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Published in: BMC Pulmonary Medicine 1/2015

Open Access 01-12-2015 | Research article

Patterns of heart rate variability and cardiac autonomic modulations in controlled and uncontrolled asthmatic patients

Author: Mohamed Faisal Lutfi

Published in: BMC Pulmonary Medicine | Issue 1/2015

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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.
Literature
1.
go back to reference Freeman R, Chapleau MW. Testing the autonomic nervous system. Handb Clin Neurol. 2013;115:115–36.CrossRefPubMed Freeman R, Chapleau MW. Testing the autonomic nervous system. Handb Clin Neurol. 2013;115:115–36.CrossRefPubMed
2.
go back to reference Rubio A, Van Oudenhove L, Pellissier S, Ly HG4, Dupont P, de Micheaux HL, et al. Uncertainty in anticipation of uncomfortable rectal distension is modulated by the autonomic nervous system--a fMRI study in healthy volunteers. Neuroimage. 2015;107:10–22.CrossRefPubMed Rubio A, Van Oudenhove L, Pellissier S, Ly HG4, Dupont P, de Micheaux HL, et al. Uncertainty in anticipation of uncomfortable rectal distension is modulated by the autonomic nervous system--a fMRI study in healthy volunteers. Neuroimage. 2015;107:10–22.CrossRefPubMed
3.
go back to reference Harris PR, Sommargren CE, Stein PK, Fung GL, Drew BJ. Heart rate variability measurement and clinical depression in acute coronary syndrome patients: narrative review of recent literature. Neuropsychiatr Dis Treat. 2014;10:1335–47.CrossRefPubMedPubMedCentral Harris PR, Sommargren CE, Stein PK, Fung GL, Drew BJ. Heart rate variability measurement and clinical depression in acute coronary syndrome patients: narrative review of recent literature. Neuropsychiatr Dis Treat. 2014;10:1335–47.CrossRefPubMedPubMedCentral
4.
go back to reference Jain S, Ton TG, Perera S, Zheng Y, Stein PK, Thacker E, et al. Cardiovascular physiology in premotor Parkinson's disease: a neuroepidemiologic study. Mov Disord. 2012;27(8):988-95. Jain S, Ton TG, Perera S, Zheng Y, Stein PK, Thacker E, et al. Cardiovascular physiology in premotor Parkinson's disease: a neuroepidemiologic study. Mov Disord. 2012;27(8):988-95.
5.
go back to reference Gomes EL, Sampaio LM, Costa IP, Dias FD, Ferneda VS, Silva GA, et al. Analysis of autonomic modulation during maximal and submaximal work rate and functional capacity in asthmatic children. J Asthma. 2013;50(6):613–8.CrossRefPubMed Gomes EL, Sampaio LM, Costa IP, Dias FD, Ferneda VS, Silva GA, et al. Analysis of autonomic modulation during maximal and submaximal work rate and functional capacity in asthmatic children. J Asthma. 2013;50(6):613–8.CrossRefPubMed
6.
go back to reference Gupta J, Dube A, Singh V, Gupta RC. Spectral analysis of heart rate variability in bronchial asthma patients. Indian J Physiol Pharmacol. 2012;56(4):330–6.PubMed Gupta J, Dube A, Singh V, Gupta RC. Spectral analysis of heart rate variability in bronchial asthma patients. Indian J Physiol Pharmacol. 2012;56(4):330–6.PubMed
7.
go back to reference Tsai YS, Lai FC, Chen SR, Jeng C. The influence of physical activity level on heart rate variability among asthmatic adults. J Clin Nurs. 2011;20(1-2):111–8.CrossRefPubMed Tsai YS, Lai FC, Chen SR, Jeng C. The influence of physical activity level on heart rate variability among asthmatic adults. J Clin Nurs. 2011;20(1-2):111–8.CrossRefPubMed
9.
go back to reference Garcia-Araújo AS, Pires Di Lorenzo VA, Labadessa IG, Jürgensen SP, Di Thommazo-Luporini L, Garbim CL, et al. Increased sympathetic modulation and decreased response of the heart rate variability in controlled asthma. J Asthma. 2014;31:1–8. Garcia-Araújo AS, Pires Di Lorenzo VA, Labadessa IG, Jürgensen SP, Di Thommazo-Luporini L, Garbim CL, et al. Increased sympathetic modulation and decreased response of the heart rate variability in controlled asthma. J Asthma. 2014;31:1–8.
