1
|
Chaves Quirino PG, Rizzo JÂ, Hunter S, de Albuquerque Rodrigues Filho E, Sarinho E, de Almeida Santos CM, Medeiros D, Costa EC, Silva AS, Farah BQ, de Valois Correia Júnior MA. Is there cardiac autonomic dysfunction in children and adolescents with exercise-induced bronchospasm? Expert Rev Respir Med 2023; 17:823-831. [PMID: 37795708 DOI: 10.1080/17476348.2023.2265819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The pulmonary impairment in patients with bronchoconstriction induced by eucapnic voluntary hyperpnea(EVH) goes beyond the respiratory system, also impairing autonomic nervous modulation. This study aimed to evaluate the behavior of cardiac autonomic modulation in young asthmatics with and without EIB after the EVH test. RESEARCH DESIGN AND METHODS A cross-sectional study design using 54 asthmatics(51.9% female), aged between 10 and 19 years, investigated with the EVH test. Forced expiratory volume in one second(FEV1) was measured at 5, 10, 15, and 30 min after EVH. Heart rate variability(HRV) measures of time were assessed pre and 30 min-post EVH. The diagnosis of Exercise-Induced bronchoconstriction with underlying clinical asthma(EIBA) was confirmed by a fall in FEV1 ≥10% compared to baseline. RESULTS Thirty(55.5%) asthmatics had EIBA. Subjects with EIBA have reduced mean of the R-R intervals in relation to baseline until 15 minutes after EVH. Individuals without EIBA had increased parasympathetic activity compared to baseline(rMSSD) from 5 min after EVH(p < 0.05). This parasympathetic activity increase in relation to baseline was seen in individuals with EIBA after 25 minutes (rMSSD = 49.9 ± 5.3 vs 63.5 ± 7.2, p < 0.05). CONCLUSION Young asthmatics with EIBA present a delay in the increase of the parasympathetic component after EVH when compared to asthmatics without EIBA.
Collapse
Affiliation(s)
- Polyanna Guerra Chaves Quirino
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
| | - José Ângelo Rizzo
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
| | - Steve Hunter
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, UK
| | | | - Emanuel Sarinho
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
| | - Camila Matias de Almeida Santos
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
| | - Decio Medeiros
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
| | - Emilia Chagas Costa
- Postgraduate Program in Nutrition, Universidade Federal de Pernambuco, Recife, Brazil
| | - Alexandre Sérgio Silva
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
| | - Breno Quintella Farah
- Department of Physical Education, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Marco Aurélio de Valois Correia Júnior
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
- Postgraduate Program in Hebiatrics, Universidade de Pernambuco, Recife, Brazil
| |
Collapse
|
2
|
Schiwe D, Vendrusculo FM, Becker NA, Donadio MVF. Impact of asthma on heart rate variability in children and adolescents: Systematic review and meta-analysis. Pediatr Pulmonol 2023; 58:1310-1321. [PMID: 36719098 DOI: 10.1002/ppul.26340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 02/01/2023]
Abstract
PURPOSE Asthma is associated with abnormal autonomic function, and heart rate variability is considered a simple, accurate, and noninvasive tool for monitoring the autonomic system. Thus, the aim of this study was to investigate the impact of asthma on heart rate variability in children and adolescents. METHODS This systematic review of observational studies and clinical trials evaluated heart rate variability in children and adolescents with asthma compared to healthy controls. The data were extracted independently by two reviewers. The quality of the selected articles was assessed using Agency for Health Care Research and Quality indicators. Random effects meta-analysis was performed for each outcome, with the effect size reported as standardized mean difference. RESULTS Fifteen studies were included, of which five were classified as having high methodological quality. In the meta-analysis, long-term recording of the standard deviation of all normal-to-normal sinus R-R intervals differed significantly between groups (standardized mean difference [SMD] = -0.46 [95% confidence interval {CI}: -0.79 to -0.14], p < 0.005, I2 = 0%). Moreover, R-R intervals (long-term) were significantly shorter in asthmatic children than controls (SMD = -0.47 [95% CI: -0.68 to -0.25], p < 0.0001, I2 = 0). There were no significant differences between adjacent normal R-R intervals that exceed 50 ms (long-term) and the root mean square of successive differences between normal sinus R-R intervals (short-term). Regarding frequency-domain variables, long-term low frequency measurements differed significantly between groups (SMD = -0.34 [95% CI: -0.58 to -0.10], p < 0.005, I2 = 15%). There were no differences in high frequency measurements or in the ratio between low/high frequency powers (short- or long-term) between groups. CONCLUSION The results confirm the impact of asthma on heart rate variability in children and adolescents, indicating lower heart rate variability and sympathetic modulation.
