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    The acute effect of bi-level positive airway pressure on heart rate variability in chronic obstructive pulmonary disease patients with hypercapnic respiratory failure
    (TURKISH SOC CARDIOLOGY, 2008) Yazici, Mehmet; Uzun, Kuersat; Ulgen, Mehmet Siddik; Teke, Turgut; Maden, Emin; Kayrak, Mehmet; Turan, Yasar
    Objective: Non-invasive mechanical ventilation (NIMV) has the potential to improve sympathovagal control of heart rate. The aim of this study was to investigate the acute effects of NIMV on heart rate variability (HRV) in chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure (HRF). Methods: In this prospective study 28 COPD patients (64 +/- 10 years) with HRF underwent electrocardiographic Holter monitorization. Both time domain (TD) and frequency domain (FD) means of HRV analysis were measured for two hours before and during NIMV application. For the TD, mean-RR, SDNN, SDANN, SDNN index, RMSSD, pNN50 and HRV triangular index were measured. For FD, high frequency (HF) and low frequency (LF) were detected. To compare HRV parameters before and during bi-level positive airway pressure (BiPAP) application; paired sample t test was used for normally distributed variables and Wilcoxon signed rank test was used for the variables that were not normally distributed. Pearson correlation test was used to analyze the correlation between HRV and blood gas parameters during BiPAP application. Results: High frequency power of HRV (39 (18-65) ms(2) vs. 28 (12-50) ms(2), p < 0.05), HRV triangular index (9 (3-17) units vs. 6 (2-13) units, p < 0.05) and pNN50 (59% (13-110) vs. 42% (5-84), p < 0.05), were higher during NIMV than before noninvasive mechanical ventilation. Conclusions: We think that NIMV may improve heart rate variability indices of parasympathetic modulation of heart rate in COPD cases with HRF and decrease arrhythmic potential. (Anadolu Kardiyol Derg 2008; 8: 426-30)