Department of Pneumology, University Hospital Ruhrlandklinik, Essen, Germany.
Respirology. 2011 Aug;16(6):939-46. doi: 10.1111/j.1440-1843.2011.01992.x.
COPD is associated with impaired health-related quality of life (HRQL) and cardiac autonomic dysfunction. Data describing the association between these factors in patients with COPD are mostly lacking. The objective of this study was to evaluate whether there is an association between cardiac autonomic dysfunction and HRQL in COPD.
We studied 60 patients with COPD (37 women, mean (SD) age 65.20 (7.73) years, FEV(1) % pred. 46.58 (18.53) %) and measured HRQL, as assessed by the Chronic Respiratory Disease Questionnaire, and cardiac autonomic dysfunction, as assessed by heart rate variability (HRV). Analysis of HRV was performed using a Holter-ECG device during a recording period of 5 min. To evaluate a possible association between these factors, univariate and multivariate analyses were used.
There was a significant correlation between Chronic Respiratory Disease Questionnaire total score and both variables of HRV reflecting parasympathetic tone; root mean square successive difference of RR intervals (rMSSD) (r = 0.34, P = 0.012) and the density of the beat-to-beat oscillation in the N-N interval of HRV in the high-frequency band (HF power) (r = 0.35, P = 0.01). In a multivariate analysis rMSSD was found to be independently associated with HRQL after correcting for FEV(1), carbon monoxide transfer coefficient (DL(CO)), 6MWD and CRP.
Resting parasympathetic tone, as measured by HRV, is independently associated with HRQL, which emphasizes the role of cardiac autonomic dysfunction on HRQL in patients with COPD.
COPD 与健康相关生活质量（HRQL）受损和心脏自主神经功能障碍相关。描述 COPD 患者中这些因素之间关联的数据大多缺乏。本研究旨在评估 COPD 患者中是否存在心脏自主神经功能障碍与 HRQL 之间的关联。
我们研究了 60 例 COPD 患者（37 名女性，平均年龄（标准差）为 65.20（7.73）岁，FEV1%预测值为 46.58（18.53）%），并使用慢性呼吸道疾病问卷评估 HRQL，使用动态心电图仪在 5 分钟的记录期间评估心脏自主神经功能障碍。使用单变量和多变量分析来分析 HRV 与 HRQL 之间的可能关联。
慢性呼吸道疾病问卷总分与反映副交感神经张力的 HRV 两个变量均存在显著相关性；RR 间期的均方根连续差异（rMSSD）（r=0.34，P=0.012）和 HRV 中高频带（HF 功率）中 N-N 间期的逐搏振荡密度（r=0.35，P=0.01）。在多元分析中，在校正 FEV1、一氧化碳转移系数（DL（CO））、6MWD 和 CRP 后，rMSSD 被发现与 HRQL 独立相关。
HRV 测量的静息副交感神经张力与 HRQL 独立相关，这强调了心脏自主神经功能障碍对 COPD 患者 HRQL 的作用。