Collapse
Affiliation(s)
- Daniele Schiwe
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Fernanda Maria Vendrusculo
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Nicolas Acosta Becker
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Department of Physiotherapy, Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| |
Collapse
|
3
|
Silva JLD, Soares BA, Silva JC, Blum PB, Reimberg MM, Corso SD, Lanza FC. Functional capacity and quality of life in children and adolescents with sickle cell anemia. Pediatr Pulmonol 2023; 58:1100-1105. [PMID: 36593732 DOI: 10.1002/ppul.26300] [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: 06/22/2022] [Revised: 11/16/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the functional and exercise capacity, lung function, quality of life of children and adolescents with sickle cell anemia (SCA HbSS) and to test the reproducibility of functional capacity tests in this population. METHOD Cross-sectional study with volunteers with SCA Hb-SS (SCAG), aged 6-18 years matched in age and gender to the control group (CG) with healthy individuals. Spirometry, 5-repetition sit-to-stand test (5STS-test), modified shuttle test (MST), and Pediatric Quality of Life Questionnaire (PedsQL) were performed. The reproducibility of 5STS-test and MST was evaluated: RESULTS: Forty eight volunteers of SCAG and 48 of CG were evaluated. Lung function of SCAG (FVC: 92 ± 15% pred.; FEV1 /FVC: 84 ± 8% pred.) was worse than the CG (104 ± 15% pred.; FEV1 /FVC: 90 ± 6% pred.) p < 0.05. SCAG had worse functional capacity registered by distance walked: 576 m (515-672 m) and 5STS-test: 8 s (7.4-8.9 s) compared with the CG who showed distance walked: 1010 m (887-1219 m) and 5STS-test: 7 s (7.0-8.1 s), p < 0.001. SCAG had worse quality of life compared to CG, p < 0.05. The reproducibility of MST (ICC 0.99 (0.98-0.99 IC-95%)) and 5STS-test (ICC 0.80 (0.69-0.88) was considered good, p < 0.001. CONCLUSION Children and adolescents with sickle cell anemia presented worse capacity to walk or run, and to perform sit-to-stand test when compared with their control peers. Additionally, they have poorer quality of life. The MST and 5STS-test showed good reproducibility to be applied in pediatric individuals with SCA.
Collapse
Affiliation(s)
| | - Bruno A Soares
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Jaksoel C Silva
- University Nove de Julho, UNINOVE, Sao Paulo, Sao Paulo, Brazil
| | - Patrícia B Blum
- Darcy Vargas Children's Hospital, Sao Paulo, Sao Paulo, Brazil
| | | | | | - Fernanda C Lanza
- University Nove de Julho, UNINOVE, Sao Paulo, Sao Paulo, Brazil.,Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
4
|
Reimberg MM, Ritti-Dias R, Selman JP, Scalco RS, Wandalsen GF, Solé D, Hulzebos EJ, Takken T, Dal Corso S, Lanza FC. Is the modified shuttle test a maximal effort test in children and adolescents with asthma? Pediatr Pulmonol 2022; 57:75-80. [PMID: 34569722 DOI: 10.1002/ppul.25706] [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: 05/03/2021] [Revised: 08/12/2021] [Accepted: 09/15/2021] [Indexed: 11/11/2022]
Abstract
PURPOSE Whether the modified shuttle test (MST) achieves maximal effort in children and adolescents with asthma is unclear. The aim was to compare the physiological responses of MST to the cardiopulmonary exercise test (CPET) in pediatric patients with asthma, to observe its convergent validity. PATIENTS AND METHODS A cross-sectional study with volunteers with asthma (6-17 years of age) under regular treatment. The MST is an external-paced test, and the participants were allowed to walk/run. CPET was performed on a cycle ergometer to compare with MST. Gas exchange (VO2 , VCO2 , and VE) and heart rate (HR) were the outcomes and were continuously assessed in both tests. RESULTS Forty-seven volunteers were included, normal lung function expiratory forced volume at 1st second/forced vital capacity (FEV1 /FVC) 88.6 (7.7). VO2peak was higher at MST (2.0 ± 0.6 L/min) compared to CPET (1.6 ± 0.5 L/min), p < 0.001. Similar results was observed to VE at MST (50 ± 16 L/min) versus VE at CPET (40 ± 13 L/min), and to VCO2 at MST (2.1 ± 0.8 L/min) versus VCO2 at CPET (1.7 ± 0.6 L/min), p < 0.001. HR was also higher at MST (94 ± 6%pred) versus CPET (87 ± 8%pred), p = 0.002. VO2peak in MST correlated to the CPET (r = 0.78, p < 0.001). The ICC of VO2peak between tests was 0.73 (0.06-0.89), p < 0.001, and VO2peak Bland-Altman analysis showed a bias of 0.46 L/min. CONCLUSION The MST showed a maximal physiologic response in children and adolescents with asthma. It is a valid test and can be used as an alternative to evaluating exercise capacity.
