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Silva AMVD, Nard ATD, Righi GDA, Nascimento JR, Lima RM, Signori LU. Bilevel positive airway pressure improves the autonomic balance in the postoperative period following cardiac surgery: a randomized trial. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/19023129012022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The use of bilevel positive airway pressure (BiPAP) has repercussions on cardiorespiratory outcomes. However, the literature still lacks analyses of the postoperative influence of BiPAP on the modulation of the autonomic nervous system after cardiac surgery. This study aimed to evaluate the effects of BiPAP on peripheral oxygen saturation, vital signs, and autonomic balance during hospitalization after cardiac surgery. This randomized controlled trial evaluated 36 patients before and after surgery. The BiPAP group was treated in two 20-minute daily sessions of routine physical therapy since 18 hours after surgery until discharge. The control group received routine physical therapy during the same period. Our primary outcome was peripheral oxygen saturation. Secondary outcomes were vital signs and autonomic balance evaluated by heart rate variability. We observed that peripheral oxygen saturation and blood pressure were unaffected at hospital discharge. Both groups showed a similar increase in heart and respiratory rates. The BiPAP group showed a reduction of the low sympathetic frequency component in −27.1 n.u. (95% CI: −39 to −15.2), increase of high parasympathetic frequency in 27.1 n.u. (95% CI: 15.2 to 39), and an improvement to the LF/HF ratio in −2.5 (95% CI: −3.8 to −1.2), when compared to the control group. BiPAP attenuated sympathetic activity and improved vagal modulation and autonomic balance at hospital discharge. These findings evidence that BiPAP enables more efficient autonomic mechanisms during hospitalization after cardiac surgery.
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Latremouille S, Bhuller M, Shalish W, Sant'Anna G. Cardiorespiratory effects of NIV-NAVA, NIPPV, and NCPAP shortly after extubation in extremely preterm infants: A randomized crossover trial. Pediatr Pulmonol 2021; 56:3273-3282. [PMID: 34379891 DOI: 10.1002/ppul.25607] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/05/2021] [Accepted: 07/29/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Investigate the cardiorespiratory effects of noninvasive neurally adjusted ventilatory assist (NIV-NAVA), nonsynchronized nasal intermittent positive pressure ventilation (NIPPV), and nasal continuous positive airway pressure (NCPAP) shortly after extubation. HYPOTHESIS Types of noninvasive pressure support and the presence of synchronization may affect cardiorespiratory parameters. STUDY DESIGN Randomized crossover trial. PATIENT-SUBJECT SELECTION Infants with birth weight (BW) 1250 g or under, undergoing their first planned extubation were randomly assigned to all three modes using a computer-generated sequence. METHODOLOGY Electrocardiogram and electrical activity of the diaphragm (Edi) were recorded for 30 min on each mode. Analysis of heart rate variability (HRV), diaphragmatic activity (Edi area, breath area, amplitude, inspiratory and expiratory times), and respiratory variability were compared between modes. RESULTS Twenty-three infants had full data recordings and analysis: Median (IQR) gestational age = 25.9 weeks (25.2-26.4), BW = 760 g (595-900), and postnatal age 7 (4-19) days. There were no differences in HRV between modes. A significantly reduced Edi area and breath amplitude, and increased coefficient of variation (CV) of breath amplitude were observed during NIV-NAVA and NIPPV compared to NCPAP. A higher proportion of assisted breaths (99% vs. 51%; p < .001) provided a higher mean airway pressure (MAP; 9.4 vs. 8.2 cmH2 O; p = .002) with lower peak inflation pressures (PIPs; 14 vs. 16 cmH2 O; p < .001) during NIV-NAVA compared to NIPPV. CONCLUSIONS NIV-NAVA and NIPPV applied shortly after extubation were associated with lower respiratory efforts and higher respiratory variability. These effects were more evident for NIV-NAVA where optimal patient-ventilator synchronization provided a higher MAP with lower PIPs.
