STUDY OF HEART RATE VARIABILITY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Keywords:
respiratory physical therapy, respiratory tract, lung diseases, hearth rate, pulmonary heart disease, autonomic nervous systemAbstract
As the autonomic nervous system is responsible for the balance of organic functions, in which the heart participates, beat by beat, it is understood that the recording of heartbeats and the due analysis of their consecutive intervals through the heart rate variability method can express cardiac vagal-sympathetic balance. In this research, this method (time domain) was used to study the characteristics of the cardiac autonomic behavior pattern in patients with chronic obstructive pulmonary disease (n= 10; mean age = 63.4 ± 8.1 years), the which were compared to a control group (n= 10; mean age = 55.7 ± 5.5 years), consisting of healthy individuals. For this, all volunteers had their heartbeats recorded for ten minutes, while they remained at rest in the supine position. To analyze heart rate variability, the calculation of the standard deviations of the means of all recorded normal RR intervals (IRR) was applied, called standard deviation normal to normal, which revealed lower values (p<0.05) in the patients with chronic obstructive pulmonary disease (median of 11.0 ms) when compared to the control group (median of 15.0 ms). This result suggests that chronic obstructive pulmonary disease, even considered mild, may have promoted cardiac functional changes with an impact on cardiac autonomic control.
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References
Anema JR, Heijenbrock MW, Faes JT, et al. Cardiovascular autonomic function in multiple sclerosis. J Neuro] Sei 1991; 104: 129-34.
Akselrod S, Gordon D, Ubel FA, Shannon DC, Barger AC, Cohen RJ. Power spectral analysis of heart rate íluctuation: a quantitative probe of beat-to-beat cardiovascular contra 1. Science 1981 ; 213( 10):220-2.
BethlemN. Pneumologia 3 .ed. Rio ele Janeiro: Atheneu; 1984.p.471.
Cohn JN. Abnormalities of peripheral sympathetic nervous system in congestive heart failure. Circulation 1990; 82: 159-67.
Costa D. Fisioterapia respiratória básica. Rio de .Janeiro: Atheneu; 1999. p.83.
De Meersman. Heart rate variability and aerobic fitness AmHeart J 1993; 125:726.
EwingDJ,BorseyDQ,BellvereF, ClarkeBF. Cardiac autonomic neuropathy in diabetes: comparison of measures ofR-R interval variation. Diabetologia 1981; 21 :809-14.
EwingDJ,Martin CN, YoungRJ,ClarkeBF. Thevalue of cardiovascular autonomic function tests: 1 O years experience in diabetes. Diabetes Care 1985; 8:491-8.
Fei L, Anderson MH, Katritsis D, Sneddon J, Statters DJ, MalikM, et ai. Decreased heart rate variability in survivors od sudden cardiac death not associated with coronary artery disease. Br Hear J 1994; 71(1):16-21.
Guzzetti S, Piccaluga E, Casati R, et ai. Sympathetic predominance in essential hypertension: a study employing spectral analysis of heart rate variability. JHipertens 1988;6:71 l-7.
Hirsch JA, Bishop B. Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate. Am J Physiol 1981; 241(4):H620-9.
Hon EL, Lee ST. Electronic evaluations of the fetal heart rate patterns preceding fetal death: further observations. Am J ObstetGynecol 1965; 87:814-26.
Jensen-Urstad K, Storck N, Bouvier F, Ericson M, Lindblad LE, Jensen-Urstad M. Heart rate variability in healthy subjects is related to age and gender. Acta Physiol Scand 1997; 160:235-41.
Kleiger RE, Miller JP, Bigger JRJT, Moss AJ, et ai. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987; 59 :256-62.
Leipzig TJ, Lowensohn RL. Heart rate variability in neurosurgical patients. eurosurgery 1986; 19:356-62.
Lowensohn Rl, Weiss M, Hon EH. Heart-rate variability in brain damaged adults. Lancet 1977; 1:626-8.
Longo A, Ferreira D, Correia MJ. Variabilidade da frequência cardíaca. Rev Por! Carcliol 1995; 14(3):241-62.
Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation 1991; 84(2):482-92.
Malliani A, Lombardi F, Pagani M, Cerutti S. Power spectral analysis of cardiovascular variability in patients ai risk for sudden cardiac death. J Cardiovasc Eletrophysiol 1994; 5(3):274-86.
Malpas SC, Whiteside EA, Maling TJ. Heart rate variability and carcliac autonomic function in men with chronic alcohol dependence. Br Heart J 1991; 65:84-8.
Martins LEB. A arritmia sinusal respiratória: desenvolvimento e implementação ele uma nova abordagem experimental [tese]. São Paulo: Escola Politécnica da Universidade de São Paulo; 1994.
McGavin CR, Gupta SP, McHardy GJR. Twelve minutes walking test for assessing disability in chronic bronchitis. BrMed J 1976; 1 :822-3.
Mehlsen J, Pagh K, Nielsen JSD, et ai. Heart rate response to breathing: depenclency upon breathing pattern. Clin Physiol 1987; 7: 115-24.
Molgaard H, Sorensen KE, Bjerregaarcl P. Circadian variation and influence of risk factors on heart rate variability in healthy subjects. Am J Cardiol 1991; 68:777- 4.
Pagani M, Lucini D, Pizzinelli P, Sergi M, Bosisio E, Mela GS, et ai. Effects of aging and of chronic obstructive pulmonary disease on RR interval variability. J Auton Nerv Syst 1996; 59(3 ): 125-32.
Paschoal MA. Variabilidade da feqüência cardíaca: estudo das influências autonômicas sobre suas características temporal e espectral em halterofí listas e sedentários [tese]. Campinas: Universidade Estadual de Campinas; 1999.
Paschoal MA. Avaliação cardiorrespiratória ele esforço e programa de recondicionamento aeróbio em cicloergômetro para pacientes com doença pulmonar abstrutiva crônica. Rev Bras Fisio 2002; 6(3). (no prelo).
Puig J, Freitas M, Carvalho MJ, Puga N, Ramos J, Fernandes P, et ai. Spectral analysis of heart rate variability in athletes. J Sports Med Fitness 1993; 33:44-8.
Sands KE, Appel ML, Lilly LS, et ai. Power spectrurn analysis of heart rate variability in human cardiac transplant recipients. Circulation 1989; 79:76-82.
Saul .IP. Beat to beat variations of HR reflect modulation of cardiac autonomic outflow. IPS 1990; 5:32-7.
ShinK, MinamitamiH, Onishi S, Yamazaki H, LeeM. Autonomic differences between athletes and nonathletes: spectral analysis approach. Med Sei Sports Exerc 1997; 29(11 ): 1482-90.
Singh N, Mironov D, Armstong PW, Ross AM, Langer A. Heart rate variability assessment early after acute myocardial infarction. Circulation 1997; 93(7): 1388-95.
Tarantino AB. Doenças pulmonares 4.ed. Rio de Janeiro: Guanabara Koogan; 1997. p.527.
TasakiH, Serita T, lrita A, Hano O, lliev 1, Ueyama C, et ai. A 15- year longitudinal follow- up study ofheart rate and heart rate variability in healthy elderly persons. J Gerontol A Biol Sei Med Sei 2000; 55(12):M744-9.
Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HeartRate Yariability. Standards of Measurement, Physiological lnterpretation and Clinicai Use. Circulation 1996; 93: 1043-65.
Yallbona C, Cardus D, Spencer W A, Hoff HE. Patterns ofsinus arrhythmia in patients with lesions of the central nervous system. Am J Cardiol 1965; 16:379-93.
VanoliE, AdamsonPB, LinB, Pinna GD, LazzaraR, Or WC. Heart rate variability during specific sleep stages: a comparison of healthy subjects with patients after myocardial infarction. Circulation 1995; 91 (7): 1918-22.
Yolterrani M, Scalvini S,Mazzuero G, Lanfranchi P, Colombo R, Clark MA, et ai. Decreased heart rate variability in patients with chronic obstructive pulmonary disease. Chest 1994; 106: 1432-37.