10.
go back to reference Cabiddu R, Aletti F, Duarte Souza V, Peres Costa I, Stirbulov R, Borghi Silva A, et al. Cardiorespiratory coupling during sleep in difficult-to-control asthmatic patients. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:3652–5.PubMed Cabiddu R, Aletti F, Duarte Souza V, Peres Costa I, Stirbulov R, Borghi Silva A, et al. Cardiorespiratory coupling during sleep in difficult-to-control asthmatic patients. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:3652–5.PubMed
12.
go back to reference Kazuma N, Otsuka K, Matsuoka I, Murata M. Heart rate variability during 24 hours in asthmatic children. Chronobiol Int. 1997;14:597–606.CrossRefPubMed Kazuma N, Otsuka K, Matsuoka I, Murata M. Heart rate variability during 24 hours in asthmatic children. Chronobiol Int. 1997;14:597–606.CrossRefPubMed
13.
go back to reference McLachlan CS, Ocsan R, Spence I, Hambly B, Matthews S, Wang L, et al. Increased total heart rate variability and enhanced cardiac vagal autonomic activity in healthy humans with sinus bradycardia. Proc (Bayl Univ Med Cent). 2010;23(4):368-70. McLachlan CS, Ocsan R, Spence I, Hambly B, Matthews S, Wang L, et al. Increased total heart rate variability and enhanced cardiac vagal autonomic activity in healthy humans with sinus bradycardia. Proc (Bayl Univ Med Cent). 2010;23(4):368-70.
14.
go back to reference Sridhar B, Haleagrahara N, Bhat R, Kulur AB, Avabratha S, Adhikary P. Increase in the heart rate variability with deep breathing in diabetic patients after 12-month exercise training. Tohoku J Exp Med. 2010;220(2):107–13.CrossRefPubMed Sridhar B, Haleagrahara N, Bhat R, Kulur AB, Avabratha S, Adhikary P. Increase in the heart rate variability with deep breathing in diabetic patients after 12-month exercise training. Tohoku J Exp Med. 2010;220(2):107–13.CrossRefPubMed
15.
go back to reference Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability standards of measurement, physiological interpretation and clinical use. Circulation. 1996;93:65–1043. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability standards of measurement, physiological interpretation and clinical use. Circulation. 1996;93:65–1043.
16.
go back to reference Sacha J. Interaction between heart rate and heart rate variability. Ann Noninvasive Electrocardiol. 2014;19(3):207–16.CrossRefPubMed Sacha J. Interaction between heart rate and heart rate variability. Ann Noninvasive Electrocardiol. 2014;19(3):207–16.CrossRefPubMed
17.
go back to reference Eryonucu B, Uzun K, Güler N, Tuncer M, Sezgi C. Comparison of the short-term effects of salmeterol and formoterol on heart rate variability in adult asthmatic patients. Chest. 2005;128(3):1136–9.CrossRefPubMed Eryonucu B, Uzun K, Güler N, Tuncer M, Sezgi C. Comparison of the short-term effects of salmeterol and formoterol on heart rate variability in adult asthmatic patients. Chest. 2005;128(3):1136–9.CrossRefPubMed
18.
