Rationale

The study aimed to investigate the interplay among respiratory function, autonomic dysfunction, and systemic inflammation in COPD patients.

Methods

In 19 COPD patients, functional respiratory parameters, heart rate variability (HRV), and plasma high-sensitivity-C-reactive-protein (hs-CRP) were assessed. Forced oscillation technique (FOT) was used to detect the absence (NFL) or presence (FL) of resting tidal expiratory flow limitation. Subsequently, patients underwent an incremental shuttle walking test (ISWT). Twenty healthy subjects were also shown as controls.

Results

FEV₁, DL_CO, and lung volumes displayed significant correlations with LH/FH ratio (0.56 < r²<0.27,p < 0.01). A significant relationship was found between LH/FH ratio with IC/TLC ratio% (r² = 0.29,p < 0.05) and hs-CRP (r² = 0.26,p < 0.05). Patients with FL had greater hs-CRP plasma levels (p < 0.05), lower IC/TLC% (p < 0.05), and higher LH/FH ratio (p<0.001).

Conclusions

Worse airflow obstruction was associated with a higher LH/HF ratio, directly related, to hs-CRP and indices of dynamic hyperinflation. The presence of resting tidal FL with dynamic pulmonary hyperinflation is a strong driver of systemic inflammation and autonomic dysfunction.

中文翻译：

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呼吸功能、自主神经功能障碍和全身炎症与 COPD 和潮汐流受限患者密切相关：一项探索性研究

基本原理

该研究旨在调查 COPD 患者呼吸功能、自主神经功能障碍和全身炎症之间的相互作用。

方法

在 19 名 COPD 患者中，评估了功能性呼吸参数、心率变异性 (HRV) 和血浆高敏 C 反应蛋白 (hs-CRP)。强制振荡技术 (FOT) 用于检测静息呼气流量限制的缺失 (NFL) 或存在 (FL)。随后，患者接受了增量穿梭行走试验（ISWT）。二十个健康受试者也显示为对照。

结果

FEV ₁、DL _CO和肺容积显示出与 LH/FH 比值的显着相关性（0.56 < r ² <0.27，p < 0.01）。发现 LH/FH 比率与 IC/TLC 比率%（r ² = 0.29，p < 0.05）和 hs-CRP（r ² = 0.26，p < 0.05）之间存在显着关系。FL 患者血浆 hs-CRP 水平较高（p < 0.05），IC/TLC% 较低（p < 0.05），LH/FH 比值较高（p<0.001）。

结论

更严重的气流阻塞与较高的 LH/HF 比值相关，与 hs-CRP 和动态过度充气指数直接相关。伴有动态肺过度充气的静息潮汐 FL 的存在是全身炎症和自主神经功能障碍的重要驱动因素。