hospital, Taipei, Taiwan. 5. School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan. Electronic address: bluescopy@yahoo.com.tw.
Abstract
OBJECTIVE: Patients with chronic obstructive pulmonary disease (COPD) appear to have impaired cardiac autonomic modulation with depressed heart rate variability (HRV). Pulmonary rehabilitation (PR) is recommended as an integral part of the management. However, the effect of PR on HRV at peak exercise remains unclear. METHODS: Sixty-four patients with COPD participated in a 12-week, 2 sessions-per-week, hospital-based PR program. Baseline and post-PR status were evaluated by spirometry, HRV, health-related quality of life (HRQL, St. George's Respiratory Questionnaire, SGRQ), cardiopulmonary exercise test, respiratory muscle strength, and dyspnea Borg's scale. RESULTS: After PR, there were significant improvements in the time and frequency domains of HRV with increased standard deviation of the normal R-R intervals, difference between adjacent normal R-R intervals within a given time minus one, high-frequency and decreased low-frequency, as well as concurrent improvements in HRQL, exercise capacity, dyspnea score, and respiratory muscle strength (all p < 0.05). CONCLUSIONS: PR results in significant improvements in autonomic function, with concurrent improvements in HRQL and exercise capacity.
OBJECTIVE:Patients with chronic obstructive pulmonary disease (COPD) appear to have impaired cardiac autonomic modulation with depressed heart rate variability (HRV). Pulmonary rehabilitation (PR) is recommended as an integral part of the management. However, the effect of PR on HRV at peak exercise remains unclear. METHODS: Sixty-four patients with COPD participated in a 12-week, 2 sessions-per-week, hospital-based PR program. Baseline and post-PR status were evaluated by spirometry, HRV, health-related quality of life (HRQL, St. George's Respiratory Questionnaire, SGRQ), cardiopulmonary exercise test, respiratory muscle strength, and dyspnea Borg's scale. RESULTS: After PR, there were significant improvements in the time and frequency domains of HRV with increased standard deviation of the normal R-R intervals, difference between adjacent normal R-R intervals within a given time minus one, high-frequency and decreased low-frequency, as well as concurrent improvements in HRQL, exercise capacity, dyspnea score, and respiratory muscle strength (all p < 0.05). CONCLUSIONS: PR results in significant improvements in autonomic function, with concurrent improvements in HRQL and exercise capacity.
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