This study plans to learn more 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.
This study will determine patterns of right ventricular (RV) response to aerobic exercise in patients with chronic obstructive pulmonary disease (COPD) and will design a targeted exercise intervention to improve RV response. We will study 60 patients with COPD. Participants will complete cardiopulmonary exercise testing (CPET) and transthoracic echocardiography (TTE) during rest, moderate- and high-intensity exercise. A subset of participants (n=16) who have been recommended to undergo clinical right heart catheterization will be recruited for the primary study with additional invasive pressure-volume analysis during the CPET. This testing will be used to validate measures of RV function obtained through noninvasive testing. The sample size was selected based upon our preliminary data and statistical analysis plans. To test whether an exercise intervention targeted to RV response to exercise is feasible for patients, 12 participants will complete a targeted exercise training intervention based on their RV contractile response during baseline testing. This intervention will include participants who demonstrate RV contractility increase to moderate- but not high-intensity exercise. We will test the feasibility of a moderate-intensity interval training program. Participants will complete exercise training sessions 3x/week for 12 weeks. Exercise training will be performed on an upright stationary bicycle. Following the exercise training intervention, participants will repeat CPET and TTE. They will also complete a health-related quality of life questionnaire before and after the exercise training intervention.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Exercise training will include moderate-intensity interval training 3x/week.
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
RECRUITINGRight ventricular contractility measured by transthoracic echocardiography
Global longitudinal strain, measured in absolute percent
Time frame: Up to 1 hour
Right ventricular contractility measured by conductance catheter
Maximum rate of pressure change, dP/dtmax in mmHg/sec
Time frame: Up to 1 hour
Right ventricular systolic function measured by transthoracic echocardiography
Fractional area change on transthoracic echocardiography, measured in percent
Time frame: Up to 1 hour
Right ventricular systolic function measured by transthoracic echocardiography
Tricuspid annular plane systolic excursion on transthoracic echocardiography, measured in centimeters
Time frame: Up to 1 hour
Exercise training feasibility
Proportion of exercise training sessions completed
Time frame: 4 months
Exercise training safety
Adverse events, reported or observed
Time frame: 4 months
Health-related quality of life by Short Form 36 (SF-36) questionnaire
Units, range 0-100 with greater scores indicating a more favorable health state
Time frame: Up to 1 hour
Maximum oxygen consumption (VO2max)
In L/min
Time frame: Up to 1 hour
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