Skip to main content
Log in

Heart Rate Variability and Disease Characteristics in Patients with COPD

  • Published:
Lung Aims and scope Submit manuscript

Abstract

Heart rate variability (HRV) is reduced in patients with chronic obstructive pulmonary disease (COPD). However, the relationships among HRV and characteristics of COPD are unknown. The aim of this study was to characterize HRV in patients with COPD and to verify the correlation of HRV measured during rest with disease severity and pulmonary, muscular, and functional impairment. Thirty-one patients with COPD (16 male; 66 ± 8 years; BMI = 24 ± 6 kg/m2; FEV1 = 46 ± 16% predicted) without severe cardiac dysfunction were included. HRV assessment was performed by the head-up tilt test (HUTT), and the main variables used for analysis were SDNN index, LF/HF ratio, and R-R intervals. Other tests included spirometry, bioelectrical impedance, cardiopulmonary exercise test, 6-minute walk test, respiratory and peripheral muscle force, health-related quality of life and functional status questionnaires, and objective quantification of physical activity level in daily life with the DynaPort® and SenseWear® armband activity monitors, besides calculation of the BODE index. There was a statistical difference in all variables of HRV between the HUTT positions (lying and standing). There was no correlation of HRV with BODE index or FEV1. Out of the BODE index, just the BMI was correlated with SDNN and R-R intervals (r = 0.44; p < 0.05 and r = 0.37; p < 0.05, respectively). There was correlation between HRV reduction and a lower level of physical activity in daily life, besides worse health-related quality of life, functional status, and respiratory and peripheral muscle force. Cardiac autonomic function of patients with COPD is not related to disease severity but mainly to the level of physical activity in daily life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Task Force of the European Society of Cardiology, the North American Society of Pacing, Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 93:1043–1065

    Google Scholar 

  2. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J, Global Initiative for Chronic Obstructive Lung Disease (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 176:532–555

    Article  PubMed  Google Scholar 

  3. Burrows B, Earle RH (1969) Prediction of survival in patients with chronic airway obstruction. Am Rev Respir Dis 99:865–871

    PubMed  CAS  Google Scholar 

  4. Anthonisen NR, Wright EC, Hodgkin JE (1986) Prognosis in chronic obstructive pulmonary disease. Am Rev Respir Dis 133:14–20

    PubMed  CAS  Google Scholar 

  5. Celli BR, Cote CG, Marin JM, Casanova C, Montes dO, Mendez RA, Pinto P, V, Cabral HJ (2004) The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 350:1005–1012

  6. Troosters T, Casaburi R, Gosselink R, Decramer M (2005) Pulmonary rehabilitation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 172:19–38

    Article  PubMed  Google Scholar 

  7. Volterrani M, Scalvini S, Mazzuero G, Lanfranchi P, Colombo R, Clark AL, Levi G (1994) Decreased heart rate variability in patients with chronic obstructive pulmonary disease. Chest 106:1432–1437

    Article  PubMed  CAS  Google Scholar 

  8. Pagani M, Lucini D, Pizzinelli P, Sergi M, Bosisio E, Mela GS, Malliani A (1996) Effects of aging and of chronic obstructive pulmonary disease on RR interval variability. J Auton Nerv Syst 59:125–132

    Article  PubMed  CAS  Google Scholar 

  9. Bartels MN, Jelic S, Gonzalez JM, Kim W, De Meersman RE (2004) Reproducibility of heart rate and blood pressure variability in patients with chronic obstructive pulmonary disease. Clin Auton Res 14:194–196

    Article  PubMed  Google Scholar 

  10. Yamamoto Y, Hughson RL, Peterson JC (1991) Autonomic control of heart rate during exercise studied by heart rate variability spectral analysis. J Appl Physiol 71:1136–1142

    PubMed  CAS  Google Scholar 

  11. Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell’Orto S, Piccaluga E et al (1986) Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res 59:178–193

    PubMed  CAS  Google Scholar 

  12. Malliani A, Pagani M, Lombardi F, Cerutti S (1991) Cardiovascular neural regulation explored in the frequency domain. Circulation 84:482–492

    PubMed  CAS  Google Scholar 

  13. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J 16(Suppl):5–40

  14. Knudson RJ, Slatin RC, Lebowitz MD, Burrows B (1976) The maximal expiratory flow-volume curve. Normal standards, variability, and effects of age. Am Rev Respir Dis 113:587–600

    PubMed  CAS  Google Scholar 

  15. American Thoracic Society (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166:111–117

    Google Scholar 

  16. Troosters T, Gosselink R, Decramer M (1999) Six minute walking distance in healthy elderly subjects. Eur Respir J 14:270–274

    Article  PubMed  CAS  Google Scholar 

  17. American Thoracic Society; American College of Chest Physicians (2003) ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 167:211–277

    Article  Google Scholar 

  18. Probst VS, Troosters T, Pitta F, Decramer M, Gosselink R (2006) Cardiopulmonary stress during exercise training in patients with COPD. Eur Respir J 27:1110–1118

    Article  PubMed  CAS  Google Scholar 

  19. Lukaski HC, Bolonchuk WW, Hall CB, Siders WA (1986) Validation of tetrapolar bioelectrical impedance method to assess human body composition. J Appl Physiol 60:1327–1332

