Autonomic control of heart rate in patients with chronic cardiorespiratory disease and in healthy participants at rest and during a respiratory sinus arrhythmia maneuver

作者：Reis Michel S; Deus Ana P; Simoes Rodrigo P; Aniceto Isabela A V; Catai Aparecida M; Borghi Silva Audrey^*

来源：Revista Brasileira de Fisioterapia, 2010, 14(2): 106-113.

DOI：10.1590/S1413-35552010005000003

• chronic obstructive pulmonary disease
• chronic heart failure
• autonomic control of heart rate
• respiratory sinus arrhythmia

Objective: To evaluate the autonomic modulation of heart rate (HR) at rest in the supine position and during a respiratory sinus arrhythmia maneuver (M-RSA) among participants with chronic obstructive pulmonary disease (COPD) or with chronic heart failure (CHF). Methods: Twenty-eight men were divided into three groups: ten with COPD, aged 69 9 years; nine with CHF, aged 62 8 years; and nine healthy participants aged 64 5 years (controls). At rest, the R-R interval of the electrocardiographic signal was obtained in the following situations: 1) 15 min in the supine position; and 2) 4 min during M-RSA in the supine position. The data were analyzed in the time domain (RMSSD and SDNN indices) and the frequency domain (LFab and HFab). During M-RSA, the expiratory/inspiratory ratio (E/I) and the inspiratory/expiratory difference (Delta IE) were calculated. Results: The main findings showed that the CHF patients presented lower RMSSD (12.2 +/- 2.6 vs. 20.4 +/- 6.5), LFab (99.2 +/- 72.7 vs. 305.3 +/- 208.9) and HFab (53.4 +/- 29.9 vs. 178.9 +/- 113.1), compared with the controls. The LFab band was significantly lower in the COPD group than in the controls (133.8 +/- 145.5 vs. 305.3 +/- 208.9). Additionally, both CHF patients and COPD patients showed lower E/I ratios (1.1 +/- 0.06 vs. 1.2 +/- 0.1 and 1.1 +/- 0.03 vs. 1.2 +/- 0.1) and Delta IE values (7.0 +/- 3.5 vs. 12.7 +/- 0.1 and 4.9 +/- 1.6 vs. 12.7 +/- 0.1), respectively, compared with the controls during M-RSA. Conclusion: The results from this study suggest that both COPD and CHF have a negative impact on the autonomic control of heart rate.

• 出版日期2010-4