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Acute effects of different levels of continuous positive airway pressure on cardiac autonomic modulation in chronic heart failure and chronic obstructive pulmonary disease.

Reis MS, Sampaio LM, Lacerda D, De Oliveira LV, Pereira GB, Pantoni CB, Thommazo LD, Catai AM, Borghi-Silva A - Arch Med Sci (2010)

Bottom Line: Non-invasive ventilation may improve autonomic modulation and ventilatory parameters in severely disabled patients.Respiratory rate, end tidal carbon dioxide (E(T)CO(2)), peripheral oxygen saturation (SpO(2)), heart rate (HR), blood pressure and heart rate variability in the time and frequency domains were measured during spontaneous breathing and under the sham, CPAP5 and CPAP10 conditions.In the CHF group, CPAP5 and CPAP10 increased the SDNN value (p < 0.05).

View Article: PubMed Central - PubMed

Affiliation: Cardiopulmonary Physiotherapy Laboratory, Center for Research in Physical Exercise, Federal University of São Carlos, São Paulo, Brazil.

ABSTRACT

Introduction: Non-invasive ventilation may improve autonomic modulation and ventilatory parameters in severely disabled patients. The aim of the present study was to evaluate the physiological influence of acute treatment with different levels of continuous positive airway pressure (CPAP) on the autonomic balance of heart and respiratory responses in patients with stable chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF).

Materials and methods: A COPD group (n = 10), CHF group (n = 8) and healthy subjects (n = 10) were evaluated. The participants were randomized to receive three different levels of CPAP on the same day: sham ventilation (Sham), 5 cmH(2)0 (CPAP5) and 10 cmH(2)0 (CPAP10) for 10 min. Respiratory rate, end tidal carbon dioxide (E(T)CO(2)), peripheral oxygen saturation (SpO(2)), heart rate (HR), blood pressure and heart rate variability in the time and frequency domains were measured during spontaneous breathing and under the sham, CPAP5 and CPAP10 conditions.

Results: All groups experienced a reduction in E(T)CO(2) values during treatment with CPAP (p < 0.05). CPAP increased SpO(2) and HR in the COPD group (p < 0.05). The COPD group also had lower RMSSD values during treatment with different levels of CPAP when compared to the control group (p < 0.05). In the CHF group, CPAP5 and CPAP10 increased the SDNN value (p < 0.05). CPAP10 reduced the SDNN value in the COPD group (p < 0.05).

Conclusion: The findings suggest that CPAP may cause improvements in the neural control of heart rate in patients with stable COPD and CHF. For each patient, the "best CPAP level" should be defined as the best respiratory response and autonomic balance.

No MeSH data available.


Related in: MedlinePlus

Heart rate variability during spontaneous breathing (SB) and different CPAP levelsasignificant intra-group differences compared to SB,dsignificant intra-group differences between CPAP10 vs. CPAP5, Data are presented as mean ± SD, Sham – breathing at 3 cmH2O, CPAP5 – breathing at 5 cmH2O positive pressure, CPAP10 – breathing at 10 cmH2O positive pressure, RMSSD (ms) index – SDNN index
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Figure 2: Heart rate variability during spontaneous breathing (SB) and different CPAP levelsasignificant intra-group differences compared to SB,dsignificant intra-group differences between CPAP10 vs. CPAP5, Data are presented as mean ± SD, Sham – breathing at 3 cmH2O, CPAP5 – breathing at 5 cmH2O positive pressure, CPAP10 – breathing at 10 cmH2O positive pressure, RMSSD (ms) index – SDNN index

Mentions: A significant increase in HR occurred during treatment with sham CPAP and 5 cmH2O compared to spontaneous breathing in the COPD group. During treatment with CPAP 5 and 10 cmH2O, higher HR values were found in the COPD group when compared to the CHF group (Table III). In the time domain, significantly lower RMSSD values during treatment with different CPAP levels when compared to spontaneous breathing were found in the COPD group alone (Figure 2). Moreover, significantly lower RMSSD values were found during treatment with different CPAP levels in the COPD group when compared to the control group (Table III). In the CHF group, significant increases in SDNN and power spectral density were found during treatment with CPAP 5 and 10 cmH2O when compared to spontaneous breathing (Figure 2). In the inter-group comparisons, lower SDNN values were found in the COPD group during treatment with CPAP 10 cmH2O when compared to the control group (Table III). No significant intra-group differences in R-Ri values were found during treatment with the different CPAP levels when compared to spontaneous breathing. In the inter-group comparisons, higher R-Ri values during treatment with the different CPAP levels were found in the COPD group when compared to the control group.


