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Shi M, Qumu S, Wang S, Peng Y, Yang L, Huang K, He R, Dong F, Niu H, Yang T, Wang C. Abnormal heart rate responses to exercise in non-severe COPD: relationship with pulmonary vascular volume and ventilatory efficiency. BMC Pulm Med 2024; 24:183. [PMID: 38632576 PMCID: PMC11022473 DOI: 10.1186/s12890-024-03003-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Despite being a prognostic predictor, cardiac autonomic dysfunction (AD) has not been well investigated in chronic obstructive pulmonary disease (COPD). We aimed to characterise computed tomography (CT), spirometry, and cardiopulmonary exercise test (CPET) features of COPD patients with cardiac AD and the association of AD with CT-derived vascular and CPET-derived ventilatory efficiency metrics. METHODS This observational cohort study included stable, non-severe COPD patients. They underwent clinical evaluation, spirometry, CPET, and CT. Cardiac AD was determined based on abnormal heart rate responses to exercise, including chronotropic incompetence (CI) or delayed heart rate recovery (HRR) during CPET. RESULTS We included 49 patients with FEV1 of 1.2-5.0 L (51.1-129.7%), 24 (49%) had CI, and 15 (31%) had delayed HRR. According to multivariate analyses, CI was independently related to reduced vascular volume (VV; VV ≤ median; OR [95% CI], 7.26 [1.56-33.91]) and low ventilatory efficiency (nadir VE/VCO2 ≥ median; OR [95% CI], 10.67 [2.23-51.05]). Similar results were observed for delayed HRR (VV ≤ median; OR [95% CI], 11.46 [2.03-64.89], nadir VE/VCO2 ≥ median; OR [95% CI], 6.36 [1.18-34.42]). CONCLUSIONS Cardiac AD is associated with impaired pulmonary vascular volume and ventilatory efficiency. This suggests that lung blood perfusion abnormalities may occur in these patients. Further confirmation is required in a large population-based cohort.
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Affiliation(s)
- Minghui Shi
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Capital Medical University, 100069, Beijing, China
| | - Shiwei Qumu
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Siyuan Wang
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, 100029, Beijing, China
| | - Yaodie Peng
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Peking University Health Science Center, 100871, Beijing, China
| | - Lulu Yang
- Fangzhuang Community Health Service Center, Capital Medical University, 100078, Beijing, China
| | - Ke Huang
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Ruoxi He
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Feng Dong
- Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, 100078, Beijing, China
| | - Hongtao Niu
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China
| | - Ting Yang
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
| | - Chen Wang
- National Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- National Clinical Research Center for Respiratory Diseases, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, 100029, Beijing, China.
- Capital Medical University, 100069, Beijing, China.
- Chinese Academy of Medical Sciences and Peking Union Medical College, No. 2 East Yinghua Road, Chaoyang District, 100730, Beijing, China.
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Wang J, Zang Y, Wu Q, She Y, Xu H, Zhang J, Cai S, Li Y, Zhang Z. Predicting Adverse Events During Six-Minute Walk Test Using Continuous Physiological Signals. Front Physiol 2022; 13:887954. [PMID: 35734001 PMCID: PMC9207457 DOI: 10.3389/fphys.2022.887954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/16/2022] [Indexed: 11/15/2022] Open
Abstract
Background and Objective: The 6-min walk test (6MWT) is a common functional assessment test, but adverse events during the test can be potentially dangerous and can lead to serious consequences and low quality of life. This study aimed to predict the occurrence of adverse events during 6MWT, using continuous physiological parameters combined with demographic variables. Methods: 578 patients with respiratory disease who had performed standardized 6MWT with wearable devices from three hospitals were included in this study. Adverse events occurred in 73 patients (12.6%). ECG, respiratory signal, tri-axial acceleration signals, oxygen saturation, demographic variables and scales assessment were obtained. Feature extraction and selection of physiological signals were performed during 2-min resting and 1-min movement phases. 5-fold cross-validation was used to assess the machine learning models. The predictive ability of different models and scales was compared. Results: Of the 16 features selected by the recursive feature elimination method, those related to blood oxygen were the most important and those related to heart rate were the most numerous. Light Gradient Boosting Machine (LightGBM) had the highest AUC of 0.874 ± 0.063 and the AUC of Logistic Regression was AUC of 0.869 ± 0.067. The mMRC (Modified Medical Research Council) scale and Borg scale had the lowest performance, with an AUC of 0.733 and 0.656 respectively. Conclusion: It is feasible to predict the occurrence of adverse event during 6MWT using continuous physiological parameters combined with demographic variables. Wearable sensors/systems can be used for continuous physiological monitoring and provide additional tools for patient safety during 6MWT.
