Author: Da-Wei Wu1,2,3,4, Li-Hsin Chang5, Po-Chou Yang5, Tzu-Yu Kuo2,3, Dong-Lin Tsai6, Huang-Chi Chen2,3, Hui-Lan Yuan2, Pei-Shih Chen4,7,8,9, Szu-Chia Chen2,4,10,11, I-Mei Lin5,9
Affiliation: <sup>1</sup> Doctoral Degree Program, Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
<sup>2</sup> Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
<sup>3</sup> Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
<sup>4</sup> Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
<sup>5</sup> Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
<sup>6</sup> Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
<sup>7</sup> Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
<sup>8</sup> Institute of Environmental Engineering, College of Engineering, National Sun Yat-Sen University, Kaohsiung 804, Taiwan.
<sup>9</sup> Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
<sup>10</sup> Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
<sup>11</sup> Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Conference/Journal: J Pers Med
Date published: 2022 Jun 12
Other:
Volume ID: 12 , Issue ID: 6 , Pages: 960 , Special Notes: doi: 10.3390/jpm12060960. , Word Count: 299
Autonomic nervous system (ANS) dysregulation is an important pathophysiological mechanism in patients with chronic obstructive pulmonary disease (COPD). Heart rate variability (HRV) is a common index for ANS, and HRV has been used to explore the association between ANS and clinical illnesses. This study aimed to explore the group differences in HRV, depression, anxiety, and quality of life between participants with COPD and healthy controls (HC group), and whether emotion plays a mediating role between HRV and quality of life in participants with COPD. A total of ninety-six participants with COPD and 59 participants in the HC group completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Saint George's Respiratory Questionnaire (SGRQ). Assessment of spirometry pulmonary function and five minute lead II electrocardiography (ECG) were also performed under the resting baseline. The COPD group had higher depression scores (F = 4.10, p = 0.008), and a lower quality of life (F = 14.44, p < 0.001) and HRV indices (such as standard deviation of RR intervals (F = 5.49, p < 0.05) and low frequency (F = 3.03, p < 0.05)) compared to the HC group. Sympathetic activation was positively correlated with depression (r = 0.312, p < 0.01), anxiety (r = 0.420, p < 0.001), and poor quality of life (r = 0.467, p < 0.001) in the COPD group. After controlling for age and sex, anxiety (β = 0.585, p < 0.001) and sympathetic activation (β = 0.231, p < 0.05) positively predicted poor quality of life, and lung function (β = -0.251, p < 0.01) negatively predicted poor quality of life. Therefore, anxiety is a mediator between sympathetic activation and quality of life. Emotional and HRV screening should be applied to COPD patients in clinical practice, and emotional management or HRV biofeedback training can be used to improve anxiety and HRV for future studies.
Keywords: anxiety; chronic obstructive pulmonary disease; heart rate variability; quality of life.
PMID: 35743745 DOI: 10.3390/jpm12060960