Endothelial Function in COPD Is in an Intermediate Position Between Healthy Subjects and Coronary Artery Disease Patients and Is Related to Physical Activity

Bernardi, Eva; Merlo, Carlotta; Cogo, Annalisa

doi:10.1007/s00408-018-0168-9

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…Finally, we found no association between FMD and FEV1 or traditional CVD risk factors (ie, obesity, dyslipidemia, smoking habit, diabetes and hypertension). Our results agree with those of Bernardi et al, 11 who similarly showed that in moderate COPD, the PA was the only determinant independently associated with FMD activity, while traditional CVD risk factors were not. Our findings could be due to the limitations of our study that included a small sample size and mostly OS patients who had moderate COPD.…”

supporting

confidence: 93%

A Cross-Sectional Study Evaluating the Association of Brachial Artery Flow Mediated Vasodilation with Physical Activity Measured by Accelerometry in Patients with the Overlap of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease

Macrea,

Malhotra,

ZuWallack

et al. 2024

COPD

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Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Overlap Syndrome (OS), the cooccurrence of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease. Clustering of patients in subgroups with similar pre-clinical manifestations (ie, endothelial dysfunction) may identify relevant therapeutic phenotype categories for patients with OS who are at high risk of CVD. We therefore conducted a cross-sectional pilot study of endothelial function in 7 patients with OS (Forced Expiratory Volume in 1 second/Forced Vital Capacity < 0.7) on continuous positive airway pressure therapy (n = 7) to assess the relationship between FMD and physical activity. We found a strong association between FMD and step counts (rho = 0.77, p = 0.04); and FMD and moderate physical activity (rho = 0.9, p = 0.005). Further, larger studies are needed to confirm that FMD may identify patients with OS at high risk of CVD who benefit from increased physical activity.

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supporting

confidence: 93%

A Cross-Sectional Study Evaluating the Association of Brachial Artery Flow Mediated Vasodilation with Physical Activity Measured by Accelerometry in Patients with the Overlap of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease

Macrea,

Malhotra,

ZuWallack

et al. 2024

COPD

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“…The main result of this study is that an 8-week supervised exercise training programme significantly improved endothelial function in COPD. Regarding this topic, contradictory results have been reported in the literature [6,8,9,13]; however, two recent systematic reviews demonstrated that a high percentage of COPD patients have impaired endothelial function, as assessed by FMD [4,5].…”

mentioning

confidence: 99%

“…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 ].…”

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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“…This is of particular relevance, as ED is a common feature in both COPD and the development of atherosclerosis, which in turn can cause CVDs such as myocardial infarction and stroke (50, 175,195). Interestingly, ED in patients with COPD exhibits an intermediate state between healthy patients and patients suffering from coronary artery disease (196). In a murine model of atherosclerosis (Apo.E −/− ), increased oxidative stress was suggested to link ED with COPD pathogenesis, especially with regard to the development of emphysema (197).…”

Section: Endothelial Dysfunction In Copd In Cardiovascular Diseases (Cvds)mentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease and the Cardiovascular System: Vascular Repair and Regeneration as a Therapeutic Target

Karnati

Seimetz

Kleefeldt

et al. 2021

Front. Cardiovasc. Med.

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Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and encompasses chronic bronchitis and emphysema. It has been shown that vascular wall remodeling and pulmonary hypertension (PH) can occur not only in patients with COPD but also in smokers with normal lung function, suggesting a causal role for vascular alterations in the development of emphysema. Mechanistically, abnormalities in the vasculature, such as inflammation, endothelial dysfunction, imbalances in cellular apoptosis/proliferation, and increased oxidative/nitrosative stress promote development of PH, cor pulmonale, and most probably pulmonary emphysema. Hypoxemia in the pulmonary chamber modulates the activation of key transcription factors and signaling cascades, which propagates inflammation and infiltration of neutrophils, resulting in vascular remodeling. Endothelial progenitor cells have angiogenesis capabilities, resulting in transdifferentiation of the smooth muscle cells via aberrant activation of several cytokines, growth factors, and chemokines. The vascular endothelium influences the balance between vaso-constriction and -dilation in the heart. Targeting key players affecting the vasculature might help in the development of new treatment strategies for both PH and COPD. The present review aims to summarize current knowledge about vascular alterations and production of reactive oxygen species in COPD. The present review emphasizes on the importance of the vasculature for the usually parenchyma-focused view of the pathobiology of COPD.

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Endothelial Function in COPD Is in an Intermediate Position Between Healthy Subjects and Coronary Artery Disease Patients and Is Related to Physical Activity

Cited by 8 publications

References 10 publications

A Cross-Sectional Study Evaluating the Association of Brachial Artery Flow Mediated Vasodilation with Physical Activity Measured by Accelerometry in Patients with the Overlap of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease

A Cross-Sectional Study Evaluating the Association of Brachial Artery Flow Mediated Vasodilation with Physical Activity Measured by Accelerometry in Patients with the Overlap of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease

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

Chronic Obstructive Pulmonary Disease and the Cardiovascular System: Vascular Repair and Regeneration as a Therapeutic Target

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