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

Autor(es)

ANDRÉA L.G. DA SILVA ^[1] ; CÁSSIA L. GOULART ^[2] ; KAMILA M.K. MANSOUR ^[3] ; GUILHERME D. BACK ^[4] ; RAMONA CABIDDU ^[5] ; RENATA TRIMER ^[6] ; AUDREY BORGHI-SILVA ^[7]

Afiliação do(s) autor(es)

^[1] Universidade de Santa Cruz do Sul. Departamento de Ciências da Saúde - Brasil

^[2] Universidade de Santa Cruz do Sul. Departamento de Ciências da Saúde - Brasil

^[3] Programa de Residência Multiprofissional em Saúde/ Fisioterapia. Hospital Santa Cruz - Brasil

^[4] Universidade de Santa Cruz do Sul. Departamento de Ciências da Saúde - Brasil

^[5] Universidade Federal de São Carlos. Departamento de Fisioterapia - Brasil

^[6] Universidade de Santa Cruz do Sul. Departamento de Ciências da Saúde - Brasil

^[7] Universidade Federal de São Carlos. Departamento de Fisioterapia - Brasil

• Tipo de documento: Artigo Científico
• Fonte: Anais da Academia Brasileira de Ciências; v. 92, n. 2 2020-07-20.

Resumo

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® S810i) during spontaneous breathing (10 minutes) and slow deep breathing (4 minutes), with and without 5 cmH2O expiratory positive airway pressure. Stable signals were analyzed by Kubios®. 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 cmH2O 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)

• Processo FAPESP: 15/04101-1 - Efeitos clínicos, funcionais e sistêmicos da estimulação elétrica neuromuscular corpórea no pós-operatório de cirurgia bariátrica.
• Beneficiário: Audrey Borghi Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 13/23013-0 - Analise da variabilidade da frequência cardíaca e do acoplamento cardiorrespiratório na coexistência da doença pulmonar obstrutiva crônica e da síndrome da apnéia obstrutiva do sono
• Beneficiário: Renata Trimer
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado