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Heart Rate Variability and Cardio-respiratory Coupling During Sleep in Patients Prior to Bariatric Surgery

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Abstract

Obesity is associated with increased cardiac risk of morbidly and mortality and for the development and progression of obstructive sleep apnea (OSA). Severity of obesity negatively affects the heart rate variability (HRV) in patients with indication for bariatric surgery (BS). The purpose of this study is to determine if the severity of obesity alters the autonomic cardiac regulation and the cardio-respiratory coupling during sleep using spectral analysis of HRV and respiration variability signals (RS) in patients prior to BS. Twenty-nine consecutive preoperative BS and ten subjects (controls) underwent polysomnography. The spectral and cross-spectral parameters of the HRV and RS were computed during different sleep stages (SS). Spectral analysis of the HRV and RV indicated lower respiration regularity during sleep and a lower HRV in obese patients (OP) during all SS when compared with controls (p < 0.05). Severely (SO) and super-obese patients (SOP) presented lower values of low frequency/high frequency (LF/HF) ratio and LF power during REM sleep and higher HF power (p < 0.05), while morbidly obese (MO) patients presented lower LF/HF ratio and LF power in SS-S2 and higher HF power when compared to controls (p < 0.05). The cross-spectral parameters showed that SOP presented lower percentage of tachogram power coherent with respiration in SS-S3 when compared to controls (p < 0.05). Patients prior to BS presented altered HRV and RV in all SS. SO, MO, and SOP presented altered cardio-respiratory coupling during sleep, and these alterations are related with severity of obesity and OSA parameters.

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Acknowledgments

We thank the dedicated sleep technologists and administrative staff of the Sleep Institute of São Carlos.

This study was supported by FAPESP 2009/01842-0 and CAPES 12883-12-3.

Contributions from each Author

Renata Trimer, Renata Gonçalves Mendes, Fernando de Souza Melo Costa, Antonio Delfino de Oliveira Júnior, and Audrey Borghi-Silva were in charge of data collection and study design, contributed to data analysis and interpretation, and wrote the first draft and advanced versions of the manuscript. Ramona Cabiddu and Anna Maria Bianchi contributed to data analysis and interpretation and wrote advanced versions of the manuscript. All participants have read and approved the final version of the manuscript.

Conflict of Interest

The authors have indicated no conflicts of interest in this study.

Author information

Authors and Affiliations

  1. Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, Rodovia Washington Luís, KM 235-SP 310, São Carlos, 13565-905, São Paulo, Brazil

    R. Trimer, R. G. Mendes & A. Borghi-Silva

  2. CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, 70040-020, Brazil

    R. Trimer

  3. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Via Golgi, 39, 20133, Milan, Italy

    R. Cabiddu & A. M. Bianchi

  4. Sleep Institute of São Carlos, Rua Padre Teixeira, 1152, São Carlos, 13560-000, São Paulo, Brazil

    F. S. M. Costa & A. D. Oliveira Jr

Authors
  1. R. Trimer
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  2. R. Cabiddu
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  3. R. G. Mendes
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  4. F. S. M. Costa
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  5. A. D. Oliveira Jr
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  6. A. Borghi-Silva
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  7. A. M. Bianchi
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Corresponding author

Correspondence to R. Trimer.

Additional information

The trial is registered in RBR-3jbm6d.

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Trimer, R., Cabiddu, R., Mendes, R.G. et al. Heart Rate Variability and Cardio-respiratory Coupling During Sleep in Patients Prior to Bariatric Surgery. OBES SURG 24, 471–477 (2014). https://doi.org/10.1007/s11695-013-1171-0

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  • DOI: https://doi.org/10.1007/s11695-013-1171-0

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