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Affiliation(s)
- Samantha Latremouille
- Division of Experimental Medicine, McGill University Health Center, Montreal, Quebec, Canada
| | - Monica Bhuller
- Division of Experimental Medicine, McGill University Health Center, Montreal, Quebec, Canada
| | - Wissam Shalish
- Division of Neonatology, McGill University Health Center, Montreal, Quebec, Canada
| | - Guilherme Sant'Anna
- Division of Neonatology, McGill University Health Center, Montreal, Quebec, Canada
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Pantoni CBF, Thommazo-Luporini LD, Mendes RG, Caruso FCR, Castello-Simões V, Mezzalira D, Borghi-Silva A. Effect of continuous positive airway pressure associated to exercise on the breathing pattern and heart rate variability of patients undergoing coronary artery bypass grafting surgery: a randomized controlled trial. ACTA ACUST UNITED AC 2021; 54:e10974. [PMID: 34431871 PMCID: PMC8389609 DOI: 10.1590/1414-431x2021e10974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 06/22/2021] [Indexed: 11/21/2022]
Abstract
Continuous positive airway pressure (CPAP) has been used to improve gas exchange and diaphragmatic function, among others benefits. Moreover, it can be used to increase exercise tolerance and positively influence ventilatory function and breathing pattern (BP) during exercise. However, there is no information about the long-term effects of CPAP, as an adjunct to an inpatient cardiac rehabilitation (CR) program, on BP and heart rate variability (HRV) of patients after coronary artery bypass grafting surgery (CABG). Twenty patients were allocated to receive, after randomization, standard inpatient CR without CPAP (control group - CG) or CR with CPAP between 10 to 12 cmH2O (CPAP group - CPG) associated with the exercises. Participants were assessed preoperatively and on the discharge day, in the sitting rest position. Outcome measurements included BP variables, collected by respiratory inductive plethysmography, and HRV, collected by polar precision performance. The CPG presented lower values of percent rib cage inspiratory and expiratory contributions to tidal volume (%RCi and %RCe) at discharge time, compared to CG. No statistical differences between groups were observed for HRV variables and both groups presented lower values of these indices, compared to preoperative ones. In this context, the patients who received CPAP throughout the whole rehabilitation program were discharged with a better BP, which could indicate more synchronized breathing. CPAP did not influence cardiac autonomic modulation in the long term.
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Affiliation(s)
- C B F Pantoni
- Departamento de Gerontologia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.,Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - L Di Thommazo-Luporini
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - R G Mendes
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F C R Caruso
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - V Castello-Simões
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - D Mezzalira
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - A Borghi-Silva
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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Al-Omar S, Le Rolle V, Pladys P, Samson N, Hernandez A, Carrault G, Praud JP. Influence of nasal CPAP on cardiorespiratory control in healthy neonate. J Appl Physiol (1985) 2019; 127:1370-1385. [PMID: 31369331 DOI: 10.1152/japplphysiol.00994.2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The present study aimed to further unravel the effects of nasal continuous positive airway pressure (nCPAP) on the cardiovascular and respiratory systems in the neonatal period. Six-hour polysomnographic recordings were first performed in seven healthy newborn lambs, aged 2-3 days, without and with nCPAP application at 6 cmH2O (nCPAP-6), in randomized order. The effects of nCPAP-6 on heart rate variability, respiratory rate variability, and cardiorespiratory interrelations were analyzed using a semiautomatic signal processing approach applied to ECG and respiration recordings. Thereafter, a cardiorespiratory mathematical model was adapted to the experimental conditions to gain further physiological interpretation and to simulate higher nCPAP levels (8 and 10 cmH2O). Results from the signal processing approach suggest that nCPAP-6 applied in newborns with healthy lungs: 1) increases heart rate and decreases the time and frequency domain indices of heart rate variability, especially those representing parasympathetic activity, while increasing the complexity of the RR-interval time series; 2) prolongs the respiratory cycle and expiration duration and decreases respiratory rate variability; and 3) slightly impairs cardiorespiratory interrelations. Model-based analysis revealed that nCPAP-6 increases the heart rate and decreases respiratory sinus arrhythmia amplitude, in association with a reduced parasympathetic efferent activity. These results were accentuated when simulating an increased CPAP level. Overall, our results provide a further understanding of the effects of nCPAP in neonates, in the absence of lung disease.NEW & NOTEWORTHY Application of nasal continuous positive airway pressure (CPAP) at 6 cmH2O, a level very frequently used in newborns, alters heart and respiratory rate variability, as well as cardiorespiratory interrelations in a full-term newborn model without lung disease. Moreover, whereas nasal CPAP at 6 cmH2O decreases parasympathetic efferent activity, there is no change in sympathetic efferent activity.
