Zangrando KTL, Trimer R, de Carvalho LCS, Arêas GPT, Caruso FCR, Cabiddu R, Roscani MG, Rizzatti FPG, Borghi-Silva A. Chronic obstructive pulmonary disease severity and its association with obstructive sleep apnea syndrome: impact on cardiac autonomic modulation and functional capacity.
Int J Chron Obstruct Pulmon Dis 2018;
13:1343-1351. [PMID:
29731622 PMCID:
PMC5927062 DOI:
10.2147/copd.s156168]
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Abstract
Background
The study was conducted to determine the impact of chronic obstructive pulmonary disease (COPD) in association with obstructive sleep apnea syndrome (OSAS) on cardiac autonomic control and functional capacity.
Subjects and methods
The study was a cross-sectional prospective controlled clinical study. Heart rate variability indices of 24 COPD (n = 12) and COPD+OSAS (n = 12) patients were evaluated and compared by electrocardiographic recordings acquired during rest, active postural maneuver (APM), respiratory sinus arrhythmia maneuver (RSA-m), and the 6-minute walk test (6MWT).
Results
The COPD group presented higher parasympathetic modulation during APM when compared to the COPD+OSAS group (P = 0.02). The COPD+OSAS group presented higher sympathetic modulation during RSA-m when compared to the COPD group (P = 0.00). The performance during 6MWT was similarly impaired in both groups, despite the greater severity of the COPD group.
Conclusion
Subjects with COPD+OSAS present marked sympathetic modulation, and the presence of OSAS in COPD subjects has a negative impact on functional capacity regardless of the severity of lung disease.
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