Acute effects of expiratory positive pressure on autonomic cardiac modulation during spontaneous and stow deep breathing in COPD patients

Author(s)

Silva, Andrea L. G. ^[1] ; Goulart, Cassia L. ^[1] ; Mansour, Kamila M. K. ^[2] ; Back, Guilherme D. ^[1] ; Cabiddu, Ramona ^[3] ; Trimer, Renata ^[1] ; Borghi-Silva, Audrey ^[3]

Affiliation

^[1] Univ Santa Cruz do Sul, Dept Ciencias Saude, Av Independencia 2293, Campus Univ, BR-96815900 Santa Cruz Do Sul, RS - Brazil

^[2] Hosp Santa Cruz, Programa Residencia Multiprofiss Saude Fisioterap, Rua Fernando Abott 174, BR-96810072 Santa Cruz Do Sul, RS - Brazil

^[3] Univ Fed Sao Carlos, Dept Fisioterapia, Rodovia Washington Luis, Km 235, BR-13565905 Sao Carlos, SP - Brazil

• Document type: Journal article
• Source: Anais da Academia Brasileira de Ciências; v. 92, n. 2 2020.
• Web of Science Citations: 0

Abstract

Aim: to evaluate the acute effects of expiratory positive airway pressure on cardiac autonomic modulation in chronic obstructive pulmonary disease patients during spontaneous breathing and slow deep breathing. Methods: 17 patients were evaluated. The R-R intervals were collected (Polar (R) S810i) during spontaneous breathing (10 minutes) and slow deep breathing (4 minutes), with and without 5 cmH(2)O expiratory positive airway pressure. Stable signals were analyzed by Kubios (R). Heart rate variability indices were computed in time domain and in frequency domain. Results: Expiratory positive airway pressure application affected low frequency (spontaneous breathing: 62.5 +/- 4.1 vs slow deep breathing: 28.2 +/- 4.2, p<0.001) and high frequency (spontaneous breathing: 37.4 +/- 17.3 vs slow deep breathing: 58.9 +/- 18.1, p<0.001). Interactions were observed between expiratory positive airway pressure effect and slow deep breathing effect for low frequency (p<0.001), high frequency (p<0.001) and low frequency/high frequency ratio (p<0.001). When patients were stratified by disease's severity, we identified a significant low frequency reduction (p<0.001) and high frequency increase (p<0.001) for all stages when slow deep breathing was associated with expiratory positive airway pressure. Conclusion: A 5 cmH(2)O expiratory positive airway pressure during spontaneous and slow deep breathing can elicit an acute response, resulting in a cardiac autonomic control improvement in moderate-to-very severe patients. (AU)

• FAPESP's process: 13/23013-0 - Heart rate variability and cardiorespiratory coupling in the coexistence of chronic obstructive pulmonary disease associated with obstructive sleep apnea
• Grantee: Renata Trimer
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 15/04101-1 - Clinical, functional and systemic effects of whole-body electrical stimulation after bariatric surgery
• Grantee: Audrey Borghi Silva
• Support Opportunities: Regular Research Grants