    PubMed  CAS  Google Scholar 

  20. Kyle UG, Pichard C, Rochat T, Slosman DO, Fitting JW, Thiebaud D (1998) New bioelectrical impedance formula for patients with respiratory insufficiency: comparison to dual-energy X-ray absorptiometry. Eur Respir J 12:960–966

    Article  PubMed  CAS  Google Scholar 

  21. Black LF, Hyatt RE (1969) Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis 99:696–702

    PubMed  CAS  Google Scholar 

  22. Neder JA, Andreoni S, Lerario MC, Nery LE (1999) Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res 32:719–727

    CAS  Google Scholar 

  23. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S (1985) Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil 66:69–74

    PubMed  CAS  Google Scholar 

  24. Garrod R, Bestall JC, Paul EA, Wedzicha JA, Jones PW (2000) Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London Chest Activity of Daily Living scale (LCADL). Respir Med 94:589–596

    Article  PubMed  CAS  Google Scholar 

  25. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA (1999) Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 54:581–586

    Article  PubMed  CAS  Google Scholar 

  26. Camelier A, Rosa FW, Salim C, Nascimento OA, Cardoso F, Jardim JR (2006) Using the Saint George’s Respiratory Questionnaire to evaluate quality of life in patients with chronic obstructive pulmonary disease: validating a new version for use in Brazil. J Bras Pneumol 32:114–122

    Article  PubMed  Google Scholar 

  27. Pitta F, Troosters T, Spruit MA, Decramer M, Gosselink R (2005) Activity monitoring for assessment of physical activities in daily life in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 86:1979–1985

    Article  PubMed  Google Scholar 

  28. Patel SA, Benzo RP, Slivka WA, Sciurba FC (2007) Activity monitoring and energy expenditure in COPD patients: a validation study. COPD 4:107–112

    Article  PubMed  Google Scholar 

  29. Pitta F, Troosters T, Spruit MA, Probst VS, Decramer M, Gosselink R (2005) Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 171:972–977

    Article  PubMed  Google Scholar 

  30. Schols AM, Slangen J, Volovics L, Wouters EF (1998) Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 157:1791–1797

    PubMed  CAS  Google Scholar 

  31. Landbo C, Prescott E, Lange P, Vestbo J, Almdal TP (1999) Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 160:1856–1861

    PubMed  CAS  Google Scholar 

  32. Brenes GA (2003) Anxiety and chronic obstructive pulmonary disease: prevalence, impact, and treatment. Psychosom Med 65:963–970

    Article  PubMed  Google Scholar 

  33. Zuckerman M, Persky H, Curtis GC (1968) Relationships among anxiety, depression, hostility and autonomic variables. J Nerv Ment Dis 146:481–487

    Article  PubMed  CAS  Google Scholar 

  34. Melo RC, Santos MD, Silva E, Quiterio RJ, Moreno MA, Reis MS, Verzola IA, Oliveira L, Martins LE, Gallo-Junior L, Catai AM (2005) Effects of age and physical activity on the autonomic control of heart rate in healthy men. Braz J Med Biol Res 38:1331–1338

    Article  PubMed  CAS  Google Scholar 

  35. Reland S, Ville NS, Wong S, Senhadji L, Carre F (2004) Does the level of chronic physical activity alter heart rate variability in healthy older women? Clin Sci (Lond) 107:29–35

    Article  Google Scholar 

  36. Fagard RH, Pardaens K, Staessen JA (1999) Influence of demographic, anthropometric and lifestyle characteristics on heart rate and its variability in the population. J Hypertens 17:1589–1599

    PubMed  CAS  Google Scholar 

  37. Gulli G, Cevese A, Cappelletto P, Gasparini G, Schena F (2003) Moderate aerobic training improves autonomic cardiovascular control in older women. Clin Auton Res 13:196–202

    PubMed  Google Scholar 

  38. Pichot V, Roche F, Denis C, Garet M, Duverney D, Costes F, Barthélémy JC (2005) Interval training in elderly men increases both heart rate variability and baroreflex activity. Clin Auton Res 15:107–115

    Article  PubMed  Google Scholar 

  39. Sewell L, Singh SJ, Williams JE, Collier R, Morgan MD (2005) Can individualized rehabilitation improve functional independence in elderly patients with COPD? Chest 128:1194–1200

    Article  PubMed  Google Scholar 

  40. Pitta F, Troosters T, Probst VS, Langer D, Decramer M, Gosselink R (2008) Are patients with COPD more active after pulmonary rehabilitation? Chest 134:273–280

    Article  PubMed  Google Scholar 

  41. Mercken EM, Hageman GJ, Schols AM, Akkermans MA, Bast A, Wouters EF (2005) Rehabilitation decreases exercise-induced oxidative stress in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 172:994–1001

    Article  PubMed  Google Scholar 

  42. Baarends EM, Schols AM, Mostert R, Wouters EF (1997) Peak exercise response in relation to tissue depletion in patients with chronic obstructive pulmonary disease. Eur Respir J 10:2807–2813

    Article  PubMed  CAS  Google Scholar 

  43. American Thoracic Society; European Respiratory Society (1999) Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 159:S1–S40

    Google Scholar 

  44. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC et al (1995) Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273:402–407

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fabio Pitta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Camillo, C.A., Pitta, F., Possani, H.V. et al. Heart Rate Variability and Disease Characteristics in Patients with COPD. Lung 186, 393–401 (2008). https://doi.org/10.1007/s00408-008-9105-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-008-9105-7

Keywords

Navigation