Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos, São Carlos, SP, Brazil.
Clinics (Sao Paulo). 2010 Apr;65(4):369-75. doi: 10.1590/S1807-59322010000400004.
A synchronism exists between the respiratory and cardiac cycles. However, the influence of the inspiratory muscle weakness in chronic obstructive pulmonary disease (COPD) on cardiac autonomic control is unknown. The purpose of the present investigation was to evaluate the influence of respiratory muscle strength on autonomic control in these patients.
Ten chronic obstructive pulmonary disease patients (69+/-9 years; FEV(1)/FVC 59+/-12% and FEV(1) 41+/-11% predicted) and nine age-matched healthy volunteers (64+/-5 years) participated in this study. Heart-rate variability (HRV) was obtained at rest and during respiratory sinusal arrhythmia maneuver (RSA-M) by electrocardiograph.
Chronic obstructive pulmonary disease patients demonstrated impaired cardiac autonomic modulation at rest and during RSA-M when compared with healthy subjects (p<0.05). Moreover, significant and positive correlations between maximal inspiratory pressure (MIP) and the inspiratory-expiratory difference (DeltaIE) (r = 0.60, p<0.01) were found.
Patients with chronic obstructive pulmonary disease presented impaired sympathetic-vagal balance at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in chronic obstructive pulmonary disease. Based on this evidence, future research applications of respiratory muscle training may bring to light a potentially valuable target for rehabilitation.
呼吸和心脏周期之间存在同步性。然而，慢性阻塞性肺疾病（COPD）患者吸气肌力量对心脏自主控制的影响尚不清楚。本研究旨在评估呼吸肌力量对这些患者自主控制的影响。
10 名慢性阻塞性肺疾病患者（69+/-9 岁；FEV1/FVC 59+/-12%和 FEV1 41+/-11%预计值）和 9 名年龄匹配的健康志愿者（64+/-5 岁）参与了这项研究。通过心电图在休息和呼吸窦性心律失常（RSA-M）期间获得心率变异性（HRV）。
与健康受试者相比，COPD 患者在休息和 RSA-M 期间表现出心脏自主调节受损（p<0.05）。此外，还发现最大吸气压力（MIP）和吸气-呼气差（DeltaIE）之间存在显著正相关（r = 0.60，p<0.01）。
COPD 患者在休息时表现出交感神经-迷走神经平衡受损。此外，COPD 患者的心率自主控制与吸气肌力量相关。基于这些证据，呼吸肌训练的未来研究应用可能会揭示一个有价值的康复目标。