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Affiliation(s)
- Sally Al-Omar
- Univ Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, F-35000, Rennes, France.,Neonatal Cardiorespiratory Research Unit, Departments of Pediatrics and Physiology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Virginie Le Rolle
- Univ Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, F-35000, Rennes, France
| | - Patrick Pladys
- Univ Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, F-35000, Rennes, France
| | - Nathalie Samson
- Neonatal Cardiorespiratory Research Unit, Departments of Pediatrics and Physiology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Alfredo Hernandez
- Univ Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, F-35000, Rennes, France
| | - Guy Carrault
- Univ Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, F-35000, Rennes, France
| | - Jean-Paul Praud
- Neonatal Cardiorespiratory Research Unit, Departments of Pediatrics and Physiology, University of Sherbrooke, Sherbrooke, Quebec, Canada
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Latremouille S, Shalish W, Kanbar L, Lamer P, Rao S, Kearney RE, Sant'Anna GM. The effects of nasal continuous positive airway pressure and high flow nasal cannula on heart rate variability in extremely preterm infants after extubation: A randomized crossover trial. Pediatr Pulmonol 2019; 54:788-796. [PMID: 30816025 DOI: 10.1002/ppul.24284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND NCPAP and High flow nasal cannula (HFNC) are common modes of non-invasive respiratory support used after extubation. Heart rate variability (HRV) has been demonstrated as a marker of well-being in neonates and differences in HRV were described in preterm infants receiving respiratory care. The objective was to investigate the effects of NCPAP and HFNC on HRV after extubation. METHODS Randomized crossover trial in infants with birth weight (BW) ≤1250 g after undergoing their first elective extubation. ECG recordings were performed during 45 min while on HFNC and nasal continuous positive airway pressure (NCPAP). Time domain, non-linear, and frequency domain parameters were calculated and compared during HFNC and NCPAP using paired nonparametric tests. A secondary analysis was performed in the subgroup of infants that were successfully extubated. RESULTS Thirty infants with median [range] gestational age of 27 weeks [24.1-29.3] and BW of 930 g [610-1220] were studied at 5 days [1-39] of age. No differences in HRV parameters were observed between HFNC and NCPAP. In the secondary analysis, infants successfully extubated (n = 27) had a significantly higher HRV during HFNC for some time domain parameters. For instance, the standard deviation of the RR intervals (SDRR) was more likely to be higher during HFNC compared to NCPAP (HFNC: 18/27 vs NCPAP: 9/27, P = 0.017) . CONCLUSION During the first hours after extubation, no differences in HRV were detected between HFNC and NCPAP in the overall cohort. However, a significantly higher HRV was noted during HFNC in the subgroup of infants successfully extubated.
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Affiliation(s)
- Samantha Latremouille
- Division of Neonatology, Department of Pediatrics, McGill University Health Center, Montreal, Canada
| | - Wissam Shalish
- Division of Neonatology, Department of Pediatrics, McGill University Health Center, Montreal, Canada
| | - Lara Kanbar
- Department of Biomedical Engineering, McGill University, Montreal, Canada
| | - Philippe Lamer
- Division of Neonatology, Department of Pediatrics, McGill University Health Center, Montreal, Canada
| | - Smita Rao
- Division of Neonatology, Department of Pediatrics, McGill University Health Center, Montreal, Canada
| | - Robert E Kearney
- Department of Biomedical Engineering, McGill University, Montreal, Canada
| | - Guilherme M Sant'Anna
- Division of Neonatology, Department of Pediatrics, McGill University Health Center, Montreal, Canada
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Barbosa Neto O, da Mota GR, De Sordi CC, Resende EAMR, Resende LAPR, Vieira da Silva MA, Marocolo M, Côrtes RS, de Oliveira LF, Dias da Silva VJ. Long-term anabolic steroids in male bodybuilders induce cardiovascular structural and autonomic abnormalities. Clin Auton Res 2017; 28:231-244. [DOI: 10.1007/s10286-017-0470-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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Lacerda D, Costa D, Reis M, Gomes ELDFD, Costa IP, Borghi-Silva A, Marsico A, Stirbulov R, Arena R, Sampaio LMM. Influence of bilevel positive airway pressure on autonomic tone in hospitalized patients with decompensated heart failure. J Phys Ther Sci 2016; 28:1-6. [PMID: 26957719 PMCID: PMC4755965 DOI: 10.1589/jpts.28.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/05/2015] [Indexed: 01/01/2023] Open
Abstract
[Purpose] This study evaluated the effect of Bilevel Positive Airway (BiPAP) on the autonomic control of heart rate, assessed by heart rate variability (HRV), in patients hospitalized with decompensated heart failure. [Subjects and Methods] This prospective cross-sectional study included 20 subjects (age: 69±8 years, 12 male, left ventricular ejection fraction: 36 ±8%) diagnosed with heart failure who were admitted to a semi-intensive care unit with acute decompensation. Date was collected for HRV analysis during: 10 minutes spontaneous breathing in the resting supine position; 30 minutes breathing with BiPAP application (inspiratory pressure = 20 cmH2O and expiratory pressure = 10 cmH2O); and 10 minutes immediately after removal of BiPAP, during the return to spontaneous breathing. [Results] Significantly higher values for indices representative of increased parasympathetic activity were found in the time and frequency domains as well as in nonlinear Poincaré analysis during and after BiPAP in comparison to baseline. Linear HRV analysis: standard deviation of the average of all R-R intervals in milliseconds = 30.99±4.4 pre, 40.3±6.2 during, and 53.3±12.5 post BiPAP. Non-linear HRV analysis: standard deviations parallel in milliseconds = 8.31±4.3 pre, 12.9±5.8 during, and 22.8 ±6.3 post BiPAP. [Conclusion] The present findings demonstrate that BiPAP enhances vagal tone in patients with heart failure, which is beneficial for patients suffering from acute decompensation.
