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Shi M, Qumu S, Wang S, Peng Y, Yang L, Huang K, He R, Dong F, Niu H, Yang T, Wang C. Abnormal heart rate responses to exercise in non-severe COPD: relationship with pulmonary vascular volume and ventilatory efficiency. BMC Pulm Med 2024; 24:183. [PMID: 38632576 PMCID: PMC11022473 DOI: 10.1186/s12890-024-03003-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Despite being a prognostic predictor, cardiac autonomic dysfunction (AD) has not been well investigated in chronic obstructive pulmonary disease (COPD). We aimed to characterise computed tomography (CT), spirometry, and cardiopulmonary exercise test (CPET) features of COPD patients with cardiac AD and the association of AD with CT-derived vascular and CPET-derived ventilatory efficiency metrics. METHODS This observational cohort study included stable, non-severe COPD patients. They underwent clinical evaluation, spirometry, CPET, and CT. Cardiac AD was determined based on abnormal heart rate responses to exercise, including chronotropic incompetence (CI) or delayed heart rate recovery (HRR) during CPET. RESULTS We included 49 patients with FEV1 of 1.2-5.0 L (51.1-129.7%), 24 (49%) had CI, and 15 (31%) had delayed HRR. According to multivariate analyses, CI was independently related to reduced vascular volume (VV; VV ≤ median; OR [95% CI], 7.26 [1.56-33.91]) and low ventilatory efficiency (nadir VE/VCO2 ≥ median; OR [95% CI], 10.67 [2.23-51.05]). Similar results were observed for delayed HRR (VV ≤ median; OR [95% CI], 11.46 [2.03-64.89], nadir VE/VCO2 ≥ median; OR [95% CI], 6.36 [1.18-34.42]). CONCLUSIONS Cardiac AD is associated with impaired pulmonary vascular volume and ventilatory efficiency. This suggests that lung blood perfusion abnormalities may occur in these patients. Further confirmation is required in a large population-based cohort.
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Affiliation(s)
- Minghui Shi
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Capital Medical University, 100069, Beijing, China
| | - Shiwei Qumu
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Siyuan Wang
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, 100029, Beijing, China
| | - Yaodie Peng
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Peking University Health Science Center, 100871, Beijing, China
| | - Lulu Yang
- Fangzhuang Community Health Service Center, Capital Medical University, 100078, Beijing, China
| | - Ke Huang
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Ruoxi He
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Feng Dong
- Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, 100078, Beijing, China
| | - Hongtao Niu
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Ting Yang
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
| | - Chen Wang
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Capital Medical University, 100069, Beijing, China.
- Chinese Academy of Medical Sciences and Peking Union Medical College, No. 2 East Yinghua Road, Chaoyang District, 100730, Beijing, China.
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Alqahtani JS, Aldhahir AM, Alghamdi SM, Al Ghamdi SS, AlDraiwiesh IA, Alsulayyim AS, Alqahtani AS, Alobaidi NY, Al Saikhan L, AlRabeeah SM, Alzahrani EM, Heubel AD, Mendes RG, Alqarni AA, Alanazi AM, Oyelade T. A systematic review and meta-analysis of heart rate variability in COPD. Front Cardiovasc Med 2023; 10:1070327. [PMID: 36873414 PMCID: PMC9981678 DOI: 10.3389/fcvm.2023.1070327] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/24/2023] [Indexed: 02/19/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle-Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability.
