COPD is associated with a significant reduction in heart rate variability, including a large decrease in SDNN (SMD 1.26) compared to healthy controls, indicating autonomic nervous dysfunction.
Meta-Analysis (n=839)
Does COPD reduce heart rate variability in affected patients compared to healthy controls?
COPD is associated with significant autonomic nervous dysfunction, evidenced by reduced heart rate variability and sympathetic predominance, which may contribute to increased cardiovascular risk.
Standardized Mean Difference: 1.26 (95% CI 0.063–1.89)
Background: Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle-Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results: The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion: COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability.
Alqahtani et al. (Fri,) conducted a meta-analysis in Chronic obstructive pulmonary disease (COPD) (n=839). Chronic obstructive pulmonary disease (COPD) vs. Healthy controls was evaluated on Standard deviation of NN intervals (SDNN) (SMD 1.26, 95% CI 0.063-1.89). COPD is associated with a significant reduction in heart rate variability, including a large decrease in SDNN (SMD 1.26) compared to healthy controls, indicating autonomic nervous dysfunction.