Abstract

Introduction: Autonomic regulation may play role in physiology of COPD, which was evaluted by using heart rate variability in rehabilitation.

Methods: R-R intervals were measured for 6 minutes in 36 patients (16 female; 20 male). Ectopic beats were eliminated. Parameters used: minimal pulse (p.min), average pulse (p.avg), maximal pulse (p.max), maximum-minimum pulse difference (p.max-p.min). Long term continuous RR intervals (stda), standard deviation of instantaneous beat-to-beat variability (stdb), the number of pairs of adjacent NN intervals differing by more than 50 ms divided by the total number of all NN intervals (pNN50). Spectral analysis provided the low-frequency/high-frequency ratio (LF/HF).

Results: HRV showed decreased p.max-p.min (15,78±9,2bpm), depressed dynamics (stda:39,63±33,5; stdb:22,72±35,84) with sympathetic overload (pNN50:3,17±5,24, LF/HF:169,52±208,83) heavy parasympathetic modulation (pNN50:5,51±5,59, LF/HF:27,28±13,12) in severe COPD patients. Rehabilitation resulted in lowered p.min-p.max (12,5±9,01 bpm), overdepressed dynamics (stda:34,56±35,97 ; stdb:20,88±41,5) strong sympathetic overload (pNN50:3,33±6,76, LF/HF:252,01±351,16).

Conclusion: Patients showed abnormal physiologic response in resting autonomic regulation. The rehabilitation resulted in improvement in overall status, autonomic balance.