Highlights
- •Patients with OSA-COPD had a lower functional performance than the COPD group in the period of one year.
- •Patients with OSA-COPD had a higher parasympathetic response, less sympathovagal balance and less ANS complexity during the exercise phase in the 6MWT compared to COPD alone.
- •The overlap of OSA in patients with COPD worsens the clinical evolution of these patients, causing them to present a greater number of exacerbations over the course of a year.
Abstract
Background
Functional capacity and heart rate variability (HRV) are important prognostic markers
in chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome
(OSA). However, the impact of the overlap of these diseases and the one-year clinical
follow-up has not yet been evaluated.
Objectives
To assess whether the presence of OSA can impair functional performance and cardiac
autonomic control during exercise in patients with COPD; and to verify whether the
overlap of these diseases could lead to worse clinical outcomes during the one-year
follow-up.
Methods
Thirty-four patients underwent pulmonary function tests, echocardiography and polysomnography
for diagnostic confirmation, disease staging, exclusion of any cardiac changes, and
allocation between groups. The patients underwent the six-minute walk test (6MWT)
to assess functional capacity and HRV during exercise. Subsequently, patients were
followed up for 12 months to record outcomes such as exacerbation, hospitalization,
and deaths. At the end of this period, the patients were revaluated to verify the
hypotheses of the study.
Results
The OSA-COPD group showed greater functional impairment when compared to the COPD
group (p=0.003) and showed worse cardiac autonomic responses during the 6MWT with
greater parasympathetic activation (p=0.03) and less complexity of the autonomic nervous
system, in addition to being more likely to exacerbate (p=0.03) during one year of
follow-up.
Conclusion
OSA-COPD produces deleterious effects on functional performance and a greater autonomic
imbalance that impairs clinical outcomes.
Keywords
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Article info
Publication history
Published online: October 28, 2022
Accepted:
October 16,
2022
Received in revised form:
October 13,
2022
Received:
May 9,
2022
Identification
Copyright
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