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Relationship between linear and nonlinear dynamics of heart rate and impairment of lung function in copd patients

Abstract

Background: In chronic obstructive pulmonary disease (COPD), functional andstructural impairment of lung function can negatively impact heart rate variability(HRV); however, it is unknown if static lung volumes (SLV) and lung diffusioncapacity (DL) negatively impacts HRV responses. Objective: We investigated whetherthe impairment SLV and DL would be related to HRV indices in moderate-to-severeCOPD patients. Methods: Sixteen sedentary males with COPD were enrolled in thisstudy. Resting blood gases, SLV, DL for carbon monoxide (DLCO) were measured. TheRR interval (RRi) was registered in the supine, standing and seated positions (10 mineach) and during 4 min of a respiratory sinus arrhythmia maneuver (M-RSA). Deltachanges (supine-standing and supine-M-RSA) of standard deviation of the normalRR intervals (SDNN), low frequency (LF, normalized units - nu) and high frequency(HF, nu), SD1, SD2, alpha1, alpha2 and approximate entropy (ApEn) indices werecalculated. Results: HF, LF, SD1, SD2 and alpha1 deltas significantly correlated withforced expiratory volume in 1s (FEV1), DLCO, airway resistance (Raw), residual volume(RV), inspiratory capacity/total lung capacity ratio (IC/TLC) and RV/TLC ratio.Significant and moderate associations between LF/HF ratio vs. total gas volume (TGV,%), r=0.53; LF/HF ratio vs. RV, %, r=0.52; HF vs. TGV, %, r=-0.53 (p<0.05) were alsoobserved. Linear regression analysis revealed that RRi supine-M-RSA wasindependently related to DLCO (r=-0.77, r²=0.43, p value<0.05). Conclusion:Responses of HRV indices were more prominent during M-RSA in moderate-to-severeCOPD. Moreover, greater lung function impairment was related to poorer heart ratedynamics. Finally, impaired lung diffusion capacity is related to an alteredparasympathetic response in these patients. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
MAZZUCO, ADRIANA; MEDEIROS, WLADIMIR MUSETTI; RIZK SPERLING, MILENA PELOSI; DE SOUZA, ALINE SOARES; NOMAN ALENCAR, MARIA CLARA; ARBEX, FLAVIO FERLIN; NEDER, JOSE ALBERTO; ARENA, ROSS; BORGHI-SILVA, AUDREY. Relationship between linear and nonlinear dynamics of heart rate and impairment of lung function in COPD patients. INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, v. 10, p. 1651-1661, . (15/06254-0)

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