go back to reference Anthracopoulos MB, Karatza AA, Davlouros PA, Chiladakis JA, Manolis AS, Beratis NG. Effects of two nebulization regimens on heart rate variability during acute asthma exacerbations in children. J Asthma. 2005;42(4):273–9.CrossRefPubMed Anthracopoulos MB, Karatza AA, Davlouros PA, Chiladakis JA, Manolis AS, Beratis NG. Effects of two nebulization regimens on heart rate variability during acute asthma exacerbations in children. J Asthma. 2005;42(4):273–9.CrossRefPubMed
19.
go back to reference Barnes PJ. Severe asthma: advances in current management and future therapy. J Allergy Clin Immunol. 2012;129(1):48–59.CrossRefPubMed Barnes PJ. Severe asthma: advances in current management and future therapy. J Allergy Clin Immunol. 2012;129(1):48–59.CrossRefPubMed
20.
go back to reference Giavina‐Bianchi P, Aun MV, Bisaccioni C, Agondi R, Kalil J. Difficult‐to‐control asthma management through the use of a specific protocol. Clinics. 2010;65(9):905–18.PubMedPubMedCentral Giavina‐Bianchi P, Aun MV, Bisaccioni C, Agondi R, Kalil J. Difficult‐to‐control asthma management through the use of a specific protocol. Clinics. 2010;65(9):905–18.PubMedPubMedCentral
21.
go back to reference Lutfi MF. Reliability of Asthma Control Test in Assessing Bronchial Asthma; A pilot Study in Sudanese Asthmatic Patients. Alneelain Med J. 2011;1(1):1–7. Lutfi MF. Reliability of Asthma Control Test in Assessing Bronchial Asthma; A pilot Study in Sudanese Asthmatic Patients. Alneelain Med J. 2011;1(1):1–7.
22.
go back to reference Kennedy J, Jones S. Asthma Control Test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists. Pediatrics. 2007;120:S132–3.CrossRef Kennedy J, Jones S. Asthma Control Test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists. Pediatrics. 2007;120:S132–3.CrossRef
23.
go back to reference Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–38.CrossRefPubMed Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–38.CrossRefPubMed
24.
go back to reference Lutfi MF. Review article: Heart rate variability. Sud JMS. 2011;6:43–50. Lutfi MF. Review article: Heart rate variability. Sud JMS. 2011;6:43–50.
25.
go back to reference Emin O, Esra G, Aysegül D, Ufuk E, Ayhan S, Rusen DM. Autonomic nervous system dysfunction and their relationship with disease severity in children with atopic asthma. Respir Physiol Neurobiol. 2012;183(3):206–10.CrossRefPubMed Emin O, Esra G, Aysegül D, Ufuk E, Ayhan S, Rusen DM. Autonomic nervous system dysfunction and their relationship with disease severity in children with atopic asthma. Respir Physiol Neurobiol. 2012;183(3):206–10.CrossRefPubMed
26.
go back to reference Sato K, Kawamura T, Abo T. “Senobi” stretch ameliorates asthma symptoms by restoring autonomic nervous system balance. J Investig Med. 2010;58(8):968–70.CrossRefPubMed Sato K, Kawamura T, Abo T. “Senobi” stretch ameliorates asthma symptoms by restoring autonomic nervous system balance. J Investig Med. 2010;58(8):968–70.CrossRefPubMed
27.
go back to reference Ostrowska-Nawarycz L, Wroński W, Błaszczyk J, Buczyłko K, Nawarycz T. The heart rate variability analysis in youth and children with bronchial asthma. Pol Merkur Lekarski. 2006;20(118):399–403.PubMed Ostrowska-Nawarycz L, Wroński W, Błaszczyk J, Buczyłko K, Nawarycz T. The heart rate variability analysis in youth and children with bronchial asthma. Pol Merkur Lekarski. 2006;20(118):399–403.PubMed
28.