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Affiliation(s)
- Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Saeed M Alghamdi
- Respiratory Care Program, Clinical Technology Department, College of Applied Health Science, Umm Al Qura University, Makkah, Saudi Arabia
| | - Shouq S Al Ghamdi
- Anesthesia Technology Department, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Ibrahim A AlDraiwiesh
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah S Alsulayyim
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Abdullah S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Nowaf Y Alobaidi
- Respiratory Therapy Department, King Saud bin Abdulaziz University for Health Sciences, Alahsa, Saudi Arabia
| | - Lamia Al Saikhan
- Department of Cardiac Technology, College of Applied Medial Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saad M AlRabeeah
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Eidan M Alzahrani
- Physical Therapy Department, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Alessandro D Heubel
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, SP, Brazil
| | - Renata G Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, SP, Brazil
| | - Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah M Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Tope Oyelade
- UCL Institute for Liver and Digestive Health, London, United Kingdom
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Use of a Wearable Biosensor to Study Heart Rate Variability in Chronic Obstructive Pulmonary Disease and Its Relationship to Disease Severity. SENSORS 2022; 22:s22062264. [PMID: 35336436 PMCID: PMC8952191 DOI: 10.3390/s22062264] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/05/2022] [Accepted: 03/10/2022] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to explore the relationships between heart rate variability (HRV) and various phenotypic measures that relate to health and functional status in chronic obstructive pulmonary disease (COPD), and secondly, to demonstrate the feasibility of ascertaining HRV via a chest-worn wearable biosensor in COPD patients. HRV analysis was performed using SDNN (standard deviation of the mean of all normal R-R intervals), low frequency (LF), high frequency (HF), and LF/HF ratio. We evaluated the associations between HRV and COPD severity, class of bronchodilator therapy prescribed, and patient reported outcomes. Seventy-nine participants with COPD were enrolled. There were no differences in SDNN, HF, and LF/HF ratio according to COPD severity. The SDNN in participants treated with concurrent beta-agonists and muscarinic antagonists was lower than that in other participants after adjusting heart rate (beta coefficient −3.980, p = 0.019). The SDNN was positively correlated with Veterans Specific Activity Questionnaire (VSAQ) score (r = 0.308, p = 0.006) and handgrip strength (r = 0.285, p = 0.011), and negatively correlated with dyspnea by modified Medical Research Council (mMRC) questionnaire (r = −0.234, p = 0.039), health status by Saint George’s Respiratory Questionnaire (SGRQ) (r = −0.298, p = 0.008), symptoms by COPD Assessment Test (CAT) (r = −0.280, p = 0.012), and BODE index (r = −0.269, p = 0.020). When measured by a chest-worn wearable device, reduced HRV was observed in COPD participants receiving inhaled beta-sympathomimetic agonist and muscarinic antagonists. HRV was also correlated with various health status and performance measures.
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Li Z, Zhang Y, Wang J, Xu D, Jing J, Jiang M, Li F. Difference of body surface temperature in stable chronic obstructive pulmonary disease patients with different degree of airflow limitation. Heart Lung 2022; 52:130-135. [PMID: 35016108 DOI: 10.1016/j.hrtlng.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study aimed to investigate the changes of body surface temperature of stable chronic obstructive pulmonary disease (COPD) patients and explore its clinical significance for the progression of COPD. OBJECTIVES The aim of this study was to explore the correlation between body surface temperature and disease severity in COPD patients. METHODS From May 2015 to May 2016, the patients who were diagnosed as COPD at stable phase (n = 148) were enrolled in this study. The subjects in control group (n = 49) were healthy people. The patients' general condition modified Medical Research Council (mMRC) dyspnea scale and the COPD assessment test (CAT) score were recorded, and pulmonary function of patients was determined. Back average temperature measurement was made using a thermal infrared imager (DT-9875, CEM, China). RESULTS Patients in the COPD group had significantly lower mean temperatures of the back than those in the control group. The mean temperature of the back presented a decreased tendency with the aggravation of airflow limitation. Correlation analysis revealed that in the COPD group, the back temperature was negatively correlated with smoking index and mMRC score. FEV1%, FVC% and FEV1/FVC were positively correlated with pulmonary function. Smoking showed a tendency to lower the back temperature of COPD patients. CONCLUSIONS This study preliminarily suggested that the body surface temperature of COPD patients decreased compared with that of healthy people, which may be associated with the dysfunction of autonomic nerve, increased basal metabolic rate, metabolic syndrome and peripheral nerve injury in COPD patients.