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Affiliation(s)
| | - Yaning Zang
- Department of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Qian Wu
- Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Yingjia She
- Department of Pulmonary and Critical Care Medicine, Hainan Hospital of PLA General Hospital, Sanya, China
| | - Haoran Xu
- Medical School of Chinese PLA, Beijing, China
| | - Jian Zhang
- Medical School of Chinese PLA, Beijing, China
| | - Shan Cai
- Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuzhu Li
- Department of Pulmonary and Critical Care Medicine, Hainan Hospital of PLA General Hospital, Sanya, China
- *Correspondence: Yuzhu Li, ; Zhengbo Zhang,
| | - Zhengbo Zhang
- Center for Artificial Intelligence in Medicine, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yuzhu Li, ; Zhengbo Zhang,
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Castello-Simões V, Kabbach EZ, Schafauser NS, Camargo PF, Simões RP, Heubel AD, Alqahtani JS, da Cunha Martino Pereira MB, Sgarbosa NM, Borghi-Silva A, Mendes RG. Brain-heart autonomic axis across different clinical status and severity of chronic obstructive pulmonary disease. Respir Med 2021; 185:106511. [PMID: 34175805 DOI: 10.1016/j.rmed.2021.106511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Impairment of cardiac autonomic integrity is common in chronic obstructive pulmonary disease (COPD) patients. The influence of the interaction between clinical and severity status on brain-heart autonomic axis (BHAA) is not well known. We aimed to investigate the BHAA function across different clinical status and severity of COPD. METHODS Cross-sectional study involving 77 COPD patients allocated into four groups according to clinical status [acute exacerbation (GAE) or stable (GST)] and severity [less (-) or more (+)]: 1) GAE-, n = 13; 2) GAE+, n = 20; 3) GST-, n = 23; and 4) GST+, n = 21. Heart rate variability (HRV) at rest and heart rate recovery (HRR) after 6-min walk test were markers of BHAA. Mean R-R, STDRR, RMSSD, RRtri, HF, LF, SD1, SD2, ApEn and SampEn were the HRV indexes and, HRR was obtained as: HR at 1st min of recovery minus peak HR. RESULTS A main effect of clinical status (p < 0.001) was found to vagal modulation in GAE-vs. GST- (RMSSD: 25.0 ± 14.8 vs. 12.6 ± 5.5 ms; SD1: 18.0 ± 10.6 vs. 8.9 ± 3.9 ms) and to GAE + vs. GST+ (RMSSD: 26.4 ± 15.2 vs. 15.4 ± 6.3 ms; SD1: 18.3 ± 11.2 vs. 10.9 ± 4.5 ms). An effect of clinical status (p = 0.032) and severity (p = 0.030) were found to HF (vagal) in GAE + compared to GAE- and GST+ (264.7 ± 239.0 vs. 134.7 ± 169.7 and 135.8 ± 139.7 ms2). Lower HRR was found in GAE-compared to GST- (8.0 ± 2.4 vs. 19.6 ± 2.4 bpm), p = 0.002. CONCLUSION In COPD patients, clinical status (AECOPD or stable) was more dominant than the severity on BHAA function. A more pronounced parasympathetic modulation was found in AECOPD patients with a lower HRR to exercise.
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Affiliation(s)
- Viviane Castello-Simões
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Erika Zavaglia Kabbach
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Nathany Souza Schafauser
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Patrícia Faria Camargo
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Rodrigo Polaquini Simões
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil; Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, UNIFAL, Rua Gabriel Monteiro da Silva, 700, Centro, Postal Code: 37130-001, Alfenas, MG, Brazil.
| | - Alessandro Domingues Heubel
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Jaber Saud Alqahtani
- UCL Respiratory, University College London, Rowland Hill Street, London NW3 2PF, London, EN, United Kingdom; Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Al Amal Dhahran, 34313, Dammam, Saudi Arabia.
| | - Mariana Brasil da Cunha Martino Pereira
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Nicole Marques Sgarbosa
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of Sao Carlos - UFSCar, Rodovia Washington Luis, KM 235, Jardim Guanabara, 13565-905, Sao Carlos, SP, Brazil.
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