Aerobic exercise training does not alter vascular structure and function in chronic obstructive pulmonary disease

• Published in: Experimental physiology Vol. 102; no. 11; pp. 1548 - 1560
• Main Authors: Gelinas, Jinelle C., Lewis, Nia C., Harper, Megan I., Melzer, Bernie, Agar, Gloria, Rolf, J. Douglass, Eves, Neil D.
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-11-2017
• Subjects: Aerobic capacity; Aerobics; Aged; Arteries - diagnostic imaging; Arteries - physiopathology; Bicycling; Blood Pressure; Cardiorespiratory Fitness; Cardiovascular disease; Cardiovascular diseases; Carotid artery; Carotid Intima-Media Thickness; Chronic illnesses; Chronic obstructive pulmonary disease; COPD; Dyspnea; Endothelium, Vascular - diagnostic imaging; Endothelium, Vascular - physiopathology; Exercise; Exercise Therapy - methods; Exercise Tolerance; exercise training; Female; Fitness training programs; flow‐mediated dilation; Forced Expiratory Volume; Health risk assessment; Hemodynamics; Humans; Inflammation; Inflammation Mediators - blood; Lung - physiopathology; Lung diseases; Male; Mechanical stimuli; Middle Aged; Obstructive lung disease; Physical fitness; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Pulse Wave Analysis; Respiration; Structure-function relationships; Time Factors; Treatment Outcome; Ultrasound; Vascular Stiffness; Vasodilation; Velocity; Vital Capacity; flow-mediated dilation; exercise training; COPD
• ISSN: 0958-0670; 1469-445X
• DOI: 10.1113/EP086379

New Findings
What is the central question of this study?
Chronic obstructive pulmonary disease (COPD) is associated with endothelial dysfunction, arterial stiffness and systemic inflammation, which are linked to increased cardiovascular disease risk. We asked whether periodized aerobic exercise training could improve vascular structure and function in patients with COPD.
What is the main finding and its importance?
Eight weeks of periodized aerobic training did not improve endothelial function, arterial stiffness or systemic inflammation in COPD, despite improvements in aerobic capacity, blood pressure and dyspnoea. Short‐term training programmes may not be long enough to improve vascular‐related cardiovascular risk in COPD.
Chronic obstructive pulmonary disease (COPD) has been associated with endothelial dysfunction and arterial stiffening, which are predictive of future cardiovascular events. Although aerobic exercise improves vascular function in healthy individuals and those with chronic disease, it is unknown whether aerobic exercise can positively modify the vasculature in COPD. We examined the effects of 8 weeks of periodized aerobic training on vascular structure and function and inflammation in 24 patients with COPD (age, 69 ± 7 years; forced expiratory volume in 1 second as a percentage of predicted (FEV1%pred), 68 ± 19%) and 20 matched control subjects (age, 64 ± 5 years; FEV1%pred, 113 ± 16%) for comparison. Endothelial function was measured using brachial artery flow‐mediated dilatation, whereas central and peripheral pulse wave velocity, carotid artery intima–media thickness, carotid compliance, distensibility and β‐stiffness index were measured using applanation tonometry and ultrasound. Peak aerobic power (V̇O2 peak ) was measured using an incremental cycling test. Upper and lower body cycling training was performed three times per week for 8 weeks, and designed to optimize vascular adaptation by increasing and sustaining vascular shear stress. Flow‐mediated dilatation was not increased in COPD patients (+0.15 ± 2.27%, P = 0.82) or control subjects (+0.34 ± 3.20%, P = 0.64) and was not different between groups (P = 0.68). No significant improvements in central pulse wave velocity (COPD, +0.30 ± 1.79 m s−1 versus control subjects, −0.34 ± 1.47 m s−1) or other markers of vascular structure or function were found within or between groups. The V̇O2 peak increased significantly in COPD and control subjects, and was greater in control subjects (1.6 ± 1.4 versus 4.1 ± 3.7 ml kg min−1, P = 0.003), while blood pressure and dyspnoea were reduced in COPD patients (P < 0.05). These findings demonstrate that 8 weeks of aerobic training improved cardiorespiratory fitness and blood pressure in COPD but had little effect on other established markers of cardiovascular disease risk.