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A systematic review and meta-analysis of heart rate variability in COPD

Alqahtani, Jaber SS; Aldhahir, Abdulelah MM; Alghamdi, Saeed MM; Al Ghamdi, Shouq SS; AlDraiwiesh, Ibrahim AA; Alsulayyim, Abdullah SS; Alqahtani, Abdullah SS; ... Oyelade, Tope; + view all (2023) A systematic review and meta-analysis of heart rate variability in COPD. Frontiers in Cardiovascular Medicine , 10 , Article 1070327. 10.3389/fcvm.2023.1070327. Green open access

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Abstract

Background: Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle–Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results: The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion: COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability.

Type: Article
Title: A systematic review and meta-analysis of heart rate variability in COPD
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fcvm.2023.1070327
Publisher version: https://doi.org/10.3389/fcvm.2023.1070327
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, heart rate variability, COPD, sympatho-vagal, ECG, prognosis, OBSTRUCTIVE PULMONARY-DISEASE, AUTONOMIC NERVOUS-SYSTEM, EXERCISE, DYSFUNCTION, COMPLEXITY, MORTALITY, SEVERITY, RHYTHM, POWER
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10183275
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