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May 27, 2019Düzce Tıp Fakültesi DergisiOpen Access

Alteration of Inspiratory Muscle Strength is Related to Change in Deep Breathing Heart Rate Variability in Patients Submitted to Open-Heart Surgery

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Why the study?

Although respiratory muscle strength and cardiac autonomic modulation decrease after open-heart surgery, the association between changes in these parameters had not been investigated.

Is the alteration of inspiratory muscle strength related to the change in deep breathing heart rate variability in patients undergoing open-heart surgery?

Population

32 patients aged 35 to 60 years undergoing CABG or valve surgery

Comparison

Evaluations on the day of admission vs discharge

Design

Observational cross-sectional study

Authors

KPKaran PongpanitBVBenya VISESCHOONHASILPSRSukpattaraporn Ruangklai

Discussion

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Overview

Hypothesis-generating for inspiratory muscle-HRV association post-surgery; prospective studies needed before clinical consideration.

Structured PICO

Is the alteration of inspiratory muscle strength related to the change in deep breathing heart rate variability in patients undergoing open-heart surgery?

P
Population
32 adults aged 35-60 years undergoing open-heart surgery (coronary artery bypass graft and cardiac valve surgery) at a single center in Thailand. Exclusions included chronic lung diseases, chronic heart failure, sinus rhythm disorders, myocardial infarction, unstable angina, previous cardiac surgery, implanted cardiac pacemaker, uncontrolled diabetes mellitus, uncontrolled blood pressure, neurological disorders, and mechanical ventilator use for more than 24 hours after surgery.
I
Intervention
Open-heart surgery (coronary artery bypass graft or cardiac valve surgery) followed by conventional post-operative physiotherapy (breathing exercises, airway clearance techniques, early mobilization, exercise training, and ambulation training).
C
Comparator
Pre-operative baseline (evaluations performed on the day of admission).
O
Outcome
Correlation between the change in inspiratory muscle strength (maximal inspiratory pressure) and the change in deep breathing heart rate variability (HRVdb) indices from admission to discharge.surrogate

Inspiratory muscle weakness following open-heart surgery is significantly correlated with impaired cardiac vagal modulation, suggesting that respiratory rehabilitation may help restore autonomic balance.

Limitations

  • Tidal volume and end-tidal carbon dioxide were not measured and controlled during the deep breathing protocol
  • Participants received beta-blockers, which could generate an impact on HRV data

Cite This Study

Pongpanit et al. (2019) studied this question.

synapsesocial.com/papers/6a7ca9e9b7ca9b673b7cd114https://doi.org/10.18678/dtfd.538675
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Correlations between change in neural respiratory drive and heart rate variability in patients submitted to open-heart surgery2019 · 4 citations
  2. 2Deep Breathing Heart Rate Variability is Associated with Inspiratory Muscle Weakness in Chronic Heart Failure2013 · 32 citations
  3. 3High-intensity inspiratory protocol increases heart rate variability in myocardial revascularization patients2016 · 18 citations
  4. 4Effect of Deep Breathing on Heart Rate Variability Following Coronary Artery Bypass Graft2019 · 3 citations
  5. 5Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease2010 · 51 citations