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

The Effects of Aerobic Exercise Training on Peripheral Vascular, Cardiac and Cerebral Vascular Function in Patients With Chronic Obstructive Pulmonary Disease

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.

Study Overview

• Status: Completed
• Conditions: Chronic Obstructive Pulmonary Disease
• Intervention / Treatment: Other: Individualized, non-linear aerobic exercise training

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 Type: Interventional
• Enrollment (Actual): 58
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Kelowna, British Columbia, Canada, V1V 1V7
      • University of British Columbia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

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)

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Patients with COPD; 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.	Other: Individualized, non-linear aerobic exercise training; 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
Active Comparator: Healthy Controls; 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.	Other: Individualized, non-linear aerobic exercise training; 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

What is the study measuring?

Primary Outcome Measures

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

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Arterial Stiffness	The change in pulse wave velocity measured using tonometry	8-weeks (following 24 sessions of exercise training)
Carotid intima-medial thickness	The change in carotid intima-medial thickness measured by ultrasound	8-weeks (following 24 sessions of exercise training)
Carotid Compliance	The change in carotid compliance measured using tonometry and ultrasound for the carotid arteries	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	8-weeks (following 24 sessions of exercise training)
Systolic function	The change in stroke volume using echocardiography	8-weeks (following 24 sessions of exercise training)
Diastolic function	The change in left ventricular end-diastolic volume using echocardiography	8-weeks (following 24 sessions of exercise training)
Cerebral Blood Flow	The change in cerebral and neck blood flow using ultrasound	8-weeks (following 24 sessions of exercise training)
Cerebrovascular Reactivity	The change in middle cerebral artery velocity in response to carbon dioxide	8-weeks (following 24 sessions of exercise training)
Cerebrovascular Autoregulation	The change in phase delay measured by transfer function analysis	8-weeks (following 24 sessions of exercise training)

Collaborators and Investigators

• Sponsor: University of British Columbia
• Investigators: Principal Investigator: Neil Eves, PhD, University of British Columbia

Publications and helpful links

General Publications

• Gelinas JC, Lewis NC, Harper MI, Ainslie PN, Rolf JD, Eves ND. Aerobic Exercise Training on Peripheral Vascular Structure and Function in Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, 191:A5305, 2015.

Study record dates

Study Major Dates

• Study Start: January 1, 2012
• Primary Completion (Actual): May 1, 2015
• Study Completion (Actual): May 1, 2015

Study Registration Dates

• First Submitted: August 4, 2016
• First Submitted That Met QC Criteria: August 17, 2016
• First Posted (Estimate): August 23, 2016

Study Record Updates

• Last Update Posted (Estimate): August 23, 2016
• Last Update Submitted That Met QC Criteria: August 17, 2016
• Last Verified: August 1, 2016

More Information

Terms related to this study

• Keywords: COPD; Exercise Training; Arterial Stiffness; Echocardiography; Flow-Mediated Dilation; Cerebrovascular Physiology
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
• Other Study ID Numbers: H11-02770