Peripheral endothelial function is positively associated with maximal aerobic capacity in patients with chronic obstructive pulmonary disease

Vaes, Anouk W.; Spruit, Martijn A.; Theunis, Jan; Wouters, Emiel F.M.; Boever, Patrick De

doi:10.1016/j.rmed.2018.07.013

Cited by 11 publications

(12 citation statements)

References 64 publications

(99 reference statements)

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“…It is also important to point out that the current sample, in general, did not present endothelial dysfunction. Corroborating our findings, Vaes et al () did not found correlation between RHI and the 6MWT, but they found correlation with maximal aerobic capacity (VO 2 peak). However, that sample presented less severe airflow limitation and higher prevalence of endothelial dysfunction.…”

Section: Discussionsupporting

confidence: 84%

“…Up to our knowledge, only two prior cross‐sectional studies assessed endothelial function (RHI), and only one AIx with PAT in patients with COPD (Minet et al, ; Vaes, Spruit, Theunis, Wouters, & De Boever, ). Minet et al () found a mean RHI of 0.43 ranging from −0.14 to 1.3.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies revealed that the severity of airflow obstruction is an important determinant of endothelial function assessed by FMD in patients with COPD (Clarenbach et al, , ; Eickhoff et al, ). However, data are conflicting regarding this association when assessing endothelial function with PAT (Minet et al, ; Vaes et al, ). Although our overall sample showed normal endothelial function, at the same time, they presented abnormal arterial stiffness at baseline.…”

Section: Discussionmentioning

confidence: 99%

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The effects of pulmonary rehabilitation on endothelial function and arterial stiffness in patients with chronic obstructive pulmonary disease

Araújo

Reinaldo

Foscarini

et al. 2019

Physiotherapy Res Intl

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Objectives Cardiovascular disease is a major cause of mortality in chronic obstructive pulmonary disease (COPD) and endothelial dysfunction may enhance the mortality risk. Exercise training has shown to be beneficial for improvement of endothelial function in patients with cardiovascular disease, but this remains unclear in COPD. Thus, this study aimed to assess the effect of exercise‐based pulmonary rehabilitation (PR) on endothelium function, arterial stiffness and plasma nitrite levels in patients with COPD. Methods Patients with COPD engaged a 48‐session PR program. Reactive hyperaemia index (RHI), augmentation index (AIx), and heart rate (HR) assed by peripheral arterial tonometry (PAT), plasma nitrite levels, systemic blood pressure, functional capacity (six‐minute walk test) and the BODE index were assessed at baseline and after 24 and 48 sessions of PR. Plasma nitrite levels were also assessed before and after the first session of PR. Results Twenty‐one subjects were included and completed 24 PR sessions, and 16 subjects completed 48 sessions. It was observed that a poorer AIx adjusted for HR in frequent COPD exacerbators (4.67 ± 16.5 vs. 20.9 ± 12.9; p = .02). PR improved functional capacity (380 ± 107 m vs. 442 ± 115 m; p < .001) and the BODE index (6 [2.8] vs. 4 [3]; p = .001), but did not change HR, systemic arterial pressure, RHI, AIx, and plasma nitrite levels during the follow‐up. Plasma nitrite levels reduced after the first session of PR (0.074 [0.079] μM vs. 0.061 [0.04] μM; p = .027). The acute change in plasma nitrite levels correlated with RHI in patients with preserved endothelial function (r = 0.71; p = .01). Conclusions Although exercise‐based PR improved functional capacity and the BODE index, it did not change endothelial function and arterial stiffness in patients with COPD.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The effects of pulmonary rehabilitation on endothelial function and arterial stiffness in patients with chronic obstructive pulmonary disease

Araújo

Reinaldo

Foscarini

et al. 2019

Physiotherapy Res Intl

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“…Regarding COPD, the information is limited and conflicting. When the present study was designed, there were no prospective studies investigating the effect of exercise training programmes on endothelial function in COPD, and the evidence was based on retrospective analysis [ 8 , 15 ] showing that endothelial function was positively related to physical activity level and exercise capacity. While this study was ongoing, one prospective study was published by G elinas et al .…”

mentioning

confidence: 99%

Supervised exercise training improves endothelial function in COPD patients: a method to reduce cardiovascular risk?