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Affiliation(s)
- Zheng Li
- The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Xinjiang, China; National Clinical Research Base of Traditional Chinese Medicine, Xinjiang, China
| | - Yanxin Zhang
- The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Xinjiang, China
| | - Jing Wang
- The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Xinjiang, China; National Clinical Research Base of Traditional Chinese Medicine, Xinjiang, China; Key Laboratory of Xinjiang Uygur Autonomous Region (Respiratory Disease), Xinjiang, China
| | - Dan Xu
- The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Xinjiang, China; National Clinical Research Base of Traditional Chinese Medicine, Xinjiang, China
| | - Jing Jing
- The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Xinjiang, China; National Clinical Research Base of Traditional Chinese Medicine, Xinjiang, China
| | - Min Jiang
- The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Xinjiang, China; National Clinical Research Base of Traditional Chinese Medicine, Xinjiang, China; Key Laboratory of Xinjiang Uygur Autonomous Region (Respiratory Disease), Xinjiang, China
| | - Fengsen Li
- The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Xinjiang, China; National Clinical Research Base of Traditional Chinese Medicine, Xinjiang, China.
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Shalfawi SAI. Bayesian Estimation of Correlation between Measures of Blood Pressure Indices, Aerobic Capacity and Resting Heart Rate Variability Using Markov Chain Monte Carlo Simulation and 95% High Density Interval in Female School Teachers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186750. [PMID: 32947985 PMCID: PMC7558932 DOI: 10.3390/ijerph17186750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/05/2020] [Accepted: 09/13/2020] [Indexed: 12/19/2022]
Abstract
Background: Several explanations regarding the disparity observed in the literature with regard to heart rate variability (HRV) and its association with performance parameters have been proposed: the time of day when the recording was conducted, the condition (i.e., rest, active, post activity) and the mathematical and physiological relationships that could have influenced the results. A notable observation about early studies is that they all followed the frequentist approach to data analyses. Therefore, in an attempt to explain the disparity observed in the literature, the primary purpose of this study was to estimate the association between measures of HRV indices, aerobic performance parameters and blood pressure indices using the Bayesian estimation of correlation on simulated data using Markov Chain Monte Carlo (MCMC) and the equal probability of the 95% high density interval (95% HDI). Methods: The within-subjects with a one-group pretest experimental design was chosen to investigate the relationship between baseline measures of HRV (rest; independent variable), myocardial work (rate–pressure product (RPP)), mean arterial pressure (MAP) and aerobic performance parameters. The study participants were eight local female schoolteachers aged 54.1 ± 6.5 years (mean ± SD), with a body mass of 70.6 ± 11.5 kg and a height of 164.5 ± 6.5 cm. Their HRV data were analyzed in R package, and the Bayesian estimation of correlation was calculated employing the Bayesian hierarchical model that uses MCMC simulation integrated in the JAGS package. Results: The Bayesian estimation of correlation using MCMC simulation reproduced and supported the findings reported regarding norms and the within-HRV-indices associations. The results of the Bayesian estimation showed a possible association (regardless of the strength) between pNN50% and MAP (rho = 0.671; 95% HDI = 0.928–0.004), MeanRR (ms) and RPP (rho = −0.68; 95% HDI = −0.064–−0.935), SDNN (ms) and RPP (rho = 0.672; 95% HDI = 0.918–0.001), LF (ms2) and RPP (rho = 0.733; 95% HDI = 0.935–0.118) and SD2 and RPP (rho = 0.692; 95% HDI = 0.939–0.055). Conclusions: The Bayesian estimation of correlation with 95% HDI on MCMC simulated data is a new technique for data analysis in sport science and seems to provide a more robust approach to allocating credibility through a meaningful mathematical model. However, the 95% HDI found in this study, accompanied by the theoretical explanations regarding the dynamics between the parasympathetic nervous system and the sympathetic nervous system in relation to different recording conditions (supine, reactivation, rest), recording systems, time of day (morning, evening, sleep etc.) and age of participants, suggests that the association between measures of HRV indices and aerobic performance parameters has yet to be explicated.
