COPD, Exercise, Exercise Training, Pulmonary Hypertension, Right Ventricular Dysfunction
Conditions
Brief summary
This study plans to learn about heart function among individuals with chronic obstructive pulmonary disease (COPD). In particular, the investigators want to understand the different patterns of right ventricular response during rest and moderate- vs high-intensity exercise. By identifying patterns of right ventricular dysfunction, this study will help identify better treatments for patients with COPD in the future.
Interventions
BEHAVIORALExercise
After a brief warmup, participants will be asked to perform approximately 5 minutes of exercise at moderate intensity and then approximately 2 minutes of exercise at high intensity.
Sponsors
University of Colorado, Denver
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
Study participants will undergo testing to identify patterns of right ventricular response to moderate- vs high-intensity exercise.
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* COPD (determined by ratio of forced expiratory volume in 1 second to forced vital capacity \[FEV1/FVC\] \<0.7) * Age \>= 40 years
Exclusion criteria
* Exacerbation of COPD in the 3 months prior to enrollment * Change in COPD therapy in the 3 weeks prior to enrollment * Requirement of \>6 LPM supplemental oxygen at rest * Requirement of \>10 LPM supplemental oxygen with exertion * Active/uncontrolled cardiovascular disease (e.g. hypertension with blood pressure \>150/100 despite antihypertensives; coronary artery disease with angina; left ventricular ejection fraction ≤40%; arrhythmia; pulmonic, mitral or aortic valvular abnormality greater than mild in severity; tricuspid regurgitation greater than moderate in severity) * Volume overload (jugular vascular distension or greater than trace peripheral edema) * World Health Organization Functional Class IV * Known pulmonary hypertension with mean pulmonary artery pressure \>45 mmHg * Untreated severe obstructive sleep apnea or obesity hypoventilation syndrome * Active malignancy (other than skin) * Medical conditions that limit exercise on an upright stationary bicycle (e.g. severe osteoarthritis, imbalance/gait instability, etc.) * Pregnancy * Body mass index \<18 or \>40 * Hematocrit \<25% or \>55% * For invasive CPET, chronic anticoagulation that is unable to be held for the study visit * For invasive CPET, forced expiratory volume in 1 second of \<20%
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Right ventricular contractility measured by transthoracic echocardiography | Up to 1 hour | Global longitudinal strain, measured in absolute percent |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Right ventricular contractility measured by conductance catheter | Up to 1 hour | Maximum rate of pressure change, dP/dtmax in mmHg/sec |
| Right ventricular systolic function measured by transthoracic echocardiography | Up to 1 hour | Fractional area change on transthoracic echocardiography, measured in percent |
| Health-related quality of life by Short Form 36 (SF-36) questionnaire | Up to 1 hour | Units, range 0-100 with greater scores indicating a more favorable health state |
| Maximum oxygen consumption (VO2max) | Up to 1 hour | In L/min |
| Plasma acylcarnitines measured via ultra-high-performance liquid chromatography coupled to mass spectrometry | Up to 1 hour | Peak intensity, measured as arbitrary units |
| Physical activity measured by activity monitor | 7 days | Time spent in moderate or vigorous activity in absolute percent |
Countries
United States
Contacts
CONTACTLindsay Forbes, MD
PRINCIPAL_INVESTIGATORLindsay Forbes, MD
University of Colorado, Denver
Outcome results
None listed