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


BACKGROUND
clinicaltrials.gov; Identifier: NCT00404430.
Vivodtzev
Isabelle
I
INSERM ERI17, Labotatoire HP2 (Hypoxie: Physiopathologie), Grenoble, France.
Minet
Clémence
C
Wuyam
Bernard
B
Borel
Jean-Christian
JC
Vottero
Gabrielle
G
Monneret
Denis
D
Baguet
Jean-Philippe
JP
Lévy
Patrick
P
Pépin
Jean-Louis
JL
D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D012307:Risk Factors; D013147:Spirometry; D014463:Ultrasonography; D014655:Vascular Resistance / Q000502:physiology*