Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients

Cássia Da Luz Goulart,1 Julio Cristiano Simon,1 Paloma De Borba Schneiders,1 Elisabete Antunes San Martin,1 Ramona Cabiddu,2 Audrey Borghi-Silva,2 Renata Trimer,2 Andréa Lúcia Gonçalves da Silva1 1Course of Physiotherapy, Department of Health and Physical...

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Main Authors: Goulart CL, Simon JC, Schneiders PB, San Martin EA, Cabiddu R, Borghi-Silva A, Trimer R, da Silva ALG
Format: Article
Language:English
Published: Dove Medical Press 2016-07-01
Series:International Journal of COPD
Subjects:
Online Access:https://www.dovepress.com/respiratory-muscle-strength-effect-on-linear-and-nonlinear-heart-rate--peer-reviewed-article-COPD
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author Goulart CL
Simon JC
Schneiders PB
San Martin EA
Cabiddu R
Borghi-Silva A
Trimer R
da Silva ALG
author_facet Goulart CL
Simon JC
Schneiders PB
San Martin EA
Cabiddu R
Borghi-Silva A
Trimer R
da Silva ALG
author_sort Goulart CL
collection DOAJ
description Cássia Da Luz Goulart,1 Julio Cristiano Simon,1 Paloma De Borba Schneiders,1 Elisabete Antunes San Martin,1 Ramona Cabiddu,2 Audrey Borghi-Silva,2 Renata Trimer,2 Andréa Lúcia Gonçalves da Silva1 1Course of Physiotherapy, Department of Health and Physical Education, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil; 2Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil Introduction: Chronic obstructive pulmonary disease (COPD) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities, including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders. We investigated whether alterations in respiratory muscle strength (RMS) would affect cardiac autonomic modulation in COPD patients. Methods: This study was a cross-sectional study done in ten COPD patients affected by moderate to very severe disease. The heart rate variability (HRV) signal was recorded using a Polar cardiofrequencimeter at rest in the sitting position (10 minutes) and during a respiratory sinus arrhythmia maneuver (RSA-M; 4 minutes). Linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals. RMS was assessed using a digital manometer, which provided the maximum inspiratory pressure (Pimax) and the maximum expiratory pressure (Pemax). Results: During the RSA-M, patients presented an HRV power increase in the low-frequency band (LFnu) (46.9±23.7 vs 75.8±27.2; P=0.01) and a decrease in the high-frequency band (HFnu) (52.8±23.5 vs 24.0±27.0; P=0.01) when compared to the resting condition. Significant associations were found between RMS and HRV spectral indices: Pimax and LFnu (r=-0.74; P=0.01); Pimax and HFnu (r=0.74; P=0.01); Pemax and LFnu (r=-0.66; P=0.01); Pemax and HFnu (r=0.66; P=0.03); between Pemax and sample entropy (r=0.83; P<0.01) and between Pemax and approximate entropy (r=0.74; P=0.01). Using a linear regression model, we found that Pimax explained 44% of LFnu behavior during the RSA-M. Conclusion: COPD patients with impaired RMS presented altered cardiac autonomic control, characterized by marked sympathetic modulation and a reduced parasympathetic response; reduced HRV complexity was observed during the RSA-M. Keywords: COPD, heart rate, muscle strength, autonomic nervous system, sinus arrhythmia
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spelling doaj.art-e48fb8df063f4cff8f6118683c0353d42022-12-22T03:15:28ZengDove Medical PressInternational Journal of COPD1178-20052016-07-012016Issue 11671167728087Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patientsGoulart CLSimon JCSchneiders PBSan Martin EACabiddu RBorghi-Silva ATrimer Rda Silva ALGCássia Da Luz Goulart,1 Julio Cristiano Simon,1 Paloma De Borba Schneiders,1 Elisabete Antunes San Martin,1 Ramona Cabiddu,2 Audrey Borghi-Silva,2 Renata Trimer,2 Andréa Lúcia Gonçalves da Silva1 1Course of Physiotherapy, Department of Health and Physical Education, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil; 2Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil Introduction: Chronic obstructive pulmonary disease (COPD) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities, including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders. We investigated whether alterations in respiratory muscle strength (RMS) would affect cardiac autonomic modulation in COPD patients. Methods: This study was a cross-sectional study done in ten COPD patients affected by moderate to very severe disease. The heart rate variability (HRV) signal was recorded using a Polar cardiofrequencimeter at rest in the sitting position (10 minutes) and during a respiratory sinus arrhythmia maneuver (RSA-M; 4 minutes). Linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals. RMS was assessed using a digital manometer, which provided the maximum inspiratory pressure (Pimax) and the maximum expiratory pressure (Pemax). Results: During the RSA-M, patients presented an HRV power increase in the low-frequency band (LFnu) (46.9±23.7 vs 75.8±27.2; P=0.01) and a decrease in the high-frequency band (HFnu) (52.8±23.5 vs 24.0±27.0; P=0.01) when compared to the resting condition. Significant associations were found between RMS and HRV spectral indices: Pimax and LFnu (r=-0.74; P=0.01); Pimax and HFnu (r=0.74; P=0.01); Pemax and LFnu (r=-0.66; P=0.01); Pemax and HFnu (r=0.66; P=0.03); between Pemax and sample entropy (r=0.83; P<0.01) and between Pemax and approximate entropy (r=0.74; P=0.01). Using a linear regression model, we found that Pimax explained 44% of LFnu behavior during the RSA-M. Conclusion: COPD patients with impaired RMS presented altered cardiac autonomic control, characterized by marked sympathetic modulation and a reduced parasympathetic response; reduced HRV complexity was observed during the RSA-M. Keywords: COPD, heart rate, muscle strength, autonomic nervous system, sinus arrhythmiahttps://www.dovepress.com/respiratory-muscle-strength-effect-on-linear-and-nonlinear-heart-rate--peer-reviewed-article-COPDCOPDheart ratemuscle strengthautonomic nervous systemsinus arrhythmia
spellingShingle Goulart CL
Simon JC
Schneiders PB
San Martin EA
Cabiddu R
Borghi-Silva A
Trimer R
da Silva ALG
Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients
International Journal of COPD
COPD
heart rate
muscle strength
autonomic nervous system
sinus arrhythmia
title Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients
title_full Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients
title_fullStr Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients
title_full_unstemmed Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients
title_short Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients
title_sort respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in copd patients
topic COPD
heart rate
muscle strength
autonomic nervous system
sinus arrhythmia
url https://www.dovepress.com/respiratory-muscle-strength-effect-on-linear-and-nonlinear-heart-rate--peer-reviewed-article-COPD
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