Is there cardiac autonomic dysfunction in children and adolescents with exercise-induced bronchospasm?

ABSTRACT

Background

The pulmonary impairment in patients with bronchoconstriction induced by eucapnic voluntary hyperpnea(EVH) goes beyond the respiratory system, also impairing autonomic nervous modulation. This study aimed to evaluate the behavior of cardiac autonomic modulation in young asthmatics with and without EIB after the EVH test.

Research design and methods

A cross-sectional study design using 54 asthmatics(51.9% female), aged between 10 and 19 years, investigated with the EVH test. Forced expiratory volume in one second(FEV₁) was measured at 5, 10, 15, and 30 min after EVH. Heart rate variability(HRV) measures of time were assessed pre and 30 min-post EVH. The diagnosis of Exercise-Induced bronchoconstriction with underlying clinical asthma(EIB_A) was confirmed by a fall in FEV₁ ≥10% compared to baseline.

Results

Thirty(55.5%) asthmatics had EIB_A. Subjects with EIB_A have reduced mean of the R-R intervals in relation to baseline until 15 minutes after EVH. Individuals without EIB_A had increased parasympathetic activity compared to baseline(rMSSD) from 5 min after EVH(p < 0.05). This parasympathetic activity increase in relation to baseline was seen in individuals with EIB_A after 25 minutes (rMSSD = 49.9 ± 5.3 vs 63.5 ± 7.2, p < 0.05).

Conclusion

Young asthmatics with EIB_A present a delay in the increase of the parasympathetic component after EVH when compared to asthmatics without EIB_A.

KEYWORDS:

• Exercise-induced bronchoconstriction
• heart rate variability
• asthma
• adolescent
• eucapnic voluntary hyperpnea

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

We appreciate the partnership with Pernambuco University, London South Bank University, Rural Federal University of Pernambuco, Federal University of Paraiba and Federal Pernambuco University.

Author contributions

Hunter S, Rodrigues Filho EA, Medeiros D, Costa EC, and Sarinho E, were involved in revising it critically for intellectual content; and the final approval of the version to be published; Almeida Santos CM, Quirino PGC, Rizzo JA, Sérgio Silva A, Farah BQ, and Correia Júnior MAV were involved in the conception and design, analysis and interpretation of the data; the drafting of the paper, revising it critically for intellectual content; and the final approval of the version to be published.

Additional information

Funding

This paper was not funded.