Brain-heart autonomic axis across different clinical status and severity of chronic obstructive pulmonary disease

• Autor(a) principal: Castello-Simões, Viviane
• Data de Publicação: 2021
• Outros Autores: Kabbach, Erika Zavaglia, Schafauser, Nathany Souza, Camargo, Patrícia Faria, Simões, Rodrigo Polaquini, Heubel, Alessandro Domingues, Alqahtani, Jaber Saud, Pereira, Mariana Brasil da Cunha Martino, Sgarbosa, Nicole Marques, Silva, Audrey Borghi, Mendes, Renata Gonçalves
• Idioma: eng
• Título da fonte: Repositório Institucional da UFSCAR
• Texto Completo: https://doi.org/10.1016/j.rmed.2021.106511; https://repositorio.ufscar.br/handle/ufscar/15572
• topic: Acute exacerbation; Autonomic nervous system; Exercise; Heart rate variability; Respiratory disease; CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

Purpose: Impairment of cardiac autonomic integrity is common in chronic obstructive pulmonary disease (COPD) patients. The influence of the interaction between clinical and severity status on brain-heart autonomic axis (BHAA) is not well known. We aimed to investigate the BHAA function across different clinical status and severity of COPD. Methods: Cross-sectional study involving 77 COPD patients allocated into four groups according to clinical status [acute exacerbation (GAE) or stable (GST)] and severity [less (-) or more (+)]: 1) GAE-, n = 13; 2) GAE+, n = 20; 3) GST-, n = 23; and 4) GST+, n = 21. Heart rate variability (HRV) at rest and heart rate recovery (HRR) after 6-min walk test were markers of BHAA. Mean R-R, STDRR, RMSSD, RRtri, HF, LF, SD1, SD2, ApEn and SampEn were the HRV indexes and, HRR was obtained as: HR at 1st min of recovery minus peak HR. Results: A main effect of clinical status (p < 0.001) was found to vagal modulation in GAE-vs. GST- (RMSSD: 25.0 ± 14.8 vs. 12.6 ± 5.5 ms; SD1: 18.0 ± 10.6 vs. 8.9 ± 3.9 ms) and to GAE + vs. GST+ (RMSSD: 26.4 ± 15.2 vs. 15.4 ± 6.3 ms; SD1: 18.3 ± 11.2 vs. 10.9 ± 4.5 ms). An effect of clinical status (p = 0.032) and severity (p = 0.030) were found to HF (vagal) in GAE + compared to GAE- and GST+ (264.7 ± 239.0 vs. 134.7 ± 169.7 and 135.8 ± 139.7 ms2). Lower HRR was found in GAE-compared to GST- (8.0 ± 2.4 vs. 19.6 ± 2.4 bpm), p = 0.002. Conclusion: In COPD patients, clinical status (AECOPD or stable) was more dominant than the severity on BHAA function. A more pronounced parasympathetic modulation was found in AECOPD patients with a lower HRR to exercise.