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Affiliation(s)
- Diego Lacerda
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil
| | - Dirceu Costa
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil
| | - Michel Reis
- Physical Therapy Department, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Brazil
| | | | - Ivan Peres Costa
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), Brazil
| | - Aline Marsico
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil
| | | | - Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, USA
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Pantoni CBF, Di Thommazo-Luporini L, Mendes RG, Caruso FCR, Mezzalira D, Arena R, Amaral-Neto O, Catai AM, Borghi-Silva A. Continuous Positive Airway Pressure During Exercise Improves Walking Time in Patients Undergoing Inpatient Cardiac Rehabilitation After Coronary Artery Bypass Graft Surgery: A RANDOMIZED CONTROLLED TRIAL. J Cardiopulm Rehabil Prev 2015; 36:20-7. [PMID: 26468628 DOI: 10.1097/hcr.0000000000000144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Continuous positive airway pressure (CPAP) has been used as an effective support to decrease the negative pulmonary effects of coronary artery bypass graft (CABG) surgery. However, it is unknown whether CPAP can positively influence patients undergoing CABG during exercise. This study evaluated the effectiveness of CPAP on the first day of ambulation after CABG in patients undergoing inpatient cardiac rehabilitation (CR). METHODS Fifty-four patients after CABG surgery were randomly assigned to receive either inpatient CR and CPAP (CPG) or standard CR without CPAP (CG). Cardiac rehabilitation included walking and CPAP pressures were set between 10 to 12 cmH2O. Participants were assessed on the first day of walking at rest and during walking. Outcome measures included breathing pattern variables, exercise time in seconds (ETs), dyspnea/leg effort ratings, and peripheral oxygen saturation (SpO2). RESULTS Twenty-seven patients (13 CPG vs 14 CG) completed the study. Compared with walking without noninvasive ventilation assistance, CPAP increased ETs by 43.4 seconds (P = .040) during walking, promoted better thoracoabdominal coordination, increased ventilation during walking by 12.5 L/min (P = .001), increased SpO2 values at the end of walking by 2.6% (P = .016), and reduced dyspnea ratings by 1 point (P = .008). CONCLUSIONS Continuous positive airway pressure can positively influence exercise tolerance, ventilatory function, and breathing pattern in response to a single bout of exercise after CABG.
