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Clinical Autonomic Research

19-03-2024 | Non-Invasive Ventilation | Letter to the Editor

Effective non-invasive ventilation reduces muscle sympathetic nerve activity in patients with stable hypercapnic COPD

Authors: Binaya Regmi, Chiara Borrelli, Alberto Giannoni, Florian Kahles, Vaughan G. Macefield, Michael Dreher, Jens Spiesshoefer

Published in: Clinical Autonomic Research

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Abstract

Increased sympathetic drive is of prognostic significance in chronic obstructive pulmonary disease (COPD) but its determinants remain poorly understood. One potential mechanism may be chemoreflex-mediated adrenergic stimulation caused by sustained hypercapnia. This study determined the impact of non-invasive ventilation (NIV) on muscle sympathetic nerve activity (MSNA) in patients with stable hypercapnic COPD. Ten patients (age 70 ± 7 years, GOLD stage 3–4) receiving long-term NIV (mean inspiratory positive airway pressure 21 ± 7 cmH2O) underwent invasive MSNA measurement via the peroneal nerve during spontaneous breathing and NIV. Compared with spontaneous breathing, NIV significantly reduced hypercapnia (PaCO2 51.5 ± 6.9 vs 42.6 ± 6.1 mmHg, p < 0.0001) along with the burst rate (64.4 ± 20.9 vs 59.2 ± 19.9 bursts/min, p = 0.03) and burst incidence (81.7 ± 29.3 vs 74.1 ± 26.9 bursts/100 heartbeats, p = 0.04) of MSNA. This shows for the first time that correcting hypercapnia with NIV decreases MSNA in COPD.
Literature
1.
Andreas S, Haarmann H, Klarner S, Hasenfuss G, Raupach T (2014) Increased sympathetic nerve activity in COPD is associated with morbidity and mortality. Lung 192:235–241CrossRefPubMed
2.
Ashley C, Burton D, Sverrisdottir YB, Sander M, McKenzie DK, Macefield VG (2010) Firing probability and mean firing rates of human muscle vasoconstrictor neurones are elevated during chronic asphyxia. J Physiol 588:701–712CrossRefPubMedPubMedCentral
3.
Vallbo AB, Hagbarth KE, Wallin BG (2004) Microneurography how the technique developed and its role in the investigation of the sympathetic nervous system. J Appl Physiol (1985) 96:1262–1269CrossRefPubMed
4.
Heindl S, Lehnert M, Criee CP, Hasenfuss G, Andreas S (2001) Marked sympathetic activation in patients with chronic respiratory failure. Am J Respir Crit Care Med 164:597–601CrossRefPubMed
5.
Barretto AC, Santos AC, Munhoz R, Rondon MU, Franco FG, Trombetta IC, Roveda F, de Matos LN, Braga AM, Middlekauff HR, Negrao CE (2009) Increased muscle sympathetic nerve activity predicts mortality in heart failure patients. Int J Cardiol 135:302–307CrossRefPubMed
6.
Haarmann H, Folle J, Nguyen XP, Herrmann P, Heusser K, Hasenfuss G, Andreas S, Raupach T (2016) Sympathetic activation is associated with exercise limitation in COPD. COPD 13:589–594CrossRefPubMed
7.
8.
Costes F, Roche F, Pichot V, Vergnon JM, Garet M, Barthelemy JC (2004) Influence of exercise training on cardiac baroreflex sensitivity in patients with COPD. Eur Respir J 23:396–401CrossRefPubMed
9.
van Gestel AJ, Kohler M, Clarenbach CF (2012) Sympathetic overactivity and cardiovascular disease in patients with chronic obstructive pulmonary disease (COPD). Discov Med 14:359–368PubMed
10.
Andreas S, Anker SD, Scanlon PD, Somers VK (2005) Neurohumoral activation as a link to systemic manifestations of chronic lung disease. Chest 128:3618–3624CrossRefPubMed
11.
Kohnlein T, Windisch W, Kohler D, Drabik A, Geiseler J, Hartl S, Karg O, Laier-Groeneveld G, Nava S, Schonhofer B, Schucher B, Wegscheider K, Criee CP, Welte T (2014) Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med 2:698–705CrossRefPubMed
12.
Borghi-Silva A, Reis MS, Mendes RG, Pantoni CB, Simoes RP, Martins LE, Catai AM (2008) Noninvasive ventilation acutely modifies heart rate variability in chronic obstructive pulmonary disease patients. Respir Med 102:1117–1123CrossRefPubMed
13.
Spiesshoefer J, Giannoni A, Borrelli C, Sciarrone P, Husstedt I, Emdin M, Passino C, Kahles F, Dawood T, Regmi B, Naughton M, Dreher M, Boentert M, Macefield VG (2022) Effects of hyperventilation length on muscle sympathetic nerve activity in healthy humans simulating periodic breathing. Front Physiol 13:934372CrossRefPubMedPubMedCentral
14.
Burnum JF, Hickam JB, Mc IH (1954) The effect of hypocapnia on arterial blood pressure. Circulation 9:89–95CrossRefPubMed
15.
Jouett NP, Watenpaugh DE, Dunlap ME, Smith ML (2015) Interactive effects of hypoxia, hypercapnia and lung volume on sympathetic nerve activity in humans. Exp Physiol 100:1018–1029CrossRefPubMed
16.
Haarmann H, Folle J, Nguyen XP, Herrmann P, Heusser K, Hasenfuss G, Andreas S, Raupach T (2017) Impact of non-invasive ventilation on sympathetic nerve activity in chronic obstructive pulmonary disease. Lung 195:69–75CrossRefPubMed
Metadata
Title
Effective non-invasive ventilation reduces muscle sympathetic nerve activity in patients with stable hypercapnic COPD
Authors
Binaya Regmi
Chiara Borrelli
Alberto Giannoni
Florian Kahles
Vaughan G. Macefield
Michael Dreher
Jens Spiesshoefer
Publication date
19-03-2024
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-024-01027-2