Heart Rate Variability on 10-Second Electrocardiogram and Risk of Acute Exacerbation of COPD: A Secondary Analysis of the BLOCK COPD Trial.

IF 0.1 3区文学 0 LANGUAGE & LINGUISTICS

Indogermanische Forschungen Pub Date : 2022-04-29 DOI:10.15326/jcopdf.2021.0264

David M MacDonald, Takudzwa Mkorombindo, Sharon X Ling, Selcuk Adabag, Richard Casaburi, John E Connett, Erika S Helgeson, Janos Porszasz, Harry B Rossiter, William W Stringer, Helen Voelker, Dongxing Zhao, Mark T Dransfield, Ken M Kunisaki

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引用次数: 0

Abstract

Introduction: Autonomic dysfunction is common in chronic obstructive pulmonary disease (COPD), and worse autonomic function may be a marker of risk for acute exacerbations of COPD (AECOPD). Heart rate variability (HRV) is a measure of autonomic function. Our objective was to test whether lower (worse) HRV is a risk factor for AECOPD.

Methods: We measured standard deviation of normal RR intervals (SDNN) and root mean square of successive RR interval differences (RMSSD) on 10-second electrocardiograms (ECGs) performed at screening and day 42 in participants in the Beta Blockers for the Prevention of Acute Exacerbations of COPD trial ( BLOCK-COPD), a placebo-controlled trial of metoprolol for prevention of AECOPD. We used Cox-proportional hazards models to test if these HRV measures were associated with risk of any AECOPD, and separately, hospitalized AECOPD. We tested associations using baseline HRV measures and incorporating HRV measures from day 42 as a time-varying covariate. We also tested for interactions with metoprolol assignment.

Results: Of 532 trial participants, 529 (forced expiratory volume in 1 second [FEV₁ ]41 ± 16.3 % predicted) were included in this analysis. We did not find a significant association between HRV measures and risk of AECOPD when all participants were analyzed together. There was a significant interaction between RMSSD and assignment to metoprolol on time to first hospitalized AECOPD; in the placebo group greater RMSSD was associated with a lower risk of hospitalized AECOPD (adjusted hazard ratio0.71, 95% confidence interval: 0.52 to 0.96, per 10 ms increase) but there was no association in the metoprolol group.

Conclusions: Autonomic dysfunction as measured by HRV may be a risk factor for AECOPD. Future studies should analyze longer HRV recordings and their performance in broader samples of people with COPD, including those on beta-blockers.

查看原文本刊更多论文

10秒心电图的心率变异性与慢性阻塞性肺病急性加重的风险：BLOCK慢性阻塞性肺病试验的二次分析。

简介：自律神经功能紊乱是慢性阻塞性肺病（COPD）的常见症状，自律神经功能恶化可能是慢性阻塞性肺病急性加重（AECOPD）的风险标志。心率变异性（HRV）是自律神经功能的一种测量方法。我们的目的是检验较低（较差）的心率变异性是否是慢性阻塞性肺病急性加重的风险因素：我们测量了 "β受体阻滞剂预防 COPD 急性加重试验"（BLOCK-COPD）参与者在筛查和第 42 天所做的 10 秒心电图（ECG）上的正常 RR 间期标准偏差（SDNN）和连续 RR 间期差的均方根（RMSSD）。我们使用 Cox 比例危险模型来检验这些心率变异指标是否与任何 AECOPD 风险相关，并分别与住院 AECOPD 风险相关。我们使用基线心率变异测量值并将第 42 天的心率变异测量值作为时变协变量来检验两者之间的相关性。我们还测试了与美托洛尔分配的交互作用：在 532 名试验参与者中，有 529 人（1 秒用力呼气容积 [FEV1 ]41 ± 16.3 % 预测值）被纳入本次分析。在对所有参与者进行综合分析时，我们没有发现心率变异测量与 AECOPD 风险之间存在显著关联。在安慰剂组中，RMSSD越大，AECOPD住院风险越低（调整后危险比0.71，95%置信区间：0.52至0.96，每增加10毫秒），而在美托洛尔组中则没有相关性：结论：通过心率变异测量的自主神经功能障碍可能是 AECOPD 的一个危险因素。未来的研究应分析更长时间的心率变异记录及其在更广泛的慢性阻塞性肺病患者样本中的表现，包括使用β-受体阻滞剂的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indogermanische Forschungen Multiple-

CiteScore

0.60

自引率

33.30%

发文量

期刊介绍： Indogermanische Forschungen publishes contributions (essays and reviews) mainly in the areas of historical-comparative linguistics, historical linguistics, typology and characteristics of the languages of the Indogermanic language family. Essays on general linguistics and non-Indogermanic languages are also featured, provided that they coincide with the main focus of the journal with respect to methods and language history.