Noninvasive ventilation can modulate heart rate variability during high-intensity exercise in COPD-CHF patients,Heart & Lung

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Noninvasive ventilation can modulate heart rate variability during high-intensity exercise in COPD-CHF patients
Heart & Lung ( IF 2.8 ) Pub Date : 2021-06-01 , DOI: 10.1016/j.hrtlng.2021.04.004
Giovana Salgado Baffa ₁ , Cássia da Luz Goulart ₁ , Flávia Rossi Caruso ₁ , Adriana S Garcia de Araújo ₁ , Polliana Batista Dos Santos ₁ , Meliza Goi Roscani ₂ , Fabio Rodrigo Prone ₃ , José Carlos Bonjorno ₂ , Renata Gonçalves Mendes ₁ , Audrey Borghi-Silva ₁

Affiliation

Objective

to assess the acute effects of non-invasive ventilation (NIV) during high-intensity exercise on heart rate variability (HRV) responses in chronic obstructive pulmonary disease (COPD) and Chronic heart failure (CHF) patients.

Methods

This was randomized, double blinded and controlled study. Fourteen patients with COPD-HF diagnosis were evaluated. The subjects underwent to the following tests: (I) cardiopulmonary exercise testing (CPET) on a cycle ergometer ramp protocol; (II) 7 days after CPET, patients randomly underwent two constant-load exercise (CLE) with NIV or Sham ventilation until tolerance limit, with 80% of the CPET peak load. R-R intervals (RRi) were continuously collected during rest, exercise and in recovery. Time and frequency domain and nonlinear heart rate variability (HRV) indices were obtained.

Results

NIV resulted in a decrease of Mean iRR, square root of the mean squared differences of successive RRi (rMSSD), RR tri index and high-frequency (HF), nu (p < 0.05) and increase of Mean HR, low-frequency (LF), nu and LF/HF (p < 0.05) during exercise when compared to rest. In addition, NIV during exercise induced lower rMSSD and Sample Entropy when compared with Sham (p < 0.05). Negative correlation was found between forced expiratory volume in 1 second (FEV_1, L) vs HF (nu) during exercise with NIV (p = 0.04; r= -0.58). Furthermore, simple linear regression showed that the FEV₁ (L) affected 30% of the HF (nu) response during the exercise with NIV.

Conclusion

NIV during exercise produced enhanced heart rate and autonomic responses in COPD-CHF patients. Additionally, COPD severity is negatively associated with a higher vagal response during exercise with NIV.

中文翻译：

无创通气可调节 COPD-CHF 患者高强度运动期间的心率变异性

客观的

评估高强度运动期间无创通气 (NIV) 对慢性阻塞性肺病 (COPD) 和慢性心力衰竭 (CHF) 患者心率变异性 (HRV) 反应的急性影响。

方法

这是随机、双盲和对照研究。对 14 名诊断为 COPD-HF 的患者进行了评估。受试者接受了以下测试：（I）基于自行车测力计斜坡协议的心肺运动测试（CPET）；（二）CPET后7天，患者随机进行两次恒负荷运动（CLE），NIV或Sham通气直至耐受极限，达到CPET峰值负荷的80%。在休息、运动和恢复期间连续收集 RR 间期 (RRi)。获得了时域和频域以及非线性心率变异性 (HRV) 指数。

结果

NIV 导致平均 iRR、连续RRi (rMSSD)、RR 三指数和高频 (HF)、nu (p < 0.05)的均方差的平方根和平均 HR、低频 ( LF)、nu 和 LF/HF (p < 0.05) 与休息相比。此外，与假手术相比，运动期间的 NIV 会导致较低的 rMSSD 和样本熵（p < 0.05）。发现NIV 运动期间1 秒用力呼气量 (FEV _1, L)与HF (nu)之间呈负相关（p = 0.04；r = -0.58）。此外，简单的线性回归表明 FEV ₁ (L) 在 NIV 运动期间影响了 30% 的 HF (nu) 反应。