Physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease: A cross-sectional analysis

Abstract

Background: The cardiac autonomic function in patients with chronic obstructive pulmonary disease (COPD) has been poorly studied.

Objectives: We aimed to 1) describe the cardiac autonomic function assessed by heart rate recovery (HRR) and chronotropic response (CR) during a 6-min walk test (6MWT) and afterward and 2) estimate the association of physical activity with HRR and CR in COPD patients.

Methods: This cross-sectional analysis included 320 patients with mild to very severe COPD. Physical activity (steps, time in any/moderate-to-vigorous/vigorous physical activity, intensity and sedentary time) was measured during 1 week by accelerometer. CR and HRR were measured during a 6MWT and 5min after, respectively, and their association with physical activity parameters was estimated by multivariable linear regression models.

Results: Patients were 82% male and had a mean (SD) age 68 (8) years, post-bronchodilator FEV₁ 57 (18) % predicted, and walked a mean of 7716 (4139) steps/day. HRR was slow until 5min after the 6MWT; the mean (SD) HRR was 15 (10), 22 (11), 25 (12), 25 (12) and 27 (12) bpm after 1, 2, 3, 4 and 5min, respectively. The mean (SD) CR was 35% (16). After adjusting for relevant confounders, time in vigorous physical activity was significantly associated with a fast decrease in HRR (p=0.044) and an increase in CR (p=0.021). We found no independent association for other physical activity parameters.

Conclusion: A cardiac autonomic dysfunction is present in patients with mild to very severe COPD and is inversely related to the practice of vigorous physical activity. Trial registration ClinicalTrials.gov NCT01897298.

Keywords: Autonomic nervous system; Chronic obstructive; Exercise; Heart rate; Pulmonary disease.