Collapse
Affiliation(s)
- Mariana M Reimberg
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, São Paulo, Brazil
| | - Raphael Ritti-Dias
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, São Paulo, Brazil
| | - Jessyca P Selman
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, São Paulo, Brazil
| | - Rebeca S Scalco
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, São Paulo, Brazil
| | - Gustavo F Wandalsen
- Pediatric Department of Federal University of São Paulo-UNIFESP, São Paulo, São Paulo, Brazil
| | - Dirceu Solé
- Pediatric Department of Federal University of São Paulo-UNIFESP, São Paulo, São Paulo, Brazil
| | - Erik J Hulzebos
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Tim Takken
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Simone Dal Corso
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, São Paulo, Brazil
| | - Fernanda C Lanza
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, São Paulo, Brazil.,Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minhas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
5
|
Sinha M, Behera AK, Sinha R, Parganiha A, Pande B, Sharma R, Pati AK. Circadian rhythmicity of heart rate variability and its impact on cardiac autonomic modulation in asthma. Chronobiol Int 2021; 38:1631-1639. [PMID: 34121548 DOI: 10.1080/07420528.2021.1938595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The commonly observed nocturnal attack of asthma is accompanied by circadian variations in airway inflammation and other physiological variables. It is also documented to present with a significantly higher risk of adverse cardiovascular events that are associated with lower heart rate variability (HRV) and depressed sympathetic and enhanced parasympathetic modulations. However, available literature is scarce with regard to the impact of alteration in circadian rhythmicity of long-term HRV and its day-night variation in asthmatic patients. Thus, 72-h continuous recording of RR interval and oxygen saturation was done to study the circadian variability of HRV (in terms of time and frequency domain indices) and also to assess the pattern of alterations in sympathetic and parasympathetic tones at different times of the day in asthmatic patients (n = 32) and healthy control subjects (n = 31). Repeated-measure analysis of variance and independent-samples t-test revealed significantly increased parasympathetic tone [in terms of increased square root of the mean squared differences of successive NN intervals (RMSSD), percentage of number of pairs of adjacent RR interval differing by more than 50 ms (pNN50), standard deviation of NN intervals (SDNN), and high frequency (HF)] with reduced sympathetic activity [decreased low frequency (LF) and LF/HF ratio] at early morning hours (between 04:00 and 10:00 h) in the asthma patients in contrast to the healthy subjects who had opposite response. Also, significant phase delay (p<0.05) of all the HRV indices and SpO2, was evident by cosinor analysis. Therefore, disturbed circadian rhythm of HRV indices and early morning increased parasympathetic tone points toward the possible pathophysiological basis of exacerbated asthmatic symptoms at late night/early morning hours and susceptibility of future cardiovascular pathologies. This also necessitates the assessment of HRV rhythm while dealing with the therapeutic management of asthma patients.
Collapse
Affiliation(s)
- Meenakshi Sinha
- Department of Physiology, All India Institute of Medical Sciences, Raipur, India
| | - Ajoy K Behera
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Raipur, India
| | - Ramanjan Sinha
- Department of Physiology, All India Institute of Medical Sciences, Raipur, India
| | - Arti Parganiha
- School of Studies in Life Sciences, Pt. Ravishankar Shukla University, Raipur, India
| | - Babita Pande
- Department of Physiology, All India Institute of Medical Sciences, Raipur, India
| | - Richa Sharma
- Department of Physiology, All India Institute of Medical Sciences, Raipur, India
| | - Atanu K Pati
- Department of Zoology, Gangadhar Meher University, Odisha, India
| |
Collapse
|
6
|
de Freitas Coelho P, Barbosa RRB, dos Santos Lugao R, Liberato FMG, Vidal PR, de Cássia Nunes Cruz Melotti R, Donadio MVF. Heart rate variability, exercise capacity and levels of daily physical activity in children and adolescents with mild-to-moderate cystic fibrosis. Hong Kong Physiother J 2021; 42:5-14. [PMID: 35782696 PMCID: PMC9244599 DOI: 10.1142/s1013702522500019] [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: 02/18/2021] [Accepted: 04/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Autonomic nervous system balance is altered in cystic fibrosis (CF), although its influence on physical fitness has been poorly explored. Objective: This study aimed to evaluate the association of heart rate variability (HRV) with exercise capacity and levels of daily physical activity in children and adolescents with mild-to-moderate CF. Methods: A cross-sectional study including individuals with CF aged 6–18 years, not under CFTR modulator therapy, was performed. Sociodemographic (age, sex) and clinical information (airway colonization, pancreatic insufficiency, and genotyping) were collected. In addition, exercise capacity (modified shuttle test — MST), lung function (spirometry), body composition (bioimpedance), levels of daily physical activity (5-day accelerometer), and HRV (both at rest and during the MST) were evaluated. Results: 30 individuals (20 females) aged [Formula: see text] years, mean FEV[Formula: see text]%, were included. A sympathovagal balance (LF/HF) increase ([Formula: see text]) during the MST was shown, indicating a predominance of sympathetic modulation. The standard deviation of all RR intervals (SDNN) and the high frequency (HF) index during exercise correlated significantly with FEV1 ([Formula: see text], [Formula: see text] and [Formula: see text], [Formula: see text]; respectively). MST distance also correlated positively and significantly with SDNN ([Formula: see text], [Formula: see text]), square root of the mean of the sums of squares of frequencies between RR intervals greater than 50[Formula: see text]ms — RMSSD ([Formula: see text], [Formula: see text]), low frequency — LF ([Formula: see text], [Formula: see text]), HF ([Formula: see text], [Formula: see text]), dispersion of points perpendicular to the short-term identity line — SD1 ([Formula: see text], [Formula: see text]) and negatively with LF/HF ([Formula: see text], [Formula: see text]). Regarding daily physical activity, SDNN at rest ([Formula: see text], [Formula: see text]) and exercise ([Formula: see text], [Formula: see text]) showed positive correlations with time in moderate-to-vigorous activities. When normalizing the SDNN and classifying individuals as normal or altered, those presenting altered SDNN showed poorest FEV1 ([Formula: see text]) and lower exercise capacity ([Formula: see text]). Conclusion: HRV correlates with lung function, exercise capacity and levels of daily physical activity in children and adolescents with CF. The study highlights the influence of CF on autonomic function and suggests HRV measurement as an easy tool to be used in clinical settings as an alternative marker to monitor CF individuals.