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Affiliation(s)
- Shaher A I Shalfawi
- Department of Education and Sports Science, University of Stavanger, 4036 Stavanger, Norway
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Abstract
Background: Although regular exercise is beneficially acknowledged in promoting general health status, the cardiovascular risk of sudden cardiac death in highly training athletes has been reported. Unfortunately, the primary key factor in inducing cardiac problems in athletic populations is still questioned. Objectives: In the present study, we aim to determine factors that could affect the relationship between physical activity level and cardiac autonomic function in the Thai population. Methods: Forty participants were recruited and classified into three groups based on their physical activity level and sport profession, including sedentary men, elite handball players, and professional futsal players. In all participants, we measured predicted maximal oxygen consumption, time- and frequency- domain heart rate variability (HRV) variables at rest. Results: Results demonstrated a positive correlation between time-domain HRV and estimated maximal oxygen consumption, but not with frequency-domain HRV, in which athletes aged lower than 25 years old (18 - 25 years old) had a significantly higher in the standard deviation of normal RR intervals (SDNN) and root mean square of the successive differences (RMSSD) than that in age-matched sedentary subjects. Interestingly, athletes aged above 25 years old (25 - 32 years old) had lower SDNN and RMSSD with higher low frequency/high-frequency ratio than those athletes aged under 25. Since all athletes aged above 25 years old were world-class national futsal players, stress due to the competitive level might be another factor influencing cardiac autonomic activity in athletes. Conclusions: In conclusion, the study suggested the importance of age and stress exposure on cardiac autonomic regulation in elite athletes. The observed correlation also reinforced HRV as a potential marker in detecting abnormal changes in cardiac health even in an athletic population.
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Serrão NF, Porta A, Minatel V, Castro AAM, Catai AM, Sampaio LMM, Arena R, Borghi-Silva A. Complexity analysis of heart rate variability in chronic obstructive pulmonary disease: relationship with severity and symptoms. Clin Auton Res 2020; 30:157-164. [DOI: 10.1007/s10286-019-00659-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 12/21/2019] [Indexed: 10/25/2022]
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Hu S, Lou J, Zhang Y, Chen P. Low heart rate variability relates to the progression of gastric cancer. World J Surg Oncol 2018; 16:49. [PMID: 29514707 PMCID: PMC5842632 DOI: 10.1186/s12957-018-1348-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 02/26/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastric cancer (GC) is one of the most common malignant gastrointestinal tumors with the high morbidity and mortality, affecting the quality of human life. This study aimed to identify the role of heart rate variability (HRV) in patients with GC. METHODS From January 2010 to June 2014, 383 consecutive patients diagnosed with GC were enrolled in this study. Clinical and pathological information from each patient were retrospectively recorded. HRV, including standard deviation of normal-to-normal RR intervals (SDNN) and root mean square of successive differences (RMSSD), were measured by electrocardiography. RESULTS The results showed that the SDNN and RMSSD in GC patients were 19.02 ± 13.58 ms and 21.64 ± 17.57 ms, respectively. HRV decreased with advanced clinical stage (P < 0.0001). HRV correlated with tumor size, tumor infiltration, lymph node metastasis and distant metastasis (P < 0.001); however, no correlation with tumor site and metastasis severity was found (P > 0.05). C-reactive protein (CRP) was higher in the low HRV group than that in high HRV group (P = 0.008). CONCLUSIONS GC patients showed a lower HRV that was correlated with tumor stage. HRV decreased with tumor progression, which may be related to a mechanism involving vagal nerve excitement inhibiting the inflammatory reaction.
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Affiliation(s)
- Songjie Hu
- Department of Surgery, Ningbo No. 2 Hospital, Yongfeng Road, Ningbo, Zhejiang Province, 315010, China
| | - Jie Lou
- Department of Surgery, Ningbo No. 2 Hospital, Yongfeng Road, Ningbo, Zhejiang Province, 315010, China
| | - Youping Zhang
- Department of Surgery, Ningbo No. 2 Hospital, Yongfeng Road, Ningbo, Zhejiang Province, 315010, China
| | - Ping Chen
- Department of Surgery, Ningbo No. 2 Hospital, Yongfeng Road, Ningbo, Zhejiang Province, 315010, China.
