title: Heart rate variability in patients with severe chronic obstructive pulmonary disease in a home care program.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) patients present functional and structural changes of the respiratory system that have a profound influence on cardiac autonomic dysfunction.
  
  
  OBJECTIVE
  To analyse heart rate variability in COPD patients under stable condition and during acute exacerbation episodes (AECOPD).
  
  
  METHODS
  Twenty three severe COPD male patients, 69.6 ± 7.3 years, in stable condition were followed up for two years. Home visits were carried out by a nurse every month, and home or hospital visits were arranged on demand. Every three months an ECG, oxygen saturation and spirometric recording was obtained for each patient. If the patient presented AECOPD compatible clinical data the same measurements were performed before any change of treatment. Spectral parameters of heart rate variability in time and frequency domains were obtained from ECG. The time evolution of power in low frequency (LF) and high frequency (HF) bands were obtained from the spectrogram. In addition, we calculated the LF/HF ratio and total heart rate variability power (POW).
  
  
  RESULTS
  We analysed 154 patient-visit records during the follow up, pertaining to 23 patients and 8 controls; 19 of the patients had experienced at least one AECOPD. Stable COPD patients had higher HF values than control subjects. No significant differences were found in LF, LF/HF ratio or POW variables. AECOPD patients had higher LF, HF and POW than the stable COPD and control groups.
  
  
  CONCLUSIONS
  AECOPD patients exhibited signs of increased autonomic activity compared with stable COPD.
authors.affiliation: Division of Respiratory Medicine, Hospital Clínico Universitario, Santiago de Compostela, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Zamarrón
authors.affiliation: Department of Computer Science, University of Vigo, Vigo, Galicia, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Lado
authors.affiliation: Centro de Investigación en Tecnologías de la Información, USC, (CITIUS) Santiago de Composptela, Spain.
authors.forename: Tomas
authors.initials: T
authors.lastname: Teijeiro
authors.affiliation: Division of Respiratory Medicine, Hospital Clínico Universitario, Santiago de Compostela, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Morete
authors.affiliation: Department of Computer Science, University of Vigo, Vigo, Galicia, Spain.
authors.forename: Xose A
authors.initials: XA
authors.lastname: Vila
authors.affiliation: Centro de Investigación en Tecnologías de la Información, USC, (CITIUS) Santiago de Composptela, Spain.
authors.forename: Paulo Felix
authors.initials: PF
authors.lastname: Lamas
mesh_terms: D000208:Acute Disease; D000368:Aged; D016022:Case-Control Studies; D004562:Electrocardiography; D006339:Heart Rate / Q000502:physiology*; D006699:Home Care Services; D006801:Humans; D008297:Male; D010092:Oximetry; D019095:Point-of-Care Systems; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000628:therapy; D012129:Respiratory Function Tests
keywords: Chronic obstructive pulmonary disease; autonomic dysfunction; heart rate variability; home care program