et al. 2020

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Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular diseases, particularly coronary artery disease (CAD) [1]. Endothelial dysfunction is a marker of cardiovascular risk [2]; a validated and standardised method to assess endothelial function is flow-mediated dilation (FMD) [3]. Previous studies have shown impaired endothelial function in COPD patients compared to that in healthy subjects [4, 5], with intermediate function between CAD patients and healthy subjects [6]. Endothelial function is positively associated with physical activity and is improved by exercise training in sedentary elderly subjects and cardiac patients [7]. Regarding COPD, this relationship has been reported in retrospective studies, but has not been confirmed in prospective studies [8, 9]. The objective of the present study was to determine whether an 8-week supervised walking-based training programme can improve endothelial function in COPD. 20 COPD (14 males and six females) with forced expiratory volume in 1 s (FEV 1) ⩾30% and ⩽80% predicted [10] who were in a stable clinical condition for ⩾6 weeks were consecutively recruited from the Respiratory Disease Outpatient Clinic, Ferrara University Hospital (Italy). Exclusion criteria were: 1) major cardiovascular diseases (i.e. CAD, uncontrolled hypertension, arrhythmias or heart failure); 2) orthopaedic and neuromuscular exercise limitations; and 3) current structured exercise performance. The Ethics Committee of Ferrara University approved the study (number 140794). Each subject gave informed consent. At baseline (t 0), all patients underwent spirometry and a 6-min walk test (6MWT) [11]. The Charlson Comorbidity Index was calculated and a blood analysis (⩽3 months) was collected. On a separate day, blood pressure was measured in triplicate after 20 min of rest and the FMD test was subsequently performed on the opposite arm. Daily physical activity was monitored for 7 days with the activity and metabolic Holter SenseWear Armband (BodyMedia, Pittsburgh, PA, USA). An 8-week supervised walking-based training programme was described, and the subjects were randomised into two groups: exercise and control. Neither group changed medication; the control group maintained their lifestyle habits, checked with a questionnaire [12]. The exercise group performed a maximal incremental cardiopulmonary exercise test on a cycle ergometer (10-15 W•min −1) to determine the exercise capacity. After 8 weeks (t 1), the subjects repeated all the tests. @ERSpublications Supervised exercise training is key to health improvement in chronic obstructive pulmonary disease patients https://bit.ly/2AdfKvb Cite this article as: Merlo C, Bernardi E, Bellotti F, et al. Supervised exercise training improves endothelial function in COPD patients: a method to reduce cardiovascular risk?

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“…Clarenbach et al showed that patients with severe airflow obstruction who were physically active were less prone to more severe impairments of FMD, compared to inactive COPD patients with severe airflow obstruction, suggesting that physical activity may attenuate the progression of vascular dysfunction in COPD 40 . Vaes et al 41 also www.nature.com/scientificreports/ demonstrated a significant association between reduced maximal aerobic capacity (VO 2 peak) and impaired peripheral endothelial function in patients with stable COPD. In this way, our findings revealed significant associations between exercise capacity and endothelial function in severe acute exacerbation of COPD.…”

Section: Exercise Capacity and Endothelial Function In Aecopdmentioning

confidence: 94%

Association of exercise capacity and endothelial function in patients with severe exacerbations of chronic obstructive pulmonary disease

Kabbach

Heubel

Goulart

et al. 2021

Sci Rep

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Severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with significant poor outcomes including an increased risk of cardiovascular (CV) events and exercise intolerance. Endothelial dysfunction might contribute to an impaired vascular homeostasis and consequently to CV events and exercise capacity. This study aimed to evaluate the association between exercise capacity and endothelial function in patients with severe AECOPD. Forty-five COPD patients diagnosed with severe AECOPD and admitted to the University Hospital of São Carlos from 2017 to 2019 were enrolled in this observational clinical study. Endothelial Function was assessed by brachial artery ultrasonography (M-Turbo, Sonosite, Bottle, WA, USA) and Flow Mediated Dilatation (FMD) technique in absolute (mm) and percentage values (%). Walking distance (6MWD) obtained by six-minute walk test was considered to characterize the exercise capacity. Pearson’s correlation analysis and linear regression model were applied and a significance level of 5%. There was a significant positive correlation between exercise capacity and endothelial function. Pearson correlation coefficient were 0.36 (p = 0.02) and 0.40 (p = 0.01) between 6MWD and FMD in mm and %, respectively. Linear regression model revealed 6MWD (p = 0.007), accounting for 15% of FMD (%) variance (R2 adjusted). FMD (%) = 2.11 + (0.0081*6MWD). Exercise capacity is associated with endothelial function in patients with severe AECOPD. FMD was found to be increasing with increasing walked distance. Further research is needed to provide evidence of effectiveness of rehabilitation on exercise capacity and endothelial function in these patients and its prognostic value.

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Peripheral endothelial function is positively associated with maximal aerobic capacity in patients with chronic obstructive pulmonary disease

Cited by 11 publications

References 64 publications

The effects of pulmonary rehabilitation on endothelial function and arterial stiffness in patients with chronic obstructive pulmonary disease

The effects of pulmonary rehabilitation on endothelial function and arterial stiffness in patients with chronic obstructive pulmonary disease

Supervised exercise training improves endothelial function in COPD patients: a method to reduce cardiovascular risk?

Association of exercise capacity and endothelial function in patients with severe exacerbations of chronic obstructive pulmonary disease

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