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Affiliation(s)
- Camila Bianca Falasco Pantoni
- Cardiopulmonary Physiotherapy Laboratory (Dr Pantoni, Dr Thommazo-Luporini, Dr Mendes, Dr Caruso, Mr Mezzalira, Dr Catai, and Dr Borghi-Silva), Nucleus of Research in Physical Exercise, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Department of Physical Therapy (Dr Arena), College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois; and Irmandade Santa Casa Misericordia Hospital (Dr Amaral-Neto), Araraquara, São Paulo, Brazil
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de Souza Naves KA, Lopes CR, Dionisio VC. Effects of noninvasive ventilation on heart rate variability after coronary bypass grafting: comparison between ventilators. Intensive Care Med 2015; 41:946-7. [DOI: 10.1007/s00134-015-3745-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 11/28/2022]
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Pantoni CBF, Mendes RG, Di Thommazo-Luporini L, Simões RP, Amaral-Neto O, Arena R, Guizilini S, Gomes WJ, Catai AM, Borghi-Silva A. Recovery of linear and nonlinear heart rate dynamics after coronary artery bypass grafting surgery. Clin Physiol Funct Imaging 2013; 34:449-56. [PMID: 24666784 DOI: 10.1111/cpf.12115] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 11/15/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND Conventional coronary artery bypass grafting (C-CABG) and off-pump CABG (OPCAB) surgery may produce different patients' outcomes, including the extent of cardiac autonomic (CA) imbalance. The beneficial effects of an exercise-based inpatient programme on heart rate variability (HRV) for C-CABG patients have already been demonstrated by our group. However, there are no studies about the impact of a cardiac rehabilitation (CR) on HRV behaviour after OPCAB. The aim of this study is to compare the influence of both operative techniques on HRV pattern following CR in the postoperative (PO) period. METHODS Cardiac autonomic function was evaluated by HRV indices pre- and post-CR in patients undergoing C-CABG (n = 15) and OPCAB (n = 13). All patients participated in a short-term (approximately 5 days) supervised CR programme of early mobilization, consisting of progressive exercises, from active-assistive movements at PO day 1 to climbing flights of stairs at PO day 5. RESULTS Both groups demonstrated a reduction in HRV following surgery. The CR programme promoted improvements in HRV indices at discharge for both groups. The OPCAB group presented with higher HRV values at discharge, compared to the C-CABG group, indicating a better recovery of CA function. CONCLUSION Our data suggest that patients submitted to OPCAB and an inpatient CR programme present with greater improvement in CA function compared to C-CABG.
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Affiliation(s)
- Camila Bianca Falasco Pantoni
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos, São Carlos, Brazil
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Gomes AM, Higa DA. Pulmonary research recently published in Brazilian journals. J Bras Pneumol 2012; 38:634-42. [PMID: 23147057 DOI: 10.1590/s1806-37132012000500014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 09/14/2012] [Indexed: 11/22/2022] Open
Abstract
We reviewed original articles in the field of pulmonary medicine that had been recently published in 12 Brazilian journals--general or specialty journals--excluding the Brazilian Journal of Pulmonology. All were journals indexed for the Institute for Scientific Information Web of Knowledge. The selection of articles was based on the "continuously variable rating" concept. We have organized the articles by category.
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Kunz VC, Borges EN, Coelho RC, Gubolino LA, Martins LEB, Silva E. Linear and nonlinear analysis of heart rate variability in healthy subjects and after acute myocardial infarction in patients. Braz J Med Biol Res 2012; 45:450-8. [PMID: 22370707 PMCID: PMC3854283 DOI: 10.1590/s0100-879x2012007500025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 02/07/2012] [Indexed: 11/22/2022] Open
Abstract
The objectives of this study were to evaluate and compare the use of linear and nonlinear methods for analysis of heart rate variability (HRV) in healthy subjects and in patients after acute myocardial infarction (AMI). Heart rate (HR) was recorded for 15 min in the supine position in 10 patients with AMI taking β-blockers (aged 57 ± 9 years) and in 11 healthy subjects (aged 53 ± 4 years). HRV was analyzed in the time domain (RMSSD and RMSM), the frequency domain using low- and high-frequency bands in normalized units (nu; LFnu and HFnu) and the LF/HF ratio and approximate entropy (ApEn) were determined. There was a correlation (P < 0.05) of RMSSD, RMSM, LFnu, HFnu, and the LF/HF ratio index with the ApEn of the AMI group on the 2nd (r = 0.87, 0.65, 0.72, 0.72, and 0.64) and 7th day (r = 0.88, 0.70, 0.69, 0.69, and 0.87) and of the healthy group (r = 0.63, 0.71, 0.63, 0.63, and 0.74), respectively. The median HRV indexes of the AMI group on the 2nd and 7th day differed from the healthy group (P < 0.05): RMSSD = 10.37, 19.95, 24.81; RMSM = 23.47, 31.96, 43.79; LFnu = 0.79, 0.79, 0.62; HFnu = 0.20, 0.20, 0.37; LF/HF ratio = 3.87, 3.94, 1.65; ApEn = 1.01, 1.24, 1.31, respectively. There was agreement between the methods, suggesting that these have the same power to evaluate autonomic modulation of HR in both AMI patients and healthy subjects. AMI contributed to a reduction in cardiac signal irregularity, higher sympathetic modulation and lower vagal modulation.
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Affiliation(s)
- V C Kunz
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisa em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, SP, Brasil.
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