Zabara-Antal Andreea, Crisan-Dabija Radu, Arcana Raluca-Ioana, Melinte Oana Elena, Pintilie Adriana-Loredana, Grosu-Creanga Ionela Alina, Zabara Mihai Lucian, Trofor Antigona
Clinical Hospital of Pulmonary Diseases Iasi, 700116 Iasi, Romania.
Faculty of General Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Doctoral Student, 700115 Iasi, Romania.
J Clin Med. 2025 Jun 30;14(13):4630. doi: 10.3390/jcm14134630.
Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are prevalent conditions with overlapping clinical features and shared consequences on autonomic function. Heart rate variability (HRV), a non-invasive biomarker of autonomic nervous system activity, may offer diagnostic, prognostic, and therapeutic insights in this patient population.
A comprehensive literature review was conducted using PubMed, Google Scholar, and MEDLINE to identify peer-reviewed English-language studies published between January 2015 and December 2024. Studies were included if they evaluated HRV parameters in individuals with OSA, COPD, or overlap syndrome, explored HRV as a marker of disease severity or progression. A total of 239 studies were identified; after screening, 41 met the inclusion criteria.
The analysis revealed consistent evidence linking reduced HRV with both OSA and COPD severity. HRV alterations were more pronounced in overlap syndrome, reflecting synergistic autonomic dysfunction. HRV showed potential in differentiating disease stages, predicting cardiovascular risk, and evaluating treatment efficacy, particularly for CPAP therapy in OSA. Short-term HRV was particularly sensitive to autonomic changes, while long-term recordings helped track disease progression. Emerging evidence supports the use of HRV derived from wearable technologies as a viable screening tool for health and wellness.
HRV is a valuable, non-invasive tool for assessing autonomic dysfunction in OSA, COPD, and their overlap. It offers significant potential for early diagnosis, disease monitoring, and treatment evaluation. Integrating HRV into clinical practice, could enhance diagnostic efficiency, reduce healthcare burden, and improve outcomes in high-risk respiratory populations. Furthermore, longitudinal studies are warranted to standardise HRV thresholds and validate their use in routine screening protocols.
阻塞性睡眠呼吸暂停（OSA）和慢性阻塞性肺疾病（COPD）是常见病症，具有重叠的临床特征，并对自主神经功能产生共同影响。心率变异性（HRV）是自主神经系统活动的一种非侵入性生物标志物，可能为该患者群体提供诊断、预后和治疗方面的见解。
使用PubMed、谷歌学术和MEDLINE进行了全面的文献综述，以识别2015年1月至2024年12月期间发表的经同行评审的英文研究。如果研究评估了OSA、COPD或重叠综合征患者的HRV参数，将HRV作为疾病严重程度或进展的标志物进行探索，则纳入研究。共识别出239项研究；经过筛选，41项符合纳入标准。
分析显示有一致的证据表明HRV降低与OSA和COPD的严重程度相关。HRV改变在重叠综合征中更为明显，反映了协同的自主神经功能障碍。HRV在区分疾病阶段、预测心血管风险和评估治疗效果方面显示出潜力，特别是对于OSA的持续气道正压通气（CPAP）治疗。短期HRV对自主神经变化特别敏感，而长期记录有助于追踪疾病进展。新出现的证据支持将可穿戴技术衍生的HRV用作健康和 wellness 的可行筛查工具。
HRV是评估OSA、COPD及其重叠情况中自主神经功能障碍的一种有价值的非侵入性工具。它在早期诊断、疾病监测和治疗评估方面具有巨大潜力。将HRV纳入临床实践可以提高诊断效率、减轻医疗负担并改善高危呼吸人群的预后。此外，有必要进行纵向研究以标准化HRV阈值并验证其在常规筛查方案中的应用。
