Kronik Obstrüktif Akciðer Hastalarýnda Otonomik Fonksiyonlarýn Deðerlendirilmesi EVALUATION OF AUTONOMIC FUNCTIONS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Summary In patient with chronic obstructive pulmonary disease (COPD), there is always autonomic dysfunction associated with an increase in respiratory tract resistance and respiratory work load even in the absence of clinical respiratory failure and hypoxic neural damage. Therefore, evaluation of sympathetic and parasympathetic nervous system balance is of importance for understanding COPD pathogenesis and treatment of COPD. This study examined the autonomic dysfunction of patients with COPD using non-invasive tests. A total of 31 patients (23 male, 8 female) aged between 58-75 (65.3±4.4) with COPD but without any hypoxic neuronal damage and 25 healthy age-matched controls (with mean age of 65.7±6.3) were included in this study. After determination of basal heart rate, parasympathetic functions of both group was evaluated by performing Valsalva manoeuvre, deep breathing test and determining ECG changes in standing position. Changes in blood pressure due to standing up were used for evaluating sympathetic functions. The basal heart rate values in patients with COPD and in control group were (81.5±10 and 74.5±6.1/minute, p<0.05), respectively. The mean results of patients versus control for Valsalva manoeuvre (19.5±1.1 and 12.3±0.9/minute, p<0.001), deep breathing test (20.5±1.6 and 10.2±0.9, p<0.001), heart rate in standing position (14.4±9 and 5.8±2.5, p<0.001) were significantly high. The decrease in blood pressure due to standing up were significantly higher in patients with COPD compared to control subjects (13.5±6.3 and 7.1±4.5 mmHg, p<0.01). In conclusion, in patients with COPD parasympathetic activity increases while their sympathetic activity is insuf ficient.