title: Influence of bilevel positive airway pressure on autonomic tone in hospitalized patients with decompensated heart failure.
abstract: [Purpose] This study evaluated the effect of Bilevel Positive Airway (BiPAP) on the autonomic control of heart rate, assessed by heart rate variability (HRV), in patients hospitalized with decompensated heart failure. [Subjects and Methods] This prospective cross-sectional study included 20 subjects (age: 69±8 years, 12 male, left ventricular ejection fraction: 36 ±8%) diagnosed with heart failure who were admitted to a semi-intensive care unit with acute decompensation. Date was collected for HRV analysis during: 10 minutes spontaneous breathing in the resting supine position; 30 minutes breathing with BiPAP application (inspiratory pressure = 20 cmH2O and expiratory pressure = 10 cmH2O); and 10 minutes immediately after removal of BiPAP, during the return to spontaneous breathing. [Results] Significantly higher values for indices representative of increased parasympathetic activity were found in the time and frequency domains as well as in nonlinear Poincaré analysis during and after BiPAP in comparison to baseline. Linear HRV analysis: standard deviation of the average of all R-R intervals in milliseconds = 30.99±4.4 pre, 40.3±6.2 during, and 53.3±12.5 post BiPAP. Non-linear HRV analysis: standard deviations parallel in milliseconds = 8.31±4.3 pre, 12.9±5.8 during, and 22.8 ±6.3 post BiPAP. [Conclusion] The present findings demonstrate that BiPAP enhances vagal tone in patients with heart failure, which is beneficial for patients suffering from acute decompensation.
authors.affiliation: Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil.
authors.forename: Diego
authors.initials: D
authors.lastname: Lacerda
authors.affiliation: Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil.
authors.forename: Dirceu
authors.initials: D
authors.lastname: Costa
authors.affiliation: Physical Therapy Department, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Brazil.
authors.forename: Michel
authors.initials: M
authors.lastname: Reis
authors.affiliation: Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil.
authors.forename: Evelim Leal de F Dantas
authors.initials: EL
authors.lastname: Gomes
authors.affiliation: Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil.
authors.forename: Ivan Peres
authors.initials: IP
authors.lastname: Costa
authors.affiliation: Cardiopulmonary Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), Brazil.
authors.forename: Audrey
authors.initials: A
authors.lastname: Borghi-Silva
authors.affiliation: Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: Marsico
authors.affiliation: Santa Casa de Misericórdia São Paulo Hospital, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Stirbulov
authors.affiliation: Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.affiliation: Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Brazil.
authors.forename: Luciana Maria Malosá
authors.initials: LM
authors.lastname: Sampaio
keywords: Autonomic nervous system; Cardiac heart failure; Noninvasive ventilation