Blunted muscle angiogenic training-response in COPD patients versus sedentary controls

Eur Respir J. 2013 Apr;41(4):806-14. doi: 10.1183/09031936.00053512. Epub 2012 Jul 12.


The impaired skeletal muscle of chronic obstructive pulmonary disease (COPD) patients reduces exercise capacity. Similar to the oxidative muscle fibres, the angio-adaptation of muscle to training may be blunted in these patients, as in other chronic conditions. We therefore compared muscle functional responses and angio-adaptations after training in COPD patients and sedentary healthy subjects (SHS). 24 COPD patients (forced expiratory volume in 1 s 45.6 ± 17.5% predicted) and 23 SHS (<150 min · week(-1) of moderate-to-vigorous exercise) completed a 6-week rehabilitation programme based on individualised moderate-intensity endurance training. Histomorphological muscle analysis and measurements of pro-angiogenic vascular endothelial growth factor (VEGF)-A and anti-angiogenic thrombospondin (TSP)-1 were conducted before and after training. COPD patients and SHS showed improved symptom-limited oxygen consumption and muscle endurance, although improvements were lower in COPD patients (+0.96 ± 2.4 versus +2.9 ± 2.6 mL · kg(-1) · min(-1), p<0.05, and +65% versus +108%, p = 0.06, respectively). The capillary-to-fibre (C/F) ratio increased less in COPD patients than SHS (+16 ± 10% versus +37 ± 20%, p<0.05) and no fibre type switch occurred in COPD patients. The VEGF-A/TSP-1 ratio increased in COPD patients and SHS (+65% versus +35%, p<0.05). Changes in C/F and symptom-limited oxygen consumption were correlated (r = 0.51, p<0.05). In addition to a lack of fibre switch, COPD patients displayed a blunted angiogenic response to training.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological
  • Aged
  • Biopsy
  • Capillaries / metabolism
  • Case-Control Studies
  • Exercise
  • Exercise Test
  • Exercise Tolerance / physiology
  • Female
  • Forced Expiratory Volume
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Muscles / pathology*
  • Neovascularization, Physiologic*
  • Oxygen / metabolism
  • Oxygen Consumption
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Respiratory Function Tests
  • Sedentary Behavior
  • Thrombospondins / metabolism
  • Vascular Endothelial Growth Factor A / metabolism


  • Thrombospondins
  • Vascular Endothelial Growth Factor A
  • Oxygen