Assessment of Autonomic Dysfunction and Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease Visiting a Tertiary Care Center in Southern Bihar

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a systemic disorder associated not only with pulmonary impairment but also with significant extrapulmonary manifestations. Autonomic nervous system dysfunction, reflected by alterations in heart rate variability (HRV), has emerged as an important contributor to cardiovascular morbidity and mortality in COPD patients. Reduced HRV indicates sympathovagal imbalance and has been linked to disease severity and poor outcomes.

Objectives: To assess autonomic dysfunction and heart rate variability parameters in patients with COPD attending a tertiary care center in southern Bihar.

Materials and Methods: This prospective observational study was conducted over 12 months at Narayan Medical College and Hospital, Jamuhar. A total of 108 diagnosed COPD patients were enrolled. Autonomic function was assessed using standard cardiovascular reflex tests and HRV analysis derived from resting electrocardiogram recordings. Statistical analysis was performed using appropriate parametric and non-parametric tests, with p < 0.05 considered statistically significant.

Results: COPD patients demonstrated significant reduction in time-domain and frequency-domain HRV parameters, indicating autonomic dysfunction with predominant sympathetic activity. HRV parameters showed a significant association with disease severity.

Conclusion: Autonomic dysfunction is prevalent among COPD patients and is reflected by reduced HRV parameters. Early identification of autonomic impairment may help in risk stratification and improved management of COPD patients.

Keywords: Chronic obstructive pulmonary disease, autonomic dysfunction, heart rate variability, sympathetic activity