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Mazzuco A, Medeiros WM, Souza ASD, Alencar MCN, Neder JA, Borghi-Silva A. Are heart rate dynamics in the transition from rest to submaximal exercise related to maximal cardiorespiratory responses in COPD? Braz J Phys Ther 2017; 21:251-258. [PMID: 28558953 PMCID: PMC5537469 DOI: 10.1016/j.bjpt.2017.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 07/27/2016] [Accepted: 09/08/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Poor exercise capacity is an important negative prognostic marker in patients with chronic obstructive pulmonary disease (COPD). Heart rate variability (HRV) responses can indicate alterations in cardiac autonomic control. Nevertheless, it remains unclear whether these abnormalities are related to cardiorespiratory responses to exercise in these patients. OBJECTIVE To evaluate whether HRV at rest and submaximal exercise are related to impaired cardiopulmonary responses to exercise in COPD patients. METHODS Fifteen men (66.2±8.7 years) with COPD (FEV1: 55.1±19.2%) were assessed. The R-R interval (RRi) data collection was performed at rest (stand position) and during the six-minute walk test (6MWT). All patients performed a symptom-limited cardiopulmonary exercise test on a cycle ergometer. The HRV changes from rest to submaximal exercise (Δ rest-6MWT) were calculated. RESULTS We found significant correlations between low frequency (LF) and high frequency (HF) Δ rest-6MWT with Δ oxyhemoglobin saturation by pulse oximetry (r=-0.64 and r=0.65, respectively; p<0.05), minute ventilation/carbon dioxide output relationship from beginning to peak exercise (r=-0.52 and r=0.53, p<0.05), and exercise ventilatory power (r=0.52 and r=-0.53, p<0.05). Interestingly, there was a strong positive correlation (r=0.82, p<0.05) between six-minute walk distance (6MWD) and Δ LF/HF from rest to exercise. CONCLUSION HRV analysis in the transition from rest to submaximal exercise is associated with exercise ventilatory and hemodynamic abnormalities in COPD patients. Rehabilitative strategies to improve HRV responses may provide an important tool to clinical practice in these patients.
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Affiliation(s)
- Adriana Mazzuco
- Laboratório de Fisioterapia Cardiopulmonar (LACAP), Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Wladimir Musetti Medeiros
- Setor de Função Pulmonar e Fisiologia Clínica do Exercício (SEFICE), Disciplina de Pneumologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Aline Soares de Souza
- Setor de Função Pulmonar e Fisiologia Clínica do Exercício (SEFICE), Disciplina de Pneumologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Maria Clara Noman Alencar
- Setor de Função Pulmonar e Fisiologia Clínica do Exercício (SEFICE), Disciplina de Pneumologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - José Alberto Neder
- Setor de Função Pulmonar e Fisiologia Clínica do Exercício (SEFICE), Disciplina de Pneumologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Audrey Borghi-Silva
- Laboratório de Fisioterapia Cardiopulmonar (LACAP), Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
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Ciccone AB, Siedlik JA, Wecht JM, Deckert JA, Nguyen ND, Weir JP. Reminder: RMSSD and SD1 are identical heart rate variability metrics. Muscle Nerve 2017; 56:674-678. [PMID: 28073153 DOI: 10.1002/mus.25573] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2017] [Indexed: 11/10/2022]
Abstract
Assessment of heart rate variability (HRV) is a common approach to examine cardiac autonomic nervous system modulation that has been employed in a variety of settings. Frequently, both the root mean square of successive differences (RMSSD) and SD1, which is a Poincaré plot component, have been used to quantify short-term heart rate variability. It is not typically appreciated, however, that RMSSD and SD1 are identical metrics of HRV. As a reminder to clinicians and researchers who use and study HRV, we show both empirically and mathematically that RMSSD and SD1 are identical metrics. Because the homology between RMSSD and SD1 is not commonly known, the inclusion of both measures has been reported in many recent publications. The inappropriate use of such redundant data may affect the interpretation of HRV studies. Muscle Nerve 56: 674-678, 2017.
