njit-etd2003-081 - New Jersey Institute of Technology

CHAPTER 1
INTRODUCTION
1.1 Scope of Research
It is of interest to use noninvasive autonomic techniques to learn more about differences
in the physiology of diseased patients. The development of improved treatments for
these patients is important, and the development of improved monitoring techniques to
assess risk of morbidity and mortality, as well as to assess response to treatment is
needed. One particular population of patients, which is used in this study, is those with
chronic obstructive pulmonary disease (COPD).
The monitoring of the progression of pulmonary disease and the prediction of
mortality and morbidity in these conditions is usually performed through the
measurement of static and dynamic lung volumes, and through tests which measure the
physiologic efficiency of gas exchange in the lungs. However, the effects of severe
pulmonary disease are not limited to the lungs. Often there are serious accompanying
cardiac problems and severe alterations to the normal state of autonomic regulation.
Patients with pulmonary disease are subject to a hyperadrenergic state and have many
alterations in their autonomic physiology that can be documented. [1] There are three
non-invasive measures of autonomic function, which can be performed in a simple
fashion and can offer a clear window into the state of the subject. These include the
heart rate variability (HRV), beat-to-beat blood pressure variability (BPV), and
baroreceptor sensitivity. In subject populations with cardiac disease, the abnormalities
found in these measures were found to have very strong correlations with subsequent
1