title: Pulmonary rehabilitation improves cardiovascular response to exercise in COPD.
abstract: BACKGROUND
  Pulmonary rehabilitation (PR) has emerged as a recommended standard of care in symptomatic COPD.
  
  
  OBJECTIVE
  We now studied whether PR may affect cardiovascular response to exercise in these patients.
  
  
  METHODS
  Twenty-seven patients (9 females aged 69 ± 8 years) with moderate-to-severe airflow obstruction admitted to a 9-week PR course performed a pre-to-post evaluation of lung function test and symptom-limited cardiopulmonary exercise test (CPET). Oxygen uptake (VO2), tidal volume (V(T)), dyspnea and leg fatigue scores were measured during CPET. Cardiovas-cular response was assessed by means of oxygen pulse (O2Pulse), the oxygen uptake efficiency slope and heart rate recovery at the 1st min.
  
  
  RESULTS
  A significant increase in peak VO2 and in all cardiovascular parameters (p < 0.05) was found following PR when compared to baseline. Leg fatigue (p < 0.05), but not dyspnea, was significantly reduced after PR. When assessed at metabolic and ventilatory iso levels [% VCO2max and % minute ventilation (VEmax)], O2Pulse and V(T) were significantly higher (p < 0.05) at submaximal exercise (75 and 50% of VCO2max and VEmax) after PR when compared to baseline. V(T) percent changes at 75% VCO2max and 75% VEmax after PR significantly correlated with corresponding changes in O2Pulse (p < 0.01).
  
  
  CONCLUSIONS
  In COPD patients, a PR training program improved the cardiovascular response during exercise at submaximal exercise independent of the external workload. This change was associated with an enhanced ventilatory function during exercise.
authors.affiliation: Respiratory Disease Unit, Clinical and Experimental Medicine, University Hospital, Parma, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Ramponi
authors.forename: Panagiota
authors.initials: P
authors.lastname: Tzani
authors.forename: Marina
authors.initials: M
authors.lastname: Aiello
authors.forename: Emilio
authors.initials: E
authors.lastname: Marangio
authors.forename: Enrico
authors.initials: E
authors.lastname: Clini
authors.forename: Alfredo
authors.initials: A
authors.lastname: Chetta
mesh_terms: D000368:Aged; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010101:Oxygen Consumption; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000379:methods*; D013990:Tidal Volume; D016896:Treatment Outcome