Zangrando Katiany Thays Lopes, Trimer Renata, de Carvalho Luiz Carlos Soares, Arêas Guilherme Peixoto Tinoco, Caruso Flávia Cristina Rossi, Cabiddu Ramona, Roscani Meliza Goi, Rizzatti Fabíola Paula Galhardo, Borghi-Silva Audrey
Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
Physical Education and Health Department, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.
Int J Chron Obstruct Pulmon Dis. 2018 Apr 26;13:1343-1351. doi: 10.2147/COPD.S156168. eCollection 2018.
The study was conducted to determine the impact of chronic obstructive pulmonary disease (COPD) in association with obstructive sleep apnea syndrome (OSAS) on cardiac autonomic control and functional capacity.
The study was a cross-sectional prospective controlled clinical study. Heart rate variability indices of 24 COPD (n = 12) and COPD+OSAS (n = 12) patients were evaluated and compared by electrocardiographic recordings acquired during rest, active postural maneuver (APM), respiratory sinus arrhythmia maneuver (RSA-m), and the 6-minute walk test (6MWT).
The COPD group presented higher parasympathetic modulation during APM when compared to the COPD+OSAS group ( = 0.02). The COPD+OSAS group presented higher sympathetic modulation during RSA-m when compared to the COPD group ( = 0.00). The performance during 6MWT was similarly impaired in both groups, despite the greater severity of the COPD group.
Subjects with COPD+OSAS present marked sympathetic modulation, and the presence of OSAS in COPD subjects has a negative impact on functional capacity regardless of the severity of lung disease.
本研究旨在确定慢性阻塞性肺疾病（COPD）合并阻塞性睡眠呼吸暂停综合征（OSAS）对心脏自主神经控制和功能能力的影响。
本研究为横断面前瞻性对照临床研究。通过在静息、主动体位动作（APM）、呼吸性窦性心律不齐动作（RSA-m）和6分钟步行试验（6MWT）期间采集的心电图记录，对24例COPD患者（n = 12）和COPD + OSAS患者（n = 12）的心率变异性指标进行评估和比较。
与COPD + OSAS组相比，COPD组在APM期间呈现出更高的副交感神经调制（P = 0.02）。与COPD组相比，COPD + OSAS组在RSA-m期间呈现出更高的交感神经调制（P = 0.00）。尽管COPD组病情更严重，但两组在6MWT期间的表现同样受损。
COPD + OSAS患者表现出明显的交感神经调制，并且COPD患者中OSAS的存在对功能能力有负面影响，而与肺部疾病的严重程度无关。
