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Nonlinear Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease and Changes after 4-week
Ina Zivanovic1, Eva Zupanic2, Viktor Avbelj3
1University Medical Centre Ljubljana, Slovenia.
Nonlinear Dynamics, Psychology, and Life Sciences
|April 2, 2022
Summary
Nonlinear heart rate variability (NHRV) in chronic obstructive pulmonary disease (COPD) patients indicates altered autonomic regulation. Pulmonary rehabilitation improved NHRV markers, suggesting reduced arrhythmia risk.
Area of Science:
- Cardiology
- Pulmonology
- Biomedical Engineering
- Autonomic Neuroscience
Background:
- Cardiovascular disease (CVD) is a primary cause of mortality in patients with chronic obstructive pulmonary disease (COPD).
- Nonlinear heart rate variability (NHRV) measures serve as indicators and predictors of CVD, especially arrhythmias.
- Autonomic nervous system dysfunction is implicated in the pathophysiology of COPD and its associated cardiovascular complications.
Purpose of the Study:
- To investigate NHRV in patients with COPD compared to healthy individuals.
- To examine the changes in NHRV following a pulmonary rehabilitation program in COPD patients.
- To assess the relationship between NHRV parameters and autonomic regulation in COPD.
Main Methods:
- Analysis of 20-minute electrocardiogram (ECG) recordings.
- Comparison of NHRV measures (detrended fluctuation analysis DFA1, DFA2; fractal dimension FD; sample entropy) between 45 healthy individuals and 31 COPD patients.
- Evaluation of NHRV changes in 16 COPD patients post-pulmonary rehabilitation versus 13 age- and sex-matched controls.
Main Results:
- Patients with COPD exhibited significantly lower DFA1 compared to healthy controls (p=.038).
- Pulmonary rehabilitation led to a decrease in high fractal dimension (p=.018) and an increase in DFA2 (p=.043).
- Cluster analysis revealed an increase in DFA1 among patients undergoing rehabilitation (p=.032), particularly those with initial DFA1 values below 1.
Conclusions:
- NHRV alterations in COPD patients reflect impaired autonomic regulation.
- Reduced DFA1 in COPD suggests a heightened pro-arrhythmic substrate and altered parasympathetic modulation.
- Pulmonary rehabilitation may positively modulate autonomic function, as indicated by NHRV changes.
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