Key result
Patients with COPD covered a significantly shorter distance during the 6-minute walk test (median 411 m) compared to healthy controls (median 726 m) and exhibited hyperactivation of the ergoreflex.
Why the study?
The study was conducted to evaluate the relationship between heart rate variability, the 6-minute walking test, and ergoreflex to assess the functional status of patients with COPD.
How do heart rate variability, 6-minute walking test, and ergoreflex correlate in assessing the functional status of patients with COPD compared to healthy controls?
Cross-Sectional (n=105)
No
How do heart rate variability, 6-minute walking test, and ergoreflex correlate in assessing the functional status of patients with COPD compared to healthy controls?
Absolute Event Rate: 411% vs 726%
p-value: p=<0.01
Ergoreflex hyperactivation may contribute to exercise limitation in COPD; hypothesis-generating and should not yet change practice.
The aim of this study was to study the relationship between heart rate variability (HRV), 6-minute walking test (6-MWT) and ergoreflex to assess the functional status of patients with chronic obstructive pulmonary disease (COPD). Methods . The study included men with COPD ( n = 64; mean age 64.98 ± 8.67) and control group volunteers without respiratory disease ( n = 41; mean age 61.68 ± 9.21). Spirometry, 6-MWT, HRV analysis before, during, and after the external peripheral vascular occlusion test were performed in all patients and subjects of the control group to evaluate ergoreflex (reflex regulation of the body by means of the reaction of ergoreceptors located in muscles to the accumulation of metabolic products and mechanical muscle stretching). Results . The distance covered during the 6-MWT differed significantly between patients with COPD and those in the control group ( p < 0.01). In 22 (34.4%) of the 64 patients with COPD, a decrease in saturation rate (SpO 2 ) of ≥ 4% ( p < 0.01) was observed during 6-MWT, while no data for SpO 2 reduction at rest were obtained. During evaluation of ergoreflex by HRV changes in patients with COPD the data testifying to its hyperactivity, causing persistent predominance of the sympathetic VNS in patients with COPD, that is reflected in "deterrence" of HRV changes during the external peripheral vascular occlusion test. Correlations between 6-MWT, spirometry and HRV have been found, indicating a high level of adherence to 6-MWT in assessing the functional status of patients with COPD. Conclusion . Differences in results of external peripheral vascular occlusion test in COPD patients and healthy subjects are interpreted by hyperactivation of ergoreflex in COPD patients, which is consistent with the increase of muscle fatigue during 6-MWT. The data of 6-MWT correlate with HRV indices, and when the techniques are applied together, the possibilities of estimating the functional status of patients during the load tests are extended. Evaluation of ergoreflex is recommended for objectification of ideas about functional status of patients with COPD before implementation of basic rehabilitation programs.
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Abrosimov et al. (2020) conducted a cross-sectional in Chronic obstructive pulmonary disease (COPD) (n=105). Chronic obstructive pulmonary disease vs. Healthy volunteers without respiratory disease was evaluated on Distance covered during the 6-minute walking test (6-MWT) in meters (p=<0.01). Patients with COPD covered a significantly shorter distance during the 6-minute walk test (median 411 m) compared to healthy controls (median 726 m) and exhibited hyperactivation of the ergoreflex.
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