Heart rate variability in bronchial asthma patients

Abstract

Aim. To study time domain parameters of heart rate variability (HRV) in bronchial asthma (BA) patients during BA exacerbation, complicated by respiratory failure and sympathomimetic overdose. Material and methods. In total, 72 patients with persistent BA were examined: 41 men, 31 women; mean age 39,3±10 years; mean BA duration – 8,6±8,5 years. Patients with moderate and severe BA forms were prevalent: 36,1% and 42,7%, respectively. Seventy participants (97%) received β-agonists. Patients with moderate or severe BA received inhaled glucocorticosteroids (500-1500 mkg/d). In all participants, 24-hour Holter electrocardiography monitoring was performed, with time domain HRV parameters analysis (SDNN, SDANN, rMSSD, pNN50). Results. In mild BA patients, SDNN was 116±12,1 ms, SDANN – 107±20,6 ms, rMSSD – 38,3±7,1 ms, pNN50 12±3,6%, and SDNNindx – 56±10 ms. In moderate and severe BA individuals, these parameters were significantly lower (p=0,002). There was a statistically significant inverse correlation between BA severity and SDNN (r=–0,59, p=0,03), or pNN50 (r=–0,32, p=0,004). Moreover, there was a statistically significant inverse correlation between β-agonist overdose and the following HRV parameters: pNN50 (r=–0,4; p=0,04), SDNN (r=–0,33; p=0,002), and rMSSD (r=–0,29; p=0,001). Conclusion. BA duration and sympathomimetic overdose result in adrenergic dysbalance, segmental and suprasegmental autonomous activity disturbances, reduced HRV and increased arrhythmia risk.

Keywords

• bronchial asthma
• heart rate variability
• β-adrenomimetics