Collapse
Affiliation(s)
- Pitiguara de Freitas Coelho
- Escola Superior de Ciˆencias da Santa Casa de Misericórdia de, Vitória – EMESCAM, Vitória, Espírito Santo, Brazil
| | | | - Rodrigo dos Santos Lugao
- Escola Superior de Ciˆencias da Santa Casa de Misericórdia de, Vitória – EMESCAM, Vitória, Espírito Santo, Brazil
| | | | - Pâmela Reis Vidal
- Escola Superior de Ciˆencias da Santa Casa de Misericórdia de, Vitória – EMESCAM, Vitória, Espírito Santo, Brazil
| | | | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica, do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
7
|
Zhang Y, Chen Z, Berhane K, Urman R, Chatzi VL, Breton C, Gilliland FD. The Dynamic Relationship Between Asthma and Obesity in Schoolchildren. Am J Epidemiol 2020; 189:583-591. [PMID: 31712801 PMCID: PMC7443205 DOI: 10.1093/aje/kwz257] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/24/2022] Open
Abstract
Asthma and obesity are among the most prevalent chronic health conditions in children. Although there has been compelling evidence of co-occurrence of asthma and obesity, it is uncertain whether asthma contributes to the development of obesity or obesity contributes to the onset of asthma or both. In this study, we used a joint transition modeling approach with cross-lagged structure to understand how asthma and obesity influence each other dynamically over time. Subjects for this study included 5,193 kindergarten and first-grade students enrolled from 13 communities in 2002-2003 in the Southern California Children's Health Study, with up to 10 years of follow-up. We found that nonobese children with diagnosed asthma at a study visit were at 37% higher odds of becoming obese by the next annual visit compared with children without asthma (odds ratio = 1.38; 95% credible interval: 1.12, 1.71). However, the presence of obesity at the current visit was not statistically significantly associated with asthma onset in the next visit (odds ratio = 1.25; 95% credible interval: 0.94, 1.62). In conclusion, childhood asthma appears to drive an increase in the onset of obesity among schoolchildren, while the onset of obesity does not necessarily imply the future onset of asthma, at least in the short term.
Collapse
Affiliation(s)
- Yue Zhang
- Department of Internal Medicine, Division of Epidemiology, School of Medicine, University of Utah, Salt Lake City, Utah
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Veteran Affairs Salt Lake City Health Care System, Salt Lake City, Utah
| | - Zhanghua Chen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kiros Berhane
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Robert Urman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Vaia Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Carrie Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Frank D Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| |
Collapse
|
8
|
Reimberg MM, Pachi JRS, Scalco RS, Serra AJ, Fernandes L, Politti F, Wandalsen GF, Solé D, Dal Corso S, Lanza FC. Patients with asthma have reduced functional capacity and sedentary behavior. J Pediatr (Rio J) 2020; 96:53-59. [PMID: 30240630 PMCID: PMC9432245 DOI: 10.1016/j.jped.2018.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The modified shuttle test is a field test that avoids the ceiling effect, and there are no reports of a multidimensional assessment concerning physical activity in asthmatic patients. Thus, the aim was to evaluate functional capacity by MST, additionally to perform a multidimensional assessment as physical activity in daily life, muscle strength, and cytokine levels in children and adolescents with asthma, and to correlate these variables. METHOD This cross-sectional study included volunteers aged between 6 and 18 years who were divided into two groups: asthma group (n=43) that received regular treatment and control group (n=24). Functional capacity was evaluated by distance walked during the MST; physical activity in daily life was evaluated using an accelerometer by the number of steps. Quadriceps femoris strength was evaluated by load cell. RESULTS Distance walked was lower for the asthma group (790m [222m]) when compared with the control group (950m [240m]; p=0.007); however, the number of steps was similar between the two groups (asthma group: 7743 [3075]; control group: 7181 [3040]; p=0.41), and both groups were classified as sedentary behavior. There was no difference in muscle strength. Tumor necrosis factor-α differed, but interleukin levels were similar between groups. Quadriceps strength was correlated to distance walked (r=0.62; p<0.001) and tumor necrosis factor-α to the number of steps taken (r=-0.54, p=0.005). CONCLUSION Children and adolescents undergoing regular asthma treatment showed reduced functional capacity and sedentary behavior. The lower the quadriceps strength, the shorter the distance walked; the higher the tumor necrosis factor-α levels, the lower their daily physical activity levels.
