Significant improvement in arterial stiffness after endurance training in patients with COPD

Chest. 2010 Mar;137(3):585-92. doi: 10.1378/chest.09-1437. Epub 2009 Oct 31.

Abstract

Background: Arterial stiffness, a strong predictor of cardiovascular mortality, is abnormally elevated in patients with COPD. We investigated whether exercise training may decrease arterial stiffness in patients with COPD.

Methods: Seventeen stable patients with COPD were included in this case-controlled study. Trained (n = 10) and untrained (n = 7) patients were matched for age (62 +/- 7 years), disease severity (FEV(1) = 50% +/- 17% predicted) and walking distance (412 +/- 70 m). Carotid-radial pulse wave velocity (PWV, a measure of arterial stiffness), pulmonary function, BP, plasmatic biomarkers, walking distance, and peripheral muscle function were evaluated in the two groups at baseline and after 4 weeks. In trained patients, aerobic capacity was also assessed during incremental exercise on a cycloergometer, before and after training.

Results: Baseline PWV was similar between both groups. PWV was stable after 4 weeks in untrained patients with COPD, whereas it was reduced in trained patients (from 10.3 +/- 0.7 to 9.2 +/- 0.8 m/s, P = .001). PWV reduction correlated with improvements in walking distance (r = -0.49), muscle endurance (r = -0.48), systolic BP (r = 0.79), and fasting glucose (r = 0.59) in all patients (P < .05), and with changes in maximal heart rate and oxygen consumption (r = -0.70, P = .02) in trained patients.

Conclusions: Arterial stiffness appears to improve after exercise training in patients with COPD proportionally to changes in exercise capacity. Suggested mechanisms for arterial stiffness improvement are training-induced reductions in systolic BP and fasting glucose.

Trial registration: clinicaltrials.gov; Identifier: NCT00404430.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiopathology*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / physiopathology*
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic / methods*
  • Prognosis
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Risk Factors
  • Spirometry
  • Ultrasonography
  • Vascular Resistance / physiology*

Associated data

  • ClinicalTrials.gov/NCT00404430