go back to reference Tascilar E, Yokusoglu M, Dundaroz R, Baysan O, Ozturk S, Yozgat Y, et al. Cardiac autonomic imbalance in children with allergic rhinitis. Tohoku J Exp Med. 2009;219(3):187–91.CrossRefPubMed Tascilar E, Yokusoglu M, Dundaroz R, Baysan O, Ozturk S, Yozgat Y, et al. Cardiac autonomic imbalance in children with allergic rhinitis. Tohoku J Exp Med. 2009;219(3):187–91.CrossRefPubMed
29.
go back to reference Boettger MK, Bär KJ, Dohrmann A, Müller H, Mertins L, Brockmeyer NH, et al. Increased vagal modulation in atopic dermatitis. J Dermatol Sci. 2009;53(1):55–9.CrossRefPubMed Boettger MK, Bär KJ, Dohrmann A, Müller H, Mertins L, Brockmeyer NH, et al. Increased vagal modulation in atopic dermatitis. J Dermatol Sci. 2009;53(1):55–9.CrossRefPubMed
30.
go back to reference Du J, He J, Wang Y. A study of heart rate variability in asthma. Zhonghua Jie He He Hu Xi Za Zhi. 2001;24:744–5.PubMed Du J, He J, Wang Y. A study of heart rate variability in asthma. Zhonghua Jie He He Hu Xi Za Zhi. 2001;24:744–5.PubMed
31.
go back to reference Dulin N, Fernandes D, Dowell M, Bellam S, McConville J, Lakser O, et al. What evidence implicates airway smooth muscle in the cause of BHR? Clin Rev Allergy Immunol. 2003;24:73–84.CrossRefPubMed Dulin N, Fernandes D, Dowell M, Bellam S, McConville J, Lakser O, et al. What evidence implicates airway smooth muscle in the cause of BHR? Clin Rev Allergy Immunol. 2003;24:73–84.CrossRefPubMed
32.
go back to reference Solway J. What makes the airways contract abnormally? Is it inflammation? Am J Respir Crit Care Med. 2000;161:S164–7.CrossRefPubMed Solway J. What makes the airways contract abnormally? Is it inflammation? Am J Respir Crit Care Med. 2000;161:S164–7.CrossRefPubMed
33.
go back to reference Brusasco V, Pellegrino R. Invited Review: Complexity of factors modulating airway narrowing in vivo: relevance to assessment of airway hyperresponsiveness. J Appl Physiol. 2003;95:1305–13.CrossRefPubMed Brusasco V, Pellegrino R. Invited Review: Complexity of factors modulating airway narrowing in vivo: relevance to assessment of airway hyperresponsiveness. J Appl Physiol. 2003;95:1305–13.CrossRefPubMed
34.
go back to reference Lambert R, Paré P. Lung parenchymal shear modulus, airway wall remodeling, and bronchial hyperresponsiveness. J Appl Physiol. 1997;83:140–7.PubMed Lambert R, Paré P. Lung parenchymal shear modulus, airway wall remodeling, and bronchial hyperresponsiveness. J Appl Physiol. 1997;83:140–7.PubMed
35.
go back to reference Reyes del Paso GA, Langewitz W, Mulder LJ, van Roon A, Duschek S. The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: a review with emphasis on a reanalysis of previous studies. Psychophysiology. 2013;50(5):477–87.CrossRefPubMed Reyes del Paso GA, Langewitz W, Mulder LJ, van Roon A, Duschek S. The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: a review with emphasis on a reanalysis of previous studies. Psychophysiology. 2013;50(5):477–87.CrossRefPubMed
36.
go back to reference Goldstein DS, Bentho O, Park MY, Sharabi Y. Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Exp Physiol. 2011;96(12):1255–61.CrossRefPubMedPubMedCentral Goldstein DS, Bentho O, Park MY, Sharabi Y. Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Exp Physiol. 2011;96(12):1255–61.CrossRefPubMedPubMedCentral
Metadata
Title
Patterns of heart rate variability and cardiac autonomic modulations in controlled and uncontrolled asthmatic patients
Author
Mohamed Faisal Lutfi
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2015
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-015-0118-8

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