Collapse
Affiliation(s)
- Mariana Mazzuca Reimberg
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | | | - Rebeca Souza Scalco
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Andrey Jorge Serra
- Universidade Federal de São Paulo (UNIFESP), Departamento de Cardiologia, São Paulo, SP, Brazil; Universidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada à Ciência da Saúde, São Paulo, SP, Brazil
| | - Leandro Fernandes
- Universidade Federal de São Paulo (UNIFESP), Programa de Pós-Graduação em Psicobiologia, São Paulo, SP, Brazil
| | - Fabiano Politti
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Gustavo Falbo Wandalsen
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil
| | - Dirceu Solé
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil
| | - Simone Dal Corso
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Fernanda Cordoba Lanza
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil.
| |
Collapse
|
9
|
Reimberg MM, Pachi JRS, Scalco RS, Serra AJ, Fernandes L, Politti F, Wandalsen GF, Solé D, Dal Corso S, Lanza FC. Patients with asthma have reduced functional capacity and sedentary behavior. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
10
|
Rodrigues Mendes FA, Teixeira RN, Martins MA, Cukier A, Stelmach R, Medeiros WM, Carvalho CRF. The relationship between heart rate and VO 2 in moderate-to-severe asthmatics. J Asthma 2019; 57:713-721. [PMID: 31267781 DOI: 10.1080/02770903.2019.1606235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The main purpose of this study was to evaluate whether the %HRR-%VO2R relationship and %HRR-VO2peak relationship are affected in patients with moderate or severe asthma and whether airway obstruction and aerobic capacity influence these relationships.Methods: A linear regression was calculated using the paired %VO2R-%HRR and %VO2peak-%HRR for 93 subjects with asthma. The mean slope and y-intercept were calculated and compared with the line of identity (y-intercept = 0, slope = 1) for all patients and subgroups for the following conditions: low and normal VO2peak and low and normal FEV1.Results: The slope and intercepts of %VO2R-%HRR were similar to the line of identity for all groups (p > 0.05), and the regressions between %HRR and %VO2peak did not coincide with the line of identity for all groups (p < 0.05). There were no associations between the intercepts of the %HRR-VO2peak and the %HRR-%VO2R relationship with the VO2peak (p > 0.05) or FEV1 (p > 0.05).Conclusions: This is the first study to confirm a constant equivalence between %HRR and %VO2R in outpatients with moderate or severe asthma. Our data also suggest that the relationship between %HRR and %VO2peak is unreliable. These results support the use of %HRR in relation to %VO2R to estimate exercise intensity in this population, independently of the pulmonary function and fitness level.
Collapse
Affiliation(s)
- Felipe A Rodrigues Mendes
- Department of Physical Therapy, Universidade Ibirapuera, São Paulo, Brazil.,Department of Physical Therapy, University of São Paulo, São Paulo, Brazil
| | - Renata Nakata Teixeira
- Department of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil
| | - Milton A Martins
- Department of Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alberto Cukier
- Department of Pulmonary Diseases, Heart Institute (Incor), Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rafael Stelmach
- Department of Pulmonary Diseases, Heart Institute (Incor), Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Celso R F Carvalho
- Department of Physical Therapy, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
11
|
McNarry MA, Lewis MJ, Wade N, Davies GA, Winn C, Eddolls WTB, Stratton GS, Mackintosh KA. Effect of asthma and six-months high-intensity interval training on heart rate variability during exercise in adolescents. J Sports Sci 2019; 37:2228-2235. [PMID: 31164059 DOI: 10.1080/02640414.2019.1626115] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Little is known regarding the influence of asthma and exercise, and their interaction, on heart rate variability (HRV) in adolescents. Thirty-one adolescents with asthma (13.7±0.9 years; 21.9±3.9 kg·m-2; 19 boys, 12 girls) and thirty-three healthy adolescents (13.8±0.9 years; 20.3±3.2 kg·m-2; 16 boys, 17 girls) completed an incremental ramp test and three heavy-intensity constant-work-rate cycle tests. Thirteen adolescents (7 boys, 6 girls; 6 asthma, 7 control) completed six-months high-intensity interval training (HIIT) and were compared to age- and sex-matched controls. Standard time-domain, frequency-domain and non-linear indices of HRV were derived at baseline, three- and six-months. Asthma did not influence HRV at baseline or following HIIT. Total power, low frequency and normalised low frequency power, and sympathovagal balance increased at three-months in HIIT, subsequently declining towards baseline at six-months. Normalised high frequency power was reduced at three-months in both groups, which was sustained at six-months. No effects of HIIT were observed in the time-domain nor in the non-linear indices. HRV was not influenced by asthma, potentially because such derangements are a function of disease progression, severity or duration. HIIT may be associated with a short-term shift towards greater sympathetic predominance during exercise, perhaps caused by physiological overload and fatigue.
