Title | Decreased Cardiac Autonomic Function is Associated with Higher Exacerbation Risk and Symptom Burden in Chronic Obstructive Pulmonary Disease. | ||
Author | Raju, Sarath; Woo, Han; Fawzy, Ashraf; Putcha, Nirupama; Balasubramanian, Aparna; Mathai, Stephen C; Berger, Ronald D; Hansel, Nadia N; McCormack, Meredith C | ||
Journal | Chronic Obstr Pulm Dis | Publication Year/Month | 2023-Jun |
PMID | 37267605 | PMCID | -N/A- |
Affiliation + expend | 1.Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States. |
Current measures of COPD severity, including lung function, do not fully explain symptom burden, and there is a need to identify predictors of exacerbation risk and morbidity. Autonomic dysfunction may be implicated in both cardiovascular and respiratory morbidity in COPD and convey risk for exacerbations. Heart Rate Variability(HRV) is a marker of cardiac autonomic function that is predictive of cardiovascular health and has promise as a non-invasive COPD biomarker. The CLEAN AIR Heart study provided opportunity to investigate the association between HRV and COPD morbidity among former smokers with moderate-severe COPD. Eighty-five participants, contributing 305 HRV measurements, underwent repeated clinical assessments over 4 study periods that included 24-Holter monitoring assessment of HRV. HRV measures of interests were SDNN(overall HRV) and RMSSD(parasympathetic function). Exacerbation risk was assessed using negative binomial models, and mixed effects models analyzed associations between HRV and symptoms. Decreases in SDNN(incidence rate ratio[IRR] 1.40; 95%CI 1.13-1.74) and RMSSD(IRR 1.60; 95%CI 1.07-2.37) were associated with severe exacerbation risk. Decreases in SDNN were associated with higher SGRQ, CAT scores and chronic bronchitis symptoms. Findings demonstrate that HRV is associated with COPD symptom burden and exacerbation risk. HRV may represent an important biomarker with the potential to identify high-risk COPD populations.