Is cardiac autonomic modulation during upper limb isometric contraction and Valsalva maneuver impaired in COPD patients?

Author(s)

Goulart, Cassia da Luz ; Cabiddu, Ramona ; Schneiders, Paloma de Borba ; San Martin, Elisabete Antunes ; Trimer, R. Enata ; Borghi-Silva, Audrey ; Goncalves da Silva, Andrea Lucia

• Document type: Journal article
• Source: INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE; v. 12, p. 9-pg., 2017-01-01.

Abstract

Purpose: To evaluate the heart rate variability (HRV) indices and heart rate (HR) responses during isometric contraction (IC) and Valsalva maneuver (VM) in COPD patients. Methods: Twenty-two stable moderate to severe COPD patients were evaluated. R-R intervals were recorded (monitor Polar r S810i) during dominant upper limb IC (2 minutes). Stable signals were analyzed by Kubios HRV r software. Indices of HRV were computed in the time domain (mean HR; square root of the mean squared differences of successive RR intervals [RMSSD] and HRV triangular index [RR tri index]) and in the frequency domain (high frequency [HF]; low frequency [LF] and LF/HF ratio). The HR responses were evaluated at rest, at the peak and at the nadir of the VM (15 seconds). The Valsalva index was also calculated. Results: During IC: time domain indices (mean HR increased [P=0.001], RMSSD, and RR tri index decreased [P=0.005 and P=0.005, respectively]); frequency domain indices (LF increased [P=0.033] and HF decreased [P=0.002]); associations were found between forced expiratory volume in 1 second (FEV1) vs RMSSD (P=0.04; r=-0.55), FEV1 vs HR (P=0.04; r=-0.48), forced vital capacity (FVC) vs RMSSD (P=0.05; r=-0.62), maximum inspiratory pressure (MIP) vs HF (P=0.02; r=0.68). FEV1 and FVC justified 30% of mean HR. During VM: HR increased (P=0.01); the nadir showed normal bradycardic response; the Valsalva index was =0.7. Conclusion: COPD patients responded properly to the upper limb IC and to the VM; however, HR recovery during VM was impaired in these patients. The severity of the disease and MIP were associated with increased parasympathetic modulation and higher chronotropic response. (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