Collapse
Affiliation(s)
- M A McNarry
- a Applied Sports Technology Exercise and Medicine Research Centre, Swansea University , Swansea , UK
| | - M J Lewis
- a Applied Sports Technology Exercise and Medicine Research Centre, Swansea University , Swansea , UK
| | | | - G A Davies
- b Swansea University Medical School, Singleton Campus, Swansea University , Swansea , UK
| | - Con Winn
- a Applied Sports Technology Exercise and Medicine Research Centre, Swansea University , Swansea , UK.,b Swansea University Medical School, Singleton Campus, Swansea University , Swansea , UK
| | - W T B Eddolls
- a Applied Sports Technology Exercise and Medicine Research Centre, Swansea University , Swansea , UK
| | - G S Stratton
- a Applied Sports Technology Exercise and Medicine Research Centre, Swansea University , Swansea , UK
| | - K A Mackintosh
- a Applied Sports Technology Exercise and Medicine Research Centre, Swansea University , Swansea , UK
| |
Collapse
|
12
|
Kim JK, Yang JH. Asthma and obesity: Is asthma a risk factor for obesity? ALLERGY ASTHMA & RESPIRATORY DISEASE 2019. [DOI: 10.4168/aard.2019.7.2.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ja Kyoung Kim
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jeong Hee Yang
- Department of Family Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| |
Collapse
|
13
|
Gomes AL, Mendonça VA, dos Santos Silva T, Pires CKV, P. Lima L, Silva AM, Camargos ACR, Neves CDC, Lacerda ACR, Leite HR. Cardiorespiratory and metabolic responses and reference equation validation to predict peak oxygen uptake for the incremental shuttle waking test in adolescent boys. PLoS One 2018; 13:e0206867. [PMID: 30383849 PMCID: PMC6211760 DOI: 10.1371/journal.pone.0206867] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/19/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous studies speculated that the Incremental Shuttle Walking Test (ISWT) is a maximal test in children and adolescents, however comparison between ISWT with cardiopulmonary exercise test has not yet performed. Furthermore, there is no regression equation available in the current literature to predict oxygen peak consumption (VO2 peak) in this population. This study aimed to assesses and correlate the cardiorespiratory responses of the ISWT with the cardiopulmonary exercise (CEPT) and to develop and validate a regression equation to predict VO2 peak in healthy sedentary adolescent boys. METHODS Forty-one participants were included in the study. In the first stage, the VO2 peak, respiratory exchange ratio (R peak), heart rate max (HR max) and percentage of predicted HR max (% predicted HR max) were evaluated in CEPT and ISWT (n = 26). Second, an equation was developed (n = 29) to predict VO2 peak. In both phases, the VO2 peak, respiratory exchange ratio R and hearth rate (HR) were evaluated. In the third stage, the validation equation was performed by another 12 participants. RESULTS Similar results in VO2 peak (P>0.05), R peak (P>0.05) and predicted maximum HR (P>0.05) were obtained between the ISWT and CEPT. Both tests showed moderate significant correlations of VO2 peak (r = 0.44, P = 0.002) e R peak (r = -0.53, P < 0.01), as well as the agreement of these measurements by Bland-Altman analysis (VO2 peak, bias = -0.13; R peak, bias = 0.0). Distance walked was the variable that explained 42.5% (R2 = 0.425, p = 0.0001) of the variance in VO2 peak. The equation was VO2 peak (predicted) = 20.94 + (0.02 x distance walked). The results obtained by the equation were not significantly different compared to the values obtained by the gas analyzer and the Bland-Altman analysis showed agreement (bias = 1.6). CONCLUSION The ISWT produced maximal cardiorespiratory responses comparable to the CEPT, and the developed equation showed viability for the prediction of VO2 peak in healthy sedentary adolescent boys.
Collapse
Affiliation(s)
- Andreza L. Gomes
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Vanessa A. Mendonça
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Tatiane dos Santos Silva
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Crislaine K. V. Pires
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Liliana P. Lima
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Alcilene M. Silva
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Ana Cristina R. Camargos
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Diamantina, Minas Gerais, Brazil
| | - Camila D. C. Neves
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Ana C. R. Lacerda
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| | - Hércules R. Leite
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK, Alto da Jacuba, Diamantina, Minas Gerais, Brazil
| |
Collapse
|
14
|
Scalco JC, Martins R, Keil PMR, Mayer AF, Schivinski CIS. PSYCHOMETRIC PROPERTIES OF FUNCTIONAL CAPACITY TESTS IN CHILDREN AND ADOLESCENTS: SYSTEMATIC REVIEW. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2018; 36:500-510. [PMID: 30462776 PMCID: PMC6322795 DOI: 10.1590/1984-0462/;2018;36;4;00002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 09/01/2017] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To identify studies that evaluated psychometric properties of functional capacity tests in children and adolescents, and to verify which of these have satisfactory properties of measurement. DATA SOURCES Searches on MEDical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scientific Electronic Library Online (SciELO) databases without limiting period or language. Two investigators independently selected articles based on the following inclusion criteria: children and/or adolescent population (healthy or with cardiorespiratory diseases); and assessment of psychometric properties of functional capacity tests. Studies with (I) adult samples, (II) sample with neurological diseases, and (III) on reference values or prediction equations only were excluded. DATA SYNTHESIS From the total of 677 articles identified, 11 were selected. These evaluated the psychometric properties of the following tests: 6-minute walk test (6MWT) (n=7); 6MWT and the 3-minute step test (3MST) (n=1); and Incremental Shuttle Walk Test (ISWT) (n=3). Reproducibility and reliability were good for 6MWT and ISWT, and moderate for 3MST. The ISWT showed high validity measures for both healthy children and children with chronic respiratory disease. The validity of 6MWT varied across studies, and should be analyzed according to the health conditions of test takers. The validity of 3MST is unclear, and further studies in pediatric population are required. CONCLUSIONS Most studies investigated 6MWT measurement properties. Validity of 6MWT varied according to different pediatric populations. The use of 6MWT, ISWT and 3MST tests to measure clinically important changes in children and adolescents with cardiorespiratory diseases is still unclear.
