Disorders of cardiorespiratory coupling in hypercapnic respiratory test and moderate physical exercise in patients with pulmonological pathology

Relevance.The comprehensive assessment of cardiorespiratory coupling (CRC) for the diagnosis of functional adaptation in pulmonological patients is presented.
The objective of the study was to test the complex criteria of CRC for objective differential diagnosis of individual adaptive reactions of pulmonological patients.
Methods and materials. 30 volunteers without verified pathology and 31 patients with restrictive and obstructive disorders were examined. All subjects underwent physical examination with traditional routine method using spiroarteriocardiorhythmography (SACR) at rest and during performing functional tests with hypercapnia and moderate physical exercise.
Results. We proposed the methodology of integrated assessment of multicomponent system of CRC, which increases the diagnostic precision of SACR in the tasks of predicting the adaptive defects of the organism at different pulmonary syndromes.
Conclusion. Breathing with a fixed frequency normalizes the regulation of CRC, both in healthy and pulmonological patients. Moderate physical activity (80 W) modifies the indicators of CRC in pulmonological patients in comparison with the control group statistically due to disorders of the heart rate and circulation. During moderate physical activity, stroke volume (SV) statistically decreases in patients differently: SV were significantly lower in the group with obstructive disorders than in the group with non-obstructive disorders.

1. Kameneva M. Yu. Methodological aspects of lung function tests. Medical alphabet. 2017;2(22(319)):26-31. (In Russ.).

2. Guder G., Brenner S., Angermann C. E., Ertl G., Held M., Sachs A. P., Lammers J.-W., Zanen P., Hoes A. W., Stork S., Rutten F. H. GOLD or lower limit of normal definition? A comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study. Respir. Res. 2012;13(1):13-22.

3. Hildebrandt G., Moser M., Lehofer M. Chronobiology and chronomedicine. Moscow, 2006:144. (In Russ.).

4. Breslav I. S., Volkov N. I., Tambovceva R. V. Breathing and muscle activity of man and sport. Moscow, Sovetskij sport, 2013:336. (In Russ.).

5. Sakhin V. T., Gordienko A. V., Sotnikov A. V. Use of spectral index of heart rate variability as a predictor of poor clinical outcome in patients with severe combined chest trauma. Military medical journal. 2016;11(337):37-42. (In Russ.).

6. Travnikova E. O., Lakman I. A., Zubairova I. R., Suyargulova D. R., Zagidullin B. I., Nagaev I. A., Zu-lkarneev R. H., Zagidullin Sh. Z., Zagidullin N. Sh. Heart rate as a cardiovascular risk factor in patients with acute coronary syndrome. Bulletin of the Russian Military Medical Academy. 2012;40(4):45-48. (In Russ.).

7. Fudin N. A., Sudakov K. V., Khadartsev A. A., Klassi-na S. Ya., Chernyschov S. V Hildebrandt's index as an integral indicator of physiological consumption at sportsmen in the course of incrising exercise stress. Journal of new medical technologies. 2011;3(18):244-248. (In Russ.).

8. Kiselev A. R., Karavaev A. S., Gridnev V. I., Prokhorov M. D., Ponomarenko V. I., Borovkova E. I., Shvartz V. A., Posnenkova O. M., Bezruchko B. P. Method of assessment of synchronization between low-frequency oscillations in heart rate variability and photoplethysmogram. Cardio-IT. 2016;3(1):e0101. Doi: 10.15275/cardioit.2016.0101. (In Russ.).

9. Gerasimova L. S., Shandybina N. D., Noskin L. A., Rubinskiy A. V., Pavlidis K. Spiro-artery-how cardiorhyth-mography a meditation as a moderator of individual adap-togenesis. System analysis and management in biomedical systems. 2016;1(15):22-27. (In Russ.).

10. Marchenko V. N., Trofimov V. I., Alexandrin V. A., Noskin L. A., Pivovarov V. V. Influence of functional tests on heart rate variability in patients with bronchial asthma. Pulmonology. 2003;6(13):83-87. (In Russ.).

11. Lin Y. C., Shida K. K., Hong S. K. Effects of hypercapnia, hypoxia, and rebreathing on circulatory response to apnea. J. Appl. Physiol. 1983;54:172-177.

12. Voronin I. M., Belov A. M. Pathophysiology of cardiovascular disorders in obstructive breathing disorder during sleep. Clinical medicine. 2000;2:9-14. (In Russ.).

13. Mikhailov V. M. Load testing under ECG control: Bicycle ergometry, treadmill test, step test, walking. Ivanovo, Talka, 2008:548. (In Russ.).

14. Garber C. E., Blissmer B., Deschenes M. R., Franklin B. A., Lamonte M. J, Lee I. M., Nieman D. C., Swain D. P. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334-1359. Doi: 10.1249/MSS.0b013e318213fefb.

15. Noskin L. A., Rubinskiy A. V., Romanchuk A. P., Marchenko V. N., Pivovarov V. V., Cherepov A. B., Zarovki-na L. A. Study of cardiovascular and respiratory synchronization in different types of breathing. Patogenez [Pathogenesis]. 2018;16(4):90-96. (In Russ.).

16. Starr I. Clinical tests of the simple method of estimating cardiac stroke volume from blood pressure and age. Circulation. 1954;9:664-668.

17. Abrosimov V. N., Garmash V. Ya. Hyperventilation syndrome. Therapeutic archive. 1988;10:136. (In Russ.).

18. Izdebska E., Izdebski J., Cybulska I., Makowiecka-Ciesla M., Tizebski A. Moderate exercise training reduces arterial chemo-receptor reflex drive in mild hypertension. J Physiol Pharmacol. 2006;57(Suppl. 11):93-102.

19. Niewinski P. Carotid body modulation in systolic heart failure from the clinical perspective. J Physiol. 2017;595(1):53-61. Doi: 10.1113/JP271692.

20. Hamazaki N., Masuda T., Kamiya K., Matsuzawa R., Nozaki K., Maekawa E., Noda C., Yamaoka-Tojo M., Ako J. Respiratory muscle weakness increases dead-space ventilation ratio aggravating ventilation-perfusion mismatch during exercise in patients with chronic heart failure. Respirology. 2019 Feb;24(2):154-161. Doi: 10.1111/resp.13432.

21. Weatherald J., Sattler C., Garcia G., Laveneziana P. Ventilatory response to exercise in cardiopulmonary disease: the role of chemosensitivity and dead space. Eur Respir J. 2018 Feb 7;51(2):700860. Doi: 10.1183/13993003.00860-2017.