Pulmonary rehabilitation and cardiovascular risk in COPD: a systematic review

Aldabayan, Yousef S; Rajeh, Ahmed M Al; Lemson, Arthur; Hurst, John R.

doi:10.1186/s40749-017-0026-9

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Furthermore, the effect of PR on CVD risk is largely unknown. A systematic review of studies investigating arterial stiffness in response to PR or an exercise-training programme in COPD patients only found three eligible studies, with conflicting results [153]; however, there may be subpopulations of patients who benefit from PR with regards to CV risk [153].…”

Section: Muscarinic Antagonistsmentioning

confidence: 99%

Cardiovascular disease and COPD: dangerous liaisons?

2018

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Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently occur together and their coexistence is associated with worse outcomes than either condition alone. Pathophysiological links between COPD and CVD include lung hyperinflation, systemic inflammation and COPD exacerbations. COPD treatments may produce beneficial cardiovascular (CV) effects, such as long-acting bronchodilators, which are associated with improvements in arterial stiffness, pulmonary vasoconstriction, and cardiac function. However, data are limited regarding whether these translate into benefits in CV outcomes. Some studies have suggested that treatment with long-acting β2-agonists and long-acting muscarinic antagonists leads to an increase in the risk of CV events, particularly at treatment initiation, although the safety profile of these agents with prolonged use appears reassuring. Some CV medications may have a beneficial impact on COPD outcomes, but there have been concerns about β-blocker use leading to bronchospasm in COPD, which may result in patients not receiving guideline-recommended treatment. However, there are few data suggesting harm with these agents and patients should not be denied β-blockers if required. Clearer recommendations are necessary regarding the identification and management of comorbid CVD in patients with COPD in order to facilitate early intervention and appropriate treatment.

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Section: Muscarinic Antagonistsmentioning

confidence: 99%

Cardiovascular disease and COPD: dangerous liaisons?

2018

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“…We have recently published a systematic review summarising studies examining the effect of PR on CV risk reduction measured by aPWV in COPD [22]. This identified three papers.…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary Rehabilitation (PR), a group exercise and education programme is an evidence-based intervention in COPD to reduce symptoms, improve exercise performance, reduce exacerbations and improve health-status [18–21]. We have previously reviewed the literature on the effect of PR on aortic stiffness in COPD [22]. Whilst the large and well-conducted study by Vanfleteren reported that, on average, there was no influence of PR on arterial stiffness in COPD, the data suggest that arterial stiffness responses to PR were highly heterogeneous such that there may have been sub-groups of patients who did and did not benefit.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary rehabilitation, physical activity and aortic stiffness in COPD

et al. 2019

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Background Patients with chronic obstructive pulmonary disease (COPD) have elevated cardiovascular risk, and cardiovascular disease is a major cause of death in COPD. The current literature indicates that changes in cardiovascular risk during pulmonary rehabilitation (assessed using aortic stiffness) are heterogeneous suggesting that there may be sub-groups of patients who do and do not benefit. Objectives To investigate the characteristics of COPD patients who do and do not experience aortic stiffness reduction during pulmonary rehabilitation, examine how changes relate to physical activity and exercise capacity, and assess whether changes in aortic stiffness are maintained at 6 weeks following rehabilitation. Methods We prospectively measured arterial stiffness (aortic pulse-wave velocity), exercise capacity (Incremental Shuttle Walk Test) and physical activity (daily step count) in 92 COPD patients who started a six week pulmonary rehabilitation programme, 54 of whom completed rehabilitation, and 29 of whom were re-assessed six weeks later. Results Whilst on average there was no influence of pulmonary rehabilitation on aortic stiffness (pre- vs. post pulse-wave velocity 11.3 vs. 11.1 m/s p = 0.34), 56% patients responded with a significant reduction in aortic stiffness. Change in aortic stiffness (absolute and/or percentage) during rehabilitation was associated with both increased physical activity (rho = − 0.30, p = 0.042) and change in exercise capacity (rho = − 0.32, p = 0.02), but in multivariable analysis most closely with physical activity. 92% of the responders who attended maintained this response six weeks later. Conclusion Elevated aortic stiffness in COPD is potentially modifiable in a subgroup of patients during pulmonary rehabilitation and is associated with increased physical activity. Trial registration ClinicalTrials.gov Identifier: NCT03003208. Registered 26/12/ 2016.

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“…The main targets of physical rehabilitation are achieved through timely activity, early start of therapeutic gymnastics and physical therapy in combination with dosed walking. Heart rate and systolic pressure are considered the main indicators of the cardiovascular system condition in clinical rehabilitation (Aldabayan et al 2017).…”

Section: Literature Reviewmentioning

confidence: 99%

Rehabilitation of athletes following cardiovascular events

Паначев

Ponomarev

Ковальчук

et al. 2020

J Public Health (Berl.)

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Aim The relevance of this study lies in the fact that cardiovascular mortality decreases in countries promoting active healthy lifestyles. The authors conducted experimental studies of the cardiovascular parameter prediction accuracy at the initial and final stages of the rehabilitation process. Subjects and methods The experiments showed sufficient accuracy of the constructed models. In particular, the maximum relative error was 11% for the simulation of the tolerable physical activity duration and 5.5% for the simulation of the exercise tolerance. The novelty of the study is that experimental studies were performed to predict the accuracy of the patient's condition at the final stage of the rehabilitation process by the assessment of exercise tolerance using bicycle ergometry test data only at the initial stage.Results The experiments showed sufficient accuracy of the constructed method. In particular, the maximum relative error of blood pressure simulation at the final stage of the rehabilitation period was 5%. The authors propose an approach to the implementation of exercise monitoring, according to which the observed pulse values are supplemented by simulated pressure values. Conclusions Experimental studies of the accuracy of the proposed approach have shown its sufficient accuracy. In particular, the maximum relative error in blood pressure simulation was 8.6%.

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Pulmonary rehabilitation and cardiovascular risk in COPD: a systematic review

Cited by 5 publications

References 13 publications

Cardiovascular disease and COPD: dangerous liaisons?

Cardiovascular disease and COPD: dangerous liaisons?

Pulmonary rehabilitation, physical activity and aortic stiffness in COPD

Rehabilitation of athletes following cardiovascular events

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