Collapse
Affiliation(s)
| | - Renata Martins
- Universidade do Estado de Santa Catarina, Florianópolis, SC,
Brasil
| | | | | | | |
Collapse
|
15
|
Pedroni AS, Schiavo A, Macedo ED, Campos NED, Winck AD, Heinzmann-Filho JP. Predictive maximal heart rate equations in child and adolescent athletes: a systematic review. FISIOTERAPIA EM MOVIMENTO 2018. [DOI: 10.1590/1980-5918.031.ao31] [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 Introduction: The maximal heart rate (HRmax) is considered the highest value of HR achieved during a physical effort close to exhaustion. Objective: To evaluate the applicability of the predictive HRmax equations during exercise tests in child and adolescent athletes through a systematic review. Methods: It is a systematic review, through Scopus, Pubmed, Lilacs, Scielo and PEDro. The included studies compared the measured and estimated HRmax predictive equations during exercise tests in child and adolescent athletes. The following search strategy was used: “Exercise test OR Exercise testing OR Cardiopulmonary exercise test OR Cardiopulmonary exercise testing OR Peak oxygen uptake OR Maximal oxygen consumption OR Exercise capacity OR Heart rate OR Heart rate OR Pulse rate OR Pulse rates OR Heart rate control OR Cardiac chronotropic OR Predictive value test AND Predictive equations”. Results: From a total of 1,664 articles, only 4 were included. All compared the measured HRmax values with those estimated by the “220 - age” equation; 3 used the formula “208 - (0.7 x age)”, and only 1 used the “223 - (1.44 x age)” equation. Although all of them stated that the “220 - age” equation overestimates HRmax, the formula “208 - (0.7 x age”) underestimated (2 articles) and overestimated (1 study) the measured results, while the equation “213 - (1.44 x age) was also not adequate. Conclusion: The use of predictive HRmax equations for child and adolescent athletes does not seem to be recommended. The use of cohort points for these estimates is carefully recommended.
Collapse
|
16
|
Lanza FDC, Zagatto EDP, Silva JC, Selman JPR, Imperatori TBG, Zanatta DJM, de Carvalho LN, Reimberg MM, Dal Corso S. Reference Equation for the Incremental Shuttle Walk Test in Children and Adolescents. J Pediatr 2015; 167:1057-61. [PMID: 26323195 DOI: 10.1016/j.jpeds.2015.07.068] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/26/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine a prediction equation for distance walked of incremental shuttle walk test (ISWT) and test its reliability in children and adolescents. STUDY DESIGN Cross-sectional study, which included 108 healthy volunteers between 6 and 18 years old. Those who had an abnormal spirometry or had a history of chronic disease were excluded. Two ISWT were performed. Heart rate and peripheral capillary oxygen saturation (SpO2) were continuously measured during the test. Dyspnea and lower limb fatigue were assessed by Borg scale before and after the tests. RESULTS Boys walked longer distances compared with girls (1066.4 ± 254.1 m vs 889.7 ± 159.6 m, respectively, P < .0001). Except for dyspnea, there were no significant differences in the other outcomes measured (heart rate, lower limb fatigue, SpO2, and distance walked) at the peak of the two ISWT. The variables included in the predicted equation were age, body mass index, and sex. The predicted equation is: ISWTpred = 845.559 + (sex * 193.265) + (age * 47.850) - (body mass index * 26.179). The distance walked had an excellent reliability between the two ISWT, 0.98 (95% CI 0.97-0.99). The Bland-Altman plot shows agreement between tests (range from -40 to 45 m). CONCLUSIONS We established a prediction equation for ISWT. It can be used as a reference to evaluate exercise capacity for children and adolescents. ISWT has excellent repeatability and it is a maximal-effort field test for this age group.
