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. 2010 Apr;65(4):369-75.
doi: 10.1590/S1807-59322010000400004.

Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease

Michel Silva Reis  1 , Ross Arena, Ana Paula Deus, Rodrigo Polaquini Simões, Aparecida Maria Catai, Audrey Borghi-Silva
Affiliations

Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease

Michel Silva Reis et al. Clinics (Sao Paulo). 2010 Apr.

Abstract

Background: A synchronism exists between the respiratory and cardiac cycles. However, the influence of the inspiratory muscle weakness in chronic obstructive pulmonary disease (COPD) on cardiac autonomic control is unknown. The purpose of the present investigation was to evaluate the influence of respiratory muscle strength on autonomic control in these patients.

Methods: Ten chronic obstructive pulmonary disease patients (69+/-9 years; FEV(1)/FVC 59+/-12% and FEV(1) 41+/-11% predicted) and nine age-matched healthy volunteers (64+/-5 years) participated in this study. Heart-rate variability (HRV) was obtained at rest and during respiratory sinusal arrhythmia maneuver (RSA-M) by electrocardiograph.

Results: Chronic obstructive pulmonary disease patients demonstrated impaired cardiac autonomic modulation at rest and during RSA-M when compared with healthy subjects (p<0.05). Moreover, significant and positive correlations between maximal inspiratory pressure (MIP) and the inspiratory-expiratory difference (DeltaIE) (r = 0.60, p<0.01) were found.

Conclusion: Patients with chronic obstructive pulmonary disease presented impaired sympathetic-vagal balance at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in chronic obstructive pulmonary disease. Based on this evidence, future research applications of respiratory muscle training may bring to light a potentially valuable target for rehabilitation.

Keywords: COPD; Heart-rate variability; Respiratory muscle strength; Respiratory sinusal arrhythmia.

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Figures

Figure 1
Figure 1
Comparison of the heart-rate variability index obtained at rest for all groups. (A) RMSSD: the square root of the sum of the squares of differences between adjacent NN intervals; (B) SDNN: the standard deviation of NN intervals; (C) High frequency; and (D) Low Frequency.
Figure 2
Figure 2
Decomposition of the spectrum into single spectral components of very low frequency (VLF), low frequency (LF), and high frequency (HF) during the respiratory sinusal arrhythmia maneuver. (A) COPD patients; (B) Control group.
Figure 3
Figure 3
Pearson correlation. Correlation between MIP and inspiratory-expiratory differences (I-E differences). (Legend: □ = COPD and + = Control).
See this image and copyright information in PMC

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