The Effects of Aerobic Exercise Training on Vascular, Cardiac and Cerebral Vascular Function in COPD

Not Applicable

Completed

• Conditions: Chronic Obstructive Pulmonary Disease
• Interventions: Other: Individualized, non-linear aerobic exercise training

• Registration Number: NCT02875522
• Lead Sponsor: University of British Columbia

Brief Summary

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.

Detailed Description

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 Timeline

• Study Start: 2012-01
• Primary Completion: 2015-05
• Study Completion: 2015-05
• Status Verified: 2016-08
• Study First Submitted: 2016-08-04
• Study First Submitted QC: 2016-08-17
• Last Update Submitted: 2016-08-17
• Study First Posted: 2016-08-23
• Last Update Posted: 2016-08-23

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 58

Inclusion Criteria

• Non-smokers (>6 months);
• Forced expiratory volume in one second/ forced vital capacity (FEV1/FVC) < 0.7 and FEV1/FVC <lower limit of normal
• Stable (>3 months exacerbation free)

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Exclusion Criteria

• On supplemental oxygen;
• Known cardiac or cerebral vascular disease, diabetes, obstructive sleep apnea;
• Uncontrolled hypertension;
• BMI >30kg/m2
• Currently performing pulmonary rehabilitation or structured exercise training;
• Desaturate during exercise (SpO2<85%)
• Cardiovascular contraindications to exercise in the incremental test used for screening

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Healthy Controls	Individualized, non-linear aerobic exercise training	Age, sex, BMI and activity matched controls participated in an 8-week (24 session) individualized, non-linear aerobic exercise training program consisting of upper and lower body cycle ergometry.
Patients with COPD	Individualized, non-linear aerobic exercise training	Stable patients with COPD participated in an 8-week (24 session) individualized, non-linear aerobic exercise training program consisting of upper and lower body cycle ergometry.

Primary Outcome Measures

Name	Time	Method
Endothelial Function	8-weeks (following 24 sessions of exercise training)	The change in brachial artery flow mediated dilation measured using reactive hyperaemia

Secondary Outcome Measures

Name	Time	Method
Inflammatory Biomarkers	8-weeks (following 24 sessions of exercise training)	The change in serum levels of CRP, IL-6, IL-10 and TNF-alpha measured using Luminex multiplex bead-based technology
Carotid intima-medial thickness	8-weeks (following 24 sessions of exercise training)	The change in carotid intima-medial thickness measured by ultrasound
Arterial Stiffness	8-weeks (following 24 sessions of exercise training)	The change in pulse wave velocity measured using tonometry
Systolic function	8-weeks (following 24 sessions of exercise training)	The change in stroke volume using echocardiography
Cerebral Blood Flow	8-weeks (following 24 sessions of exercise training)	The change in cerebral and neck blood flow using ultrasound
Carotid Compliance	8-weeks (following 24 sessions of exercise training)	The change in carotid compliance measured using tonometry and ultrasound for the carotid arteries
Diastolic function	8-weeks (following 24 sessions of exercise training)	The change in left ventricular end-diastolic volume using echocardiography
Cerebrovascular Reactivity	8-weeks (following 24 sessions of exercise training)	The change in middle cerebral artery velocity in response to carbon dioxide
Cerebrovascular Autoregulation	8-weeks (following 24 sessions of exercise training)	The change in phase delay measured by transfer function analysis

Trial Locations

Locations (1)

University of British Columbia; 🇨🇦 Kelowna, British Columbia, Canada