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SUMMARY OBJECTIVE: The aim of this study was to evaluate if there is a relationship between the number of comorbidities, autonomic modulation, and quality of life in patients diagnosed with coronary artery disease. METHODS: A cross-sectional study was conducted at an outpatient rehabilitation center in Presidente Prudente-SP, Brazil. A total of 27 participants (65.33±9.23 years) diagnosed with coronary artery disease were assessed, from a cardiac rehabilitation program, independent of sex or age. The number of comorbidities was evaluated using the Self-Administered Comorbidity Questionnaire, and quality of life was evaluated using the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) (eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health). To evaluate the cardiac autonomic modulation, the heart rate was registered beat to beat using an heart rate monitor in the supine position during rest for 30 min. A total of 1000 RR intervals were considered to calculate linear (time domain: RMSSD, SDNN; frequency domain: LF, HF, LF/HF) and nonlinear indices (SD1, SD2, SD1/SD2) of heart rate variability. RESULTS: A negative correlation was observed between the aggregation of comorbidities and the pain domain of the SF-36 (r=-0.427; p=0.03). No significant correlations were observed between other variables (p>0.05). CONCLUSION: The number of comorbidities is inversely related to the pain domain of the SF-36, suggesting that a higher pain level is related to a higher number of comorbidities in coronary artery disease patients.
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ABSTRACT Background: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. Objective: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. Methods: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). Results: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. Conclusions: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.
RESUMO Introdução: A doença de Parkinson (DP) produz alterações autonômicas, que indicam menor modulação parassimpática e variabilidade global, mas que devem ser investigadas quanto aos métodos geométricos. Objetivo: Investigar a modulação autonômica em indivíduos com DP, por meio de índices de variabilidade da frequência cardíaca (VFC) obtidos pelos métodos geométricos. Métodos: Estudo transversal, no qualforam avaliados 50 voluntários, divididos em dois grupos: o grupo doença de Parkinson (GDP; n=26; 75,36±5,21 anos) e o grupo controle (GC; n=24; 75,36±5,21 anos). Para a avaliação da modulação autonômica a frequência cardíaca foi captada batimento a batimento por meio de um cardiofrequencímetro com os indivíduos em decúbito dorsal por 30 min e índices geométricos da VFC foram avaliados (RRtri, TINN, SD1, SD2 e plot de Poincaré). Resultados: Houve reduções nos índices RRtri, TINN, SD1 e SD2 para o GDP em comparação ao GC. Para a relação SD1/SD2, diferenças significantes não foram observadas entre os grupos. O plot de Poincaré mostrou que indivíduos com DP têm menor dispersão batimento a batimento dos intervalos RR, bem como maior dispersão dos intervalos RR a longo prazo em relação ao GC. Conclusão: Os resultados sugerem haver diminuição da modulação autonômica parassimpática e da variabilidade global em indivíduos com DP em relação a indivíduos sem a doença, as quais são independentes de sexo, idade e índice de massa corporal.