Peculiarities of data of 24-hour ECG monitoring and heart rate variability in patients with hypertension associated with chronic obstructive pulmonary disease
https://doi.org/10.29001/2073-8552-2020-35-1-38-44
Abstract
We found a high frequency of co-occurrence of arterial hypertension and chronic obstructive pulmonary disease (COPD) in the therapeutic practice of 130 patients.
Objective. To investigate daily ECG monitoring results and heart rate variability (HRV) in patients with a combination of hypertension and COPD.
Material and Methods. A total of 130 patients with arterial hypertension were examined. The main group (n = 90) consisted of comorbid patients with arterial hypertension suffering of COPD, mean age of 61.3 ± 1.0 years. The comparison group (n = 40) comprised hypertensive patients without COPD, with a mean age of 59.1 ± 1.5 years. All patients received 24-hour ECG monitoring with HRV assessment.
Results. Analysis of heart rhythm abnormalities and cardiac conduction disorders allowed to detect the following arrhythmias in patients with hypertension in the presence of COPD: paired supraventricular extrasystoles, runs of supraventricular tachycardia, paroxysmal atrial fibrillation, Lown grade I ventricular extrasystoles, and paired ventricular extrasystoles. The right bundle-branch block was the most frequent conduction disorder observed in patients with COPD. Temporal analysis of HRV showed that the basic daily-average parameters responsible for the overall tone of the autonomic nervous system (SDNN, SDNNi, and SDANN) and the indicators reflecting the effects of parasympathetic regulation on the heart activity (RMSSD, pNN50, and HRVTI) were attenuated in comorbid patients.
Conclusion. This study showed that patients with arterial hypertension associated with COPD were more prone to the occurrence of potentially dangerous arrhythmias. Heart rate variability in such patients was characterized by a decrease in the tone of the parasympathetic division of the autonomic nervous system and the predominance of sympathetic effects on cardiac activity.
Objective. To investigate daily ECG monitoring results and heart rate variability (HRV) in patients with a combination of hypertension and COPD.
Material and Methods. A total of 130 patients with arterial hypertension were examined. The main group (n = 90) consisted of comorbid patients with arterial hypertension suffering of COPD, mean age of 61.3 ± 1.0 years. The comparison group (n = 40) comprised hypertensive patients without COPD, with a mean age of 59.1 ± 1.5 years. All patients received 24-hour ECG monitoring with HRV assessment.
Results. Analysis of heart rhythm abnormalities and cardiac conduction disorders allowed to detect the following arrhythmias in patients with hypertension in the presence of COPD: paired supraventricular extrasystoles, runs of supraventricular tachycardia, paroxysmal atrial fibrillation, Lown grade I ventricular extrasystoles, and paired ventricular extrasystoles. The right bundle-branch block was the most frequent conduction disorder observed in patients with COPD. Temporal analysis of HRV showed that the basic daily-average parameters responsible for the overall tone of the autonomic nervous system (SDNN, SDNNi, and SDANN) and the indicators reflecting the effects of parasympathetic regulation on the heart activity (RMSSD, pNN50, and HRVTI) were attenuated in comorbid patients.
Conclusion. This study showed that patients with arterial hypertension associated with COPD were more prone to the occurrence of potentially dangerous arrhythmias. Heart rate variability in such patients was characterized by a decrease in the tone of the parasympathetic division of the autonomic nervous system and the predominance of sympathetic effects on cardiac activity.
About the Authors
M. A. Bubnova
V.I. Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Graduate Student, Department of Therapy, Gastroenterology, Cardiology and General Medical Practice (Family Medicine), Faculty of Medical Personnel Training of Higher Qualification and Additional Professional Education, Medical Academy named after S.I. Georgievsky
4, pr. Vernadskogo, Simferopol, 295007, Republic of Crimea
O. N. Kryuchkova
V.I. Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, Department of Therapy, Gastroenterology, Cardiology and General Medical Practice (Family Medicine), Faculty of Medical Personnel Training of Higher Qualification and Additional Professional Education, Medical Academy named after S.I. Georgievsky
4, pr. Vernadskogo, Simferopol, 295007, Republic of Crimea
References
1. Oganov R.G., Denisov I.N., Simanenkov V.I., Bakulin I.G., Bakulina N.V., Boldueva S.A. et al. Comorbidities in practice. Clinical guidelines. Cardiovascular Therapy and Prevention. 2017;16(6):5–56 (In Russ.). DOI: 10.15829/1728-8800-2017-6-5-564.
2. Kushnikova I.P., Graudina V.E. Cardiovascular pathology in patients with chronic obstructive pulmonary disease: clinical and pathogenetic features and diagnosis. Vestnik SurGU. Medicinа. 2019;(1):8–13 (In Russ.).
3. Williams B., Mancia G., Spiering W., Agabiti Rosei E., Azizi M., Burnier M. et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J. Hypertens. 2018;36(10):1953–2041. DOI: 10.1097/HJH.0000000000001940.
4. Makarov L.M., Komoljatova V.N., Kuprijanova O.O., Pervova E.V., Rjabykina G.V., Sobolev A.V. et al. National Russian Guidelines on application of the methods of holter monitoring in clinical practice. Russian Journal of Cardiology. 2014;(2):6–71 (In Russ.). DOI: 10.15829/1560-4071-2014-2-6-71.
5. Kucenko M.A., Chuchalin A.G. The paradigm of comorbidity: syntropy of COPD and IHD. Person and Medicine – Kazahstan. 2015;11(57):26–31 (In Russ.).
6. Piljasova O.V., Stacenko M.E. Features of heart rate variability in patients with hypertension and chronic obstructive pulmonary disease. Volgograd Journal of Medical Research. 2008;4(20):41–43 (In Russ.).
7. Alicheva Y.M., Shpagina L.A., Panacheva L.A., Shpagin I.S., Bazhenova K.O. Circadian blood pressure profile and the state of the autonomic nervous system in elderly patients with chronic obstructive pulmonary disease combined with arterial hypertension. The Siberian Medical Journal. 2014;29(1):43–47 (In Russ.). DOI: 10.29001/2073-8552-2014-29-1-43-47.
8. Abrosimov V.N., Kosjakov A.V., Dmitrieva M.N. Comparative analysis of parameters of cardiointervalometry, ergoreflex, and data of 6-minute step walk test in patients with chronic obstructive pulmonary disease. I.P. Pavlov Russian Medical Biological Herald. 2019;27(1):49–58 (In Russ.). DOI: 10.23888/PAVLOVJ201927149-58.
Review
For citations:
Bubnova M.A., Kryuchkova O.N. Peculiarities of data of 24-hour ECG monitoring and heart rate variability in patients with hypertension associated with chronic obstructive pulmonary disease. Siberian Journal of Clinical and Experimental Medicine. 2020;35(1):38-44. (In Russ.) https://doi.org/10.29001/2073-8552-2020-35-1-38-44
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