Reactivity of cardiorespiratory system in bronchial asthma patients according to the tests with respiratory maneuvers performance

Abstract

Today asthma is defined as allergic inflammation of the respiratory tract, which is associated with hyperreactivity of the bronchi to various stimuli. The basis of asthma clinical picture forms broncho-obstructive syndrome, which is polymorphic in the mechanism of formation, and this determines the heterogeneity of asthma pathogenesis. Due to the anatomical and functional relationship with the cardiovascular system, this mechanism should be considered in a complex manner studying the composition changes in the associated cardiopulmonary system. The objective: to determine the regulatory features in asthma course of various degrees of severity during respiratory maneuvers performance. Materials and methods. In total, 86 patients (female (59 %) and male (41 %)), aged 41.0 ± 0.8 years old were divided into 2 groups. The first (comparison group) included 27 patients, the second (main) consisted of 59 patients with clinically confirmed persistent or uncontrolled asthma. At the outpatient stage of treatment, a comprehensive multifunctional method for the cardiorespiratory system examination – spiroarteriocardiorhythmography (SACR) was used. There were three consecutive two-minute registrations: at normal respiration (NR), at respiratory rate 6 times per minute (RR6) and at respiratory rate 15 times per minute (RR15). Regulatory influences were determined based on the spectral analysis of heart rate (HRV) and respiration (RV) variability. Spectral analysis was performed in three frequency bands: over low-frequency (VLF, 0–0.04 Hz), low frequency (LF, 0.04–0.15 Hz) and high-frequency (HF, 0.15–0.4 Hz). Results. Cardiorespiratory system of patients with uncontrolled course of asthma is characterized by an increase in heart rate at RR15; reduced absolute HRV indicators; an increase in the contribution of LFn and a decrease in the contribution of HFn; a decrease in the arterial baroreflex sensitivity; an increase in EB; there was also an increase in RV, RV/Tih, RV/Texh, as well as worsening of frequency and volume synchronization of the cardiorespiratory system. Conclusions. The use of respiratory maneuvers performance tests allowed revealing the characteristic regulatory features of bronchial asthma development and course, so it can be proposed for wide practical implementation in the diagnosis and monitoring of bronchial asthma course.

Keywords

• bronchial asthma
• spiroarteriocardiorhythmography
• breath tests