Are heart rate dynamics in the transition from rest to submaximal exercise related to maximal cardiorespiratory responses in COPD?

作者：Mazzuco Adriana; Medeiros Wladimir Musetti; de Souza Aline Soares; Noman Alencar Maria Clara; Neder Jose Alberto; Borghi Silva Audrey^*

来源：Brazilian Journal of Physical Therapy, 2017, 21(4): 251-258.

DOI：10.1016/j.bjpt.2017.05.002

• Six minute walk test
• Cardiopulmonary exercise testing
• Cardiac autonomic nervous system
• Rehabilitation

Background: Poor exercise capacity is an important negative prognostic marker in patients with chronic obstructive pulmonary disease (COPD). Heart rate variability (HRV) responses can indicate alterations in cardiac autonomic control. Nevertheless, it remains unclear whether these abnormalities are related to cardiorespiratory responses to exercise in these patients.
Objective: To evaluate whether HRV at rest and submaximal exercise are related to impaired cardiopulmonary responses to exercise in COPD patients.
Methods: Fifteen men (66.2 +/- 8.7 years) with COPD (FEV1: 55.1 +/- 19.2%) were assessed. The R-R interval (RRi) data collection was performed at rest (stand position) and during the six-minute walk test (6MWT). All patients performed a symptom-limited cardiopulmonary exercise test on a cycle ergometer. The HRV changes from rest to submaximal exercise (Delta rest-6MWT) were calculated.
Results: We found significant correlations between low frequency (LF) and high frequency (HF) Delta rest-6MWT with Delta oxyhemoglobin saturation by pulse oximetry (r = -0.64 and r = 0.65, respectively; p < 0.05), minute ventilation/carbon dioxide output relationship from beginning to peak exercise (r = -0.52 and r = 0.53, p < 0.05), and exercise ventilatory power (r = 0.52 and r =-0.53, p < 0.05). Interestingly, there was a strong positive correlation (r = 0.82, p < 0.05) between six-minute walk distance (6MWD) and Delta LF/HF from rest to exercise.
Conclusion: HRV analysis in the transition from rest to submaximal exercise is associated with exercise ventilatory and hemodynamic abnormalities in COPD patients. Rehabilitative strategies to improve HRV responses may provide an important tool to clinical practice in these patients.

• 出版日期2017-8