Nelson Francisco Serrão1, Alberto Porta2,3, Vinicius Minatel4, Antônio A M Castro1, Aparecida Maria Catai5, Luciana Maria Malosá Sampaio6, Ross Arena7, Audrey Borghi-Silva8. 1. Physical Therapy Department, Federal University of Pampa, Uruguaiana, Brazil. 2. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. 3. Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. 4. Physical Therapy Department, University Center Tiradentes, Maceió, Brazil. 5. Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, Sao Paulo, Brazil. 6. Sleep Laboratory, Nove de Julho University (UNINOVE), Sao Paulo, Brazil. 7. Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA. 8. Cardiopulmonary Physical Therapy Laboratory (LACAP), Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rodovia, Washington Luís, km 235, Bairro Monjolinho, São Carlos, SP, CEP 13565-905, Brazil. audrey@ufscar.br.
Abstract
PURPOSE: Chronic obstructive pulmonary disease (COPD) negatively impacts autonomic control of the heart rate, as assessed by time and frequency domains of heart rate variability (HRV) analysis. However, it is unknown whether symbolic dynamic analysis may identify cardiac autonomic impairment, and whether such nonlinear indices may be associated with disease severity, prognostic markers, perceived dyspnea and functional capacity in patients with COPD. The current study assessed cardiac autonomic modulation by symbolic analysis of HRV in patients with COPD compared with healthy controls. METHODS: We recruited 54 COPD patients and 20 healthy controls. The interval between two successive R-wave peaks was calculated in the resting supine position. HRV was analyzed using symbolic markers and Shannon entropy (SE). The six-minute walk test (6MWT) was applied in a 30-m corridor. RESULTS: We found a lower 6MWT distance in patients with COPD compared with healthy controls (p < 0.05). We found increased SE and decreased percentage of no variation patterns (0V%) in COPD patients compared with the control group (p = 0.001). Significant correlations were found between the percentage of one variation pattern (1V%) and the Medical Research Council dyspnea scale (r = 0.38, p = 0.01), BODE index (r = 0.38, p = 0.01), forced expiratory volume in the first second (FEV1) [L] (r = -0.44, p = 0.003) and FEV1 [%] (r = -0.35, p = 0.02). It was found that SE was inversely associated with 0V% (r = -0.87, p < 0.0001). CONCLUSION: COPD patients present with depressed sympathetic modulation of HR and higher SE compared with healthy controls. This increased irregularity was inversely associated with 0V%. These results suggested that COPD patients seem to have a cardiac control shifted towards a parasympathetic predominance compared with controls. Symbolic dynamic and complexity index of HRV are related to disease severity, symptoms and functional impairment in these patients.
PURPOSE:Chronic obstructive pulmonary disease (COPD) negatively impacts autonomic control of the heart rate, as assessed by time and frequency domains of heart rate variability (HRV) analysis. However, it is unknown whether symbolic dynamic analysis may identify cardiac autonomic impairment, and whether such nonlinear indices may be associated with disease severity, prognostic markers, perceived dyspnea and functional capacity in patients with COPD. The current study assessed cardiac autonomic modulation by symbolic analysis of HRV in patients with COPD compared with healthy controls. METHODS: We recruited 54 COPDpatients and 20 healthy controls. The interval between two successive R-wave peaks was calculated in the resting supine position. HRV was analyzed using symbolic markers and Shannon entropy (SE). The six-minute walk test (6MWT) was applied in a 30-m corridor. RESULTS: We found a lower 6MWT distance in patients with COPD compared with healthy controls (p < 0.05). We found increased SE and decreased percentage of no variation patterns (0V%) in COPDpatients compared with the control group (p = 0.001). Significant correlations were found between the percentage of one variation pattern (1V%) and the Medical Research Council dyspnea scale (r = 0.38, p = 0.01), BODE index (r = 0.38, p = 0.01), forced expiratory volume in the first second (FEV1) [L] (r = -0.44, p = 0.003) and FEV1 [%] (r = -0.35, p = 0.02). It was found that SE was inversely associated with 0V% (r = -0.87, p < 0.0001). CONCLUSION:COPDpatients present with depressed sympathetic modulation of HR and higher SE compared with healthy controls. This increased irregularity was inversely associated with 0V%. These results suggested that COPDpatients seem to have a cardiac control shifted towards a parasympathetic predominance compared with controls. Symbolic dynamic and complexity index of HRV are related to disease severity, symptoms and functional impairment in these patients.
Authors: Anielle C M Takahashi; Alberto Porta; Ruth C Melo; Robison J Quitério; Ester da Silva; Audrey Borghi-Silva; Eleonora Tobaldini; Nicola Montano; Aparecida M Catai Journal: Intern Emerg Med Date: 2011-01-21 Impact factor: 3.397
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Authors: Lucas Raphael Bento Silva; Paulo Gentil; Camila Simões Seguro; Gabriela Teles de Oliveira; Maria Sebastiana Silva; Antônio Roberto Zamunér; Thomas Beltrame; Ana Cristina Silva Rebelo Journal: Front Endocrinol (Lausanne) Date: 2021-11-09 Impact factor: 5.555