{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T13:45:05Z","timestamp":1789911905011,"version":"4.0.1"},"reference-count":36,"publisher":"European Respiratory Society (ERS)","issue":"180","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir Rev"],"accepted":{"date-parts":[[2026,2,19]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular disease is a primary driver of mortality in COPD. Elevated sympathetic nerve activity is a key proposed mechanism, but the magnitude of this autonomic overactivity has not been quantified in a pooled analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if adults with COPD exhibit higher resting muscle sympathetic nerve activity (MSNA) than healthy controls, assess associated cardiorespiratory effects, and evaluate the short-term impact of COPD interventions on MSNA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, eight databases were searched from inception to 15 May 2025 to inform this systematic review and meta-analysis (PROSPERO CRD420251044931). Eligible studies included adults with spirometry-defined COPD in whom MSNA was measured by microneurography at rest. Primary outcomes were MSNA burst frequency (bursts\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) and incidence (bursts per 100 heartbeats). Secondary outcomes included resting heart rate and blood pressure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 11 studies (171 COPD participants, 105 controls) met inclusion criteria. Compared with controls, COPD was associated with markedly higher MSNA, burst frequency (+18.5, 95% CI 9.4\u201327.7\u2005bursts\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) and burst incidence (+21.3, 95% CI 9.2\u201333.4 bursts per 100 heartbeats). Resting heart rate was also elevated (+10.7, 95% CI 6.1\u201315.3\u2005beats\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      ), while blood pressure did not differ significantly. Three studies on noninvasive ventilation or inhaled \u03b2\n                      <jats:sub>2<\/jats:sub>\n                      -agonists found no significant pooled changes in MSNA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Resting MSNA is significantly elevated in patients with COPD despite normal blood pressure. This chronic sympathetic excitation likely contributes to COPD-related cardiovascular morbidity and exercise intolerance, highlighting the importance of developing therapies that reduce sympathetic nerve activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/16000617.0267-2025","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T08:30:30Z","timestamp":1779870630000},"page":"250267","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Muscle sympathetic nerve activity in COPD: a systematic review and meta-analysis"],"prefix":"10.1183","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5744-471X","authenticated-orcid":false,"given":"Brady","family":"Duiker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safi","family":"Shirazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Sivak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K.","family":"Stickland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margie H.","family":"Davenport","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig D.","family":"Steinback","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"2026062507402467000_35.180.250267.1","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/S2213-2600(17)30293-X","article-title":"Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"5","author":"Soriano","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2026062507402467000_35.180.250267.2","unstructured":"World Health Organization . 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