Chronic Obstructive Pulmonary Disease
Conditions
Keywords
COPD, Exercise Training, Flow-Mediated Dilation, Arterial Stiffness, Echocardiography, Cerebrovascular Physiology
Brief summary
The primary cause of chronic obstructive pulmonary disease is smoking, which can lead to inflammation in the lungs and blood vessels that can lead to secondary problems such as blood vessel disease, high blood pressure and heart disease. Aerobic exercise training has been shown to reduce the risk of heart and brain disease; however, it is currently unknown whether exercise training can have the same affect in patients with COPD. The aim of this study is to investigate how eight weeks of aerobic exercise training improves blood vessel and heart function and brain blood flow in patients with COPD.
Detailed description
Chronic obstructive pulmonary disease (COPD) is a treatable respiratory condition that is only partially reversible. The primary cause of COPD is smoking which leads to airway inflammation and oxidative damage to the lungs, which has been linked to the development and progression of the disease. The inflammation is not isolated to the lungs as patients with COPD also have systemic inflammation that has been linked to a number of cardiovascular comorbidities such as endothelial dysfunction, cardiovascular disease and stroke. Evidence demonstrates that COPD patients have a greater incidence of vascular dysfunction and adverse vascular remodeling, which worsens with disease severity. In fact, patients with COPD are at 35 times greater risk of developing cardiovascular disease and stroke than healthy aged matched individuals. In healthy individuals and a number of chronic conditions, aerobic exercise training is well established to reduce the risk of cardiovascular and cerebrovascular disease. The benefits of exercise are likely through improvements in endothelial function, systemic inflammation, and cardiac and cerebral vascular function. However, whether exercise training can have the same effects in a chronic inflammatory condition like COPD has not been studied. The purpose of this study is to determine the effectiveness of an 8 week aerobic exercise training program in patient's chronic obstructive pulmonary disease as determined by improvements in endothelial function, systemic inflammation and cardiac and cerebral vascular function.
Interventions
OTHERIndividualized, non-linear aerobic exercise training
Aerobic exercise performed on lower body stationary ergometer and an upper extremity arm crank. Intensity (50-95% workload maximum) and durations (20-45 min) are fluctuated daily to optimize training stress and adaptation
Sponsors
University of British Columbia
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* Non-smokers (\>6 months); * Forced expiratory volume in one second/ forced vital capacity (FEV1/FVC) \< 0.7 and FEV1/FVC \<lower limit of normal * Stable (\>3 months exacerbation free)
Exclusion criteria
* On supplemental oxygen; * Known cardiac or cerebral vascular disease, diabetes, obstructive sleep apnea; * Uncontrolled hypertension; * BMI \>30kg/m2 * Currently performing pulmonary rehabilitation or structured exercise training; * Desaturate during exercise (SpO2\<85%) * Cardiovascular contraindications to exercise in the incremental test used for screening
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Endothelial Function | 8-weeks (following 24 sessions of exercise training) | The change in brachial artery flow mediated dilation measured using reactive hyperaemia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Carotid intima-medial thickness | 8-weeks (following 24 sessions of exercise training) | The change in carotid intima-medial thickness measured by ultrasound |
| Carotid Compliance | 8-weeks (following 24 sessions of exercise training) | The change in carotid compliance measured using tonometry and ultrasound for the carotid arteries |
| Inflammatory Biomarkers | 8-weeks (following 24 sessions of exercise training) | The change in serum levels of CRP, IL-6, IL-10 and TNF-alpha measured using Luminex multiplex bead-based technology |
| Systolic function | 8-weeks (following 24 sessions of exercise training) | The change in stroke volume using echocardiography |
| Arterial Stiffness | 8-weeks (following 24 sessions of exercise training) | The change in pulse wave velocity measured using tonometry |
| Cerebral Blood Flow | 8-weeks (following 24 sessions of exercise training) | The change in cerebral and neck blood flow using ultrasound |
| Cerebrovascular Reactivity | 8-weeks (following 24 sessions of exercise training) | The change in middle cerebral artery velocity in response to carbon dioxide |
| Cerebrovascular Autoregulation | 8-weeks (following 24 sessions of exercise training) | The change in phase delay measured by transfer function analysis |
| Diastolic function | 8-weeks (following 24 sessions of exercise training) | The change in left ventricular end-diastolic volume using echocardiography |
Countries
Canada
Outcome results
None listed