Noninvasive ventilation can modulate heart rate variability during high-intensity exercise in COPD-CHF patients

Author(s)

Baffa, Giovana Salgado ^[1] ; Goulart, Cassia da Luz ^[1] ; Caruso, Flavia Rossi ^[1] ; Garcia de Araujo, Adriana S. ^[1] ; dos Santos, Polliana Batista ^[1] ; Roscani, Meliza Goi ^[2] ; Prone, Fabio Rodrigo ^[3] ; Bonjorno, Jose Carlos ^[2] ; Mendes, Renata Goncalves ^[1] ; Borghi-Silva, Audrey ^[1]

Affiliation

^[1] Univ Fed Sao Carlos, Physiotherapy Dept, Cardiopulm Physiotherapy Lab, UFSCar, Rodovia Washington Luis, KM 235, BR-13565905 Sao Carlos, SP - Brazil

^[2] Univ Fed Sao Carlos, Dept Med, Sao Carlos, SP - Brazil

^[3] Univ Fed Sao Carlos, Univ Hosp, Sao Carlos, SP - Brazil

• Document type: Journal article
• Source: HEART & LUNG; v. 50, n. 5, p. 609-614, SEP-OCT 2021.
• Web of Science Citations: 0

Abstract

Objective: to assess the acute effects of non-invasive ventilation (NIV) during high-intensity exercise on heart rate variability (HRV) responses in chronic obstructive pulmonary disease (COPD) and Chronic heart failure (CHF) patients. Methods: This was randomized, double blinded and controlled study. Fourteen patients with COPD-HF diagnosis were evaluated. The subjects underwent to the following tests: (I) cardiopulmonary exercise testing (CPET) on a cycle ergometer ramp protocol; (II) 7 days after CPET, patients randomly underwent two constant-load exercise (CLE) with NIV or Sham ventilation until tolerance limit, with 80% of the CPET peak load. R-R intervals (RRi) were continuously collected during rest, exercise and in recovery. Time and frequency domain and nonlinear heart rate variability (HRV) indices were obtained. Results: NIV resulted in a decrease of Mean iRR, square root of the mean squared differences of successive RRi (rMSSD), RR tri index and high-frequency (HF), nu (p < 0.05) and increase of Mean HR, low-frequency (LF), nu and LF/HF (p < 0.05) during exercise when compared to rest. In addition, NIV during exercise induced lower rMSSD and Sample Entropy when compared with Sham (p < 0.05). Negative correlation was found between forced expiratory volume in 1 second (FEV1, L) vs HF (nu) during exercise with NIV (p = 0.04; r= -0.58). Furthermore, simple linear regression showed that the FEV1 (L) affected 30% of the HF (nu) response during the exercise with NIV. Conclusion: NIV during exercise produced enhanced heart rate and autonomic responses in COPD-CHF patients. Additionally, COPD severity is negatively associated with a higher vagal response during exercise with NIV. (C) 2021 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 18/03233-0 - Study of cardiorespiratory interaction and the supply of peripheral and cerebral oxygen as modulators of exercise capacity during bilevel application in the coexistence of COPD-CHF
• Grantee: Cássia da Luz Goulart
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)