Autonomic Nervous System Changes
in Chronic Obstructive Pulmonary
Disease (Copd) Patients
GMC Amritsar, Punjab, India
Introduction: In the patho-physiology of chronic obstructive pulmonary disease (COPD), changes in the autonomic control of the cardiopulmonary functions are important. The quantification of the para-sympathetic and the sympathetic activity may be useful in treating COPD patients. Aims And Objectives: To observe the changes in the autonomic activity in COPD patients.
Material And Methods: The present study was conducted on 90 (male) COPD patients and 30 controls. The para-sympathetic activity tests i.e. the heart rate variation with deep respiration, the valsalva manoeuver, the standing to lying ratio and postural changes (30:15) and the sympathetic activity tests i.e. orthostasis, the cold pressor test (CPT) and the blood pressure response to a sustained hand grip were conducted. An FEV1 which was >80% was the criteria for the healthy control subjects.
Results: The heart rate variation to the para-sympathetic stimuli was less in the COPD patients as compared to that in the healthy subjects. The fall in systolic blood pressure (SBP) in response to standing was lesser while the rise in diastolic blood pressure in response to a sustained hand grip was higher in the COPD patients. A significant rise in the SBP in response to CPT was observed.
Conclusion: The cardiac para-sympathetic activity was significantly reduced in COPD, while there was sympathoexcitation.