Acute effects of different levels of continuous positive airway pressure on cardiac autonomic modulation in chronic heart failure and chronic obstructive pulmonary disease.

Reis MS, Sampaio LM, Lacerda D, De Oliveira LV, Pereira GB, Pantoni CB, Thommazo LD, Catai AM, Borghi-Silva A - Arch Med Sci (2010)

Heart rate variability during spontaneous breathing (SB) and different CPAP levelsasignificant intra-group differences compared to SB,dsignificant intra-group differences between CPAP10 vs. CPAP5, Data are presented as mean ± SD, Sham – breathing at 3 cmH2O, CPAP5 – breathing at 5 cmH2O positive pressure, CPAP10 – breathing at 10 cmH2O positive pressure, RMSSD (ms) index – SDNN index
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3298341&req=5

Figure 2: Heart rate variability during spontaneous breathing (SB) and different CPAP levelsasignificant intra-group differences compared to SB,dsignificant intra-group differences between CPAP10 vs. CPAP5, Data are presented as mean ± SD, Sham – breathing at 3 cmH2O, CPAP5 – breathing at 5 cmH2O positive pressure, CPAP10 – breathing at 10 cmH2O positive pressure, RMSSD (ms) index – SDNN index
Mentions: A significant increase in HR occurred during treatment with sham CPAP and 5 cmH2O compared to spontaneous breathing in the COPD group. During treatment with CPAP 5 and 10 cmH2O, higher HR values were found in the COPD group when compared to the CHF group (Table III). In the time domain, significantly lower RMSSD values during treatment with different CPAP levels when compared to spontaneous breathing were found in the COPD group alone (Figure 2). Moreover, significantly lower RMSSD values were found during treatment with different CPAP levels in the COPD group when compared to the control group (Table III). In the CHF group, significant increases in SDNN and power spectral density were found during treatment with CPAP 5 and 10 cmH2O when compared to spontaneous breathing (Figure 2). In the inter-group comparisons, lower SDNN values were found in the COPD group during treatment with CPAP 10 cmH2O when compared to the control group (Table III). No significant intra-group differences in R-Ri values were found during treatment with the different CPAP levels when compared to spontaneous breathing. In the inter-group comparisons, higher R-Ri values during treatment with the different CPAP levels were found in the COPD group when compared to the control group.

Bottom Line: Non-invasive ventilation may improve autonomic modulation and ventilatory parameters in severely disabled patients.Respiratory rate, end tidal carbon dioxide (E(T)CO(2)), peripheral oxygen saturation (SpO(2)), heart rate (HR), blood pressure and heart rate variability in the time and frequency domains were measured during spontaneous breathing and under the sham, CPAP5 and CPAP10 conditions.In the CHF group, CPAP5 and CPAP10 increased the SDNN value (p < 0.05).

View Article: PubMed Central - PubMed

Affiliation: Cardiopulmonary Physiotherapy Laboratory, Center for Research in Physical Exercise, Federal University of São Carlos, São Paulo, Brazil.

ABSTRACT

Introduction: Non-invasive ventilation may improve autonomic modulation and ventilatory parameters in severely disabled patients. The aim of the present study was to evaluate the physiological influence of acute treatment with different levels of continuous positive airway pressure (CPAP) on the autonomic balance of heart and respiratory responses in patients with stable chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF).

Materials and methods: A COPD group (n = 10), CHF group (n = 8) and healthy subjects (n = 10) were evaluated. The participants were randomized to receive three different levels of CPAP on the same day: sham ventilation (Sham), 5 cmH(2)0 (CPAP5) and 10 cmH(2)0 (CPAP10) for 10 min. Respiratory rate, end tidal carbon dioxide (E(T)CO(2)), peripheral oxygen saturation (SpO(2)), heart rate (HR), blood pressure and heart rate variability in the time and frequency domains were measured during spontaneous breathing and under the sham, CPAP5 and CPAP10 conditions.

Results: All groups experienced a reduction in E(T)CO(2) values during treatment with CPAP (p < 0.05). CPAP increased SpO(2) and HR in the COPD group (p < 0.05). The COPD group also had lower RMSSD values during treatment with different levels of CPAP when compared to the control group (p < 0.05). In the CHF group, CPAP5 and CPAP10 increased the SDNN value (p < 0.05). CPAP10 reduced the SDNN value in the COPD group (p < 0.05).

Conclusion: The findings suggest that CPAP may cause improvements in the neural control of heart rate in patients with stable COPD and CHF. For each patient, the "best CPAP level" should be defined as the best respiratory response and autonomic balance.

No MeSH data available.


Related in: MedlinePlus