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Affiliation(s)
- Anthony B Ciccone
- Osness Human Performance Laboratories, Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, Kansas, 66045, USA
| | - Jacob A Siedlik
- Department of Exercise Science and Pre-Health Professions, Creighton University, Omaha Nebraska, USA
| | - Jill M Wecht
- Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA.,Department of Medicine and Rehabilitation Medicine, the Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Jake A Deckert
- Osness Human Performance Laboratories, Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, Kansas, 66045, USA
| | - Nhuquynh D Nguyen
- Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Joseph P Weir
- Osness Human Performance Laboratories, Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, Kansas, 66045, USA
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11
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Grainge C, Thomas PS, Mak JCW, Benton MJ, Lim TK, Ko FWS. Year in review 2015: Asthma and chronic obstructive pulmonary disease. Respirology 2016; 21:765-75. [PMID: 27028730 DOI: 10.1111/resp.12771] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 02/15/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Chris Grainge
- School of Medicine and Public Health, Centre for Asthma and Respiratory Disease, The University of Newcastle.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle
| | - Paul S Thomas
- Inflammation and Infection Research Centre and Prince of Wales' Hospital Clinical School, Faculty of Medicine, University of New South Wales, Kensington.,Department of Respiratory Medicine, Prince of Wales' Hospital, Randwick, New South Wales, Australia
| | - Judith C W Mak
- Department of Medicine and Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | - Melissa J Benton
- Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences, University of Colorado Colorado Springs, Colorado, USA
| | - Tow Keang Lim
- Department of Medicine, National University Hospital, Singapore
| | - Fanny W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
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12
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Leite MR, Ramos EMC, Kalva-Filho CA, Freire APCF, de Alencar Silva BS, Nicolino J, de Toledo-Arruda AC, Papoti M, Vanderlei LCM, Ramos D. Effects of 12 weeks of aerobic training on autonomic modulation, mucociliary clearance, and aerobic parameters in patients with COPD. Int J Chron Obstruct Pulmon Dis 2015; 10:2549-57. [PMID: 26648712 PMCID: PMC4664442 DOI: 10.2147/copd.s81363] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction Patients with chronic obstructive pulmonary disease (COPD) exhibit aerobic function, autonomic nervous system, and mucociliary clearance alterations. These parameters can be attenuated by aerobic training, which can be applied with continuous or interval efforts. However, the possible effects of aerobic training, using progressively both continuous and interval sessions (ie, linear periodization), require further investigation. Aim To analyze the effects of 12-week aerobic training using continuous and interval sessions on autonomic modulation, mucociliary clearance, and aerobic function in patients with COPD. Methods Sixteen patients with COPD were divided into an aerobic (continuous and interval) training group (AT) (n=10) and a control group (CG) (n=6). An incremental test (initial speed of 2.0 km·h−1, constant slope of 3%, and increments of 0.5 km·h−1 every 2 minutes) was performed. The training group underwent training for 4 weeks at 60% of the peak velocity reached in the incremental test (vVO2peak) (50 minutes of continuous effort), followed by 4 weeks of sessions at 75% of vVO2peak (30 minutes of continuous effort), and 4 weeks of interval training (5×3-minute effort at vVO2peak, separated by 1 minute of passive recovery). Intensities were adjusted through an incremental test performed at the end of each period. Results The AT presented an increase in the high frequency index (ms2) (P=0.04), peak oxygen uptake (VO2peak) (P=0.01), vVO2peak (P=0.04), and anaerobic threshold (P=0.02). No significant changes were observed in the CG (P>0.21) group. Neither of the groups presented changes in mucociliary clearance after 12 weeks (AT: P=0.94 and CG: P=0.69). Conclusion Twelve weeks of aerobic training (continuous and interval sessions) positively influenced the autonomic modulation and aerobic parameters in patients with COPD. However, mucociliary clearance was not affected by aerobic training.
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Affiliation(s)
- Marceli Rocha Leite
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, Brazil
| | | | | | | | | | - Juliana Nicolino
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, Brazil
| | | | - Marcelo Papoti
- School of Physical Education and Sport of Ribeirão Preto, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | | | - Dionei Ramos
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, Brazil
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13
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Gulgun M, Fidanci KM, Genc FA. Body weight, BMI and insulin resistance as influential factors on heart rate variability. Respirology 2015; 20:846. [DOI: 10.1111/resp.12562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mustafa Gulgun
- Department of Pediatrics; Division of Pediatric Cardiology; Gulhane Military Medical Academy; Ankara Turkey
| | - Kürşat Muzaffer Fidanci
- Department of Pediatrics; Division of Pediatric Cardiology; Gulhane Military Medical Academy; Ankara Turkey
| | - Fatih Alparslan Genc
- Department of Pediatrics; Division of Pediatric Cardiology; Gulhane Military Medical Academy; Ankara Turkey
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