Collapse
Affiliation(s)
- Fernanda de Cordoba Lanza
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo, SP, Brazil.
| | - Eduardo do Prado Zagatto
- School of Physiotherapy, Health Department, Universidade Nove de Julho - UNINOVE, Sao Paulo, SP, Brazil
| | - Jacksoel Cunha Silva
- School of Physiotherapy, Health Department, Universidade Nove de Julho - UNINOVE, Sao Paulo, SP, Brazil
| | | | | | | | | | - Mariana Mazzuca Reimberg
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo, SP, Brazil
| | - Simone Dal Corso
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo, SP, Brazil
| |
Collapse
|
17
|
Lutfi MF. Patterns of heart rate variability and cardiac autonomic modulations in controlled and uncontrolled asthmatic patients. BMC Pulm Med 2015; 15:119. [PMID: 26459382 PMCID: PMC4603942 DOI: 10.1186/s12890-015-0118-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 10/05/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Previous heart rate variability (HRV) studies in asthmatic subjects (AS) demonstrate predominance of parasympathetic drive concomitant with low HRV, which is against the general belief that enhanced parasympathetic modulation improves HRV. The aim of this study was to compare patterns of HRV and cardiac autonomic modulations of AS to healthy control subjects (HS). METHODS Eighty AS and forty HS were enrolled in the study. Asthma control test and spirometry were used to discriminate uncontrolled (UA) from controlled (CA) asthmatic patients. Natural logarithmic (Ln) scale of total power (TP), very low frequency (VLF), low frequency (LF) and high frequency (HF) were used to evaluate HRV. Normalized low frequency (LF Norm) and high frequency (HF Norm) were used to determine sympathetic and parasympathetic autonomic modulations respectively. RESULTS CA patients achieved significantly higher LnTP, LnLF, LnHF and HF Norm but lower LF Norm and LnLF/HF compared with UA patients (p < 0.05). Although CA patients showed increased HRV and augmented vagal modulation compared with HS, these findings were no longer significant following adjustment for mean heart rates and anti-asthma treatment. All measured HRV parameters were not significantly different in UA patients compared with the HS (p > 0.05). CONCLUSIONS CA is associated with enhanced parasympathetic modulations and higher HRV compared with UA. However, neither CA nor UA patients had different autonomic modulations and/or HRV compared with HS.
Collapse
Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan.
| |
Collapse
|
18
|
Gomes ELDFD, Costa D. Evaluation of functional, autonomic and inflammatory outcomes in children with asthma. World J Clin Cases 2015; 3:301-309. [PMID: 25789303 PMCID: PMC4360502 DOI: 10.12998/wjcc.v3.i3.301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 11/18/2014] [Accepted: 12/19/2014] [Indexed: 02/05/2023] Open
Abstract
Asthma is common in childhood. This respiratory disease is characterized by persistent inflammation of the airways even when the child is not in the throes of an attack. Chronic inflammation is caused by an imbalance between pro-inflammatory and anti-inflammatory mechanisms as well as autonomic dysfunction, which plays an important role in the pathogenesis and control of this condition. The impact of these physiopathological aspects leads to inactivity and a sedentary lifestyle, which exerts an influence on functional capacity and control of the disease. The main objective of non-pharmacological therapy is the clinical control of asthma and the minimization of airway obstruction and hyperinflation during an attack. These factors can be controlled with noninvasive ventilation. The aim or the present review was to describe important neural, inflammatory and functional mechanisms that affect children with asthma.
Collapse
|
19
|
Garcia-Araújo AS, Pires Di Lorenzo VA, Labadessa IG, Jürgensen SP, Di Thommazo-Luporini L, Garbim CL, Borghi-Silva A. Increased sympathetic modulation and decreased response of the heart rate variability in controlled asthma. J Asthma 2014; 52:246-53. [PMID: 25158110 DOI: 10.3109/02770903.2014.957765] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the autonomic modulation of heart rate (HR) in asthmatic and healthy volunteers to correlate it with the forced expiratory volume in the first second (FEV1). METHODS Ten healthy and 14 asthmatic volunteers were included in this cross-sectional study. The volunteers underwent a cardiopulmonary exercise test, spirometry and a register of both resting heart rate variability (HRV) in the supine and seated positions along with HRV during the respiratory sinus arrhythmia maneuver (M-RSA). RESULTS At rest in supine, asthmatic volunteers presented a higher HR (77.1 ± 9.9 vs. 68.7 ± 8.7 bpm), shorter interval between two R waves (R-Ri) (807.5 ± 107.2 vs. 887.5 ± 112.7 ms) when compared with the healthy volunteers, respectively. Moreover, in the frequency domain of HRV, there was increased low frequency (LF) index (50.4 ± 17.1 vs. 29.2 ± 11.1 n.u.) and decreased high frequency (HF) index (49.4 ± 17.1 vs. 70.7 ± 11.1 n.u.). During the M-RSA, the asthmatic presented higher HR (82.6 ± 10.0 vs. 72.4 ± 7.6 bpm) and lower values of R-Ri (746.4 ± 92.1 vs. 846.4 ± 81.4 ms) and approximate entropy (ApEn) (0.7 ± 0.0 vs. 0.8 ± 0.1). FEV1 was strongly correlated with the change of the continuous beat-to-beat variability of HR (SD2) index from the seated to the supine position (r = 0.78). CONCLUSION Controlled asthma in adults appears to induce an increased sympathetic modulation and attenuated response to the postural changes and the M-RSA. Furthermore, there is a correlation between the airways' obstruction and HRV, especially during postural changes.
Collapse
|