Assessment of Cardiac Autonomic Functions in Patients of Chronic Obstructive Pulmonary Disease in Relation To Severity and Duration of Disease
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 10
Abstract
Abstract: Chronic obstructive pulmonary disease (COPD) is a common and preventable disease that has great implications on global health. COPD could affect ANS due to recurrent hypoxemia, hypercapnoea, increased intrathoracic pressure swings due to airway obstruction, and increased respiratory effort, systemic inflammation and use of beta sympathomimetics. The present study was undertaken to assess the effect of severity and duration of COPD on cardiovascular autonomic nervous functions. Study was carried out on 100 diagnosed cases of COPD. They were divided as per severity into mild (n=34), moderate (n=51),severe (n=15) as per GOLD’s criteria and as per duration of disease after diagnosis into < 5 yrs (n=35),5 -10 yrs(n=52), >10 yrs (n=13). Tests done for parasympathetic function were Resting Heart Rate, E: I ratio, Valsalva ratio and 30:15 ratios. Tests done for sympathetic function were Handgrip test, orthostatic test and QTc interval. ANOVA test was used to compare different groups based on severity and duration of disease. Pearson correlation coefficient was used to find correlation between FEV1 and various parameters of autonomic functions. It was also used to find out co relation between duration of disease and autonomic functions Also based on the results of these tests, using Ewing’s criteria they were classified into normal, early ,definite and severe cardiac autonomic neuropathy (CAN). We found that patients with COPD have cardiac autonomic dysfunction that correlated with severity and duration of disease. Also severity of CAN as per Ewing’s criteria increases with severity and duration of disease. Thus it is advisable to screen all COPD patients for CAN to ensure appropriate remedial action to prevent complications and to improve life expectancy. Keywords: cardiac autonomic neuropathy (CAN), hypoxemia, hypercapnoea, COPD, ANS
Authors and Affiliations
Sarode VS, ShaikhMohiuddin Fahimuddin, Zingade US, Kowale AN
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