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.
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.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
58
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
University of British Columbia
Kelowna, British Columbia, Canada
Endothelial Function
The change in brachial artery flow mediated dilation measured using reactive hyperaemia
Time frame: 8-weeks (following 24 sessions of exercise training)
Arterial Stiffness
The change in pulse wave velocity measured using tonometry
Time frame: 8-weeks (following 24 sessions of exercise training)
Carotid intima-medial thickness
The change in carotid intima-medial thickness measured by ultrasound
Time frame: 8-weeks (following 24 sessions of exercise training)
Carotid Compliance
The change in carotid compliance measured using tonometry and ultrasound for the carotid arteries
Time frame: 8-weeks (following 24 sessions of exercise training)
Inflammatory Biomarkers
The change in serum levels of CRP, IL-6, IL-10 and TNF-alpha measured using Luminex multiplex bead-based technology
Time frame: 8-weeks (following 24 sessions of exercise training)
Systolic function
The change in stroke volume using echocardiography
Time frame: 8-weeks (following 24 sessions of exercise training)
Diastolic function
The change in left ventricular end-diastolic volume using echocardiography
Time frame: 8-weeks (following 24 sessions of exercise training)
Cerebral Blood Flow
The change in cerebral and neck blood flow using ultrasound
Time frame: 8-weeks (following 24 sessions of exercise training)
Cerebrovascular Reactivity
The change in middle cerebral artery velocity in response to carbon dioxide
Time frame: 8-weeks (following 24 sessions of exercise training)
Cerebrovascular Autoregulation
The change in phase delay measured by transfer function analysis
Time frame: 8-weeks (following 24 sessions of exercise training)
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