The features of time characteristics of heart rate variability in chronic obstructive pulmonary disease

Abstract

Aim. To study the features of time characteristics of heart rate variability during isolated chronic obstructive pulmonary disease, as well as in association with arterial hypertension and ischemic heart disease. Methods. The characteristics of heart rate variability using Holter electrocardiography monitoring, echocardiography and duplex scanning of carotid arteries were studied. The results of investigations of 298 individuals of both sexes aged 37-78 years were included into the analysis, including 79 patients with chronic obstructive pulmonary disease who were divided into three groups. The first group included 19 patients with isolated chronic obstructive pulmonary disease, the second group consisted of 25 patients with chronic obstructive pulmonary disease and arterial hypertension, the third group included 35 patients with chronic obstructive pulmonary disease and ischemic heart disease, who were divided into two subgroups: patients with (n=9) and without (n=26) a prior history of myocardial infarction. For comparison, examined were 48 patients with isolated hypertension, 132 patients with ischemic heart disease and 39 practically healthy individuals. Results. In patients with isolated chronic obstructive pulmonary disease an autonomic imbalance occurs in the form of a uniform decrease in the activity of the parasympathetic nervous system during the day and an increase of the night time heart rate, identifiable are the signs of subclinical cardiac pathology in the form of thickening of the «intima-media» complex and the formation of atherosclerotic plaques in the carotid arteries, hypertrophy of the myocardium and left ventricular diastolic dysfunction, reduced systolic velocity of the mitral valve fibrous annulus. If chronic obstructive pulmonary disease is combined with aerterial hypertension and ischemic heart disease, as opposed to isolated cardiac pathology, a monotonic tachycardia develops during the day. In cases of concomitant chronic obstructive pulmonary disease and arterial hypertension during a simultaneous decrease in all time characteristics of heart rate variability, in most patients hypertrophy of both ventricles can be visualized. Conclusion. In patients with chronic obstructive pulmonary disease the time characteristics of heart rate variability depend on the presence or absence of concomitant diseases of the cardiovascular system.