Effectiveness of a 4-week rehabilitation program on endothelial function, blood vessel elasticity in patients with chronic obstructive pulmonary disease.

BACKGROUND

Chronic obstructive pulmonary disease (COPD) may have considerable cardiovascular risk. Physical activity has a paramount role in COPD treatment. Our aim was to evaluate the applicability of arteriograph in COPD and measure the effectiveness of pulmonary rehabilitation on endothelial function.

METHODS

A total of 40 patients with COPD (FEV: 45.43±20.20%pred, BMI: 27.99±6.98 kg/m, male: female was 21:19, age: 65.47±7.39 years) participated in a 4-week rehabilitation program. We used a patented, invasively validated Arteriograph. Blood pressure, pulse, augmentation index (AIX), pulse wave velocity (PWV), diastolic area index (DAI) were registered with functional measurements in pulmonary rehabilitation.

RESULTS

Pulmonary rehabilitation was effective in 6 minutes walking distance (6MWD: 335.32±110.43 398.32±126.21 m), maximal inspiratory pressure (MIP: 57.72±22.69 63.63±18.01 cmHO), chest wall expansion (CWE: 2.84±1.26 4.00±1.76 cm), breath holding time (BHT: 25.77±10.63 to 29.21±11.60 sec) and grip strength (GS: 24.87±11.88 27.03±11.43 kg) (P<0.05). Improvement in quality of life was monitored by COPD assessment test marker (CAT: 17.00±8.49 11.89±7.31, P<0.05). Systolic (133.38±22.15 126.48±20.22 mmHg) and diastolic blood pressure (76.95±14.37 75.4±12.7 mmHg) showed a reduction tendency. Pulse also decreased (76.95±14.37 72.53±13.65 bpm). AIX levels showed slight improvement (3.54±35.59% 2.93±30.79%); 23 patients peripheral circulation progressed. The PWV data showed abnormal elasticity with minimal change (11.74±2.13 11.4±2.73 m/s); although 20 patients showed improvement. DAI detected slightly diminished coronary circulation with moderate improvement (43.32±6.81 47.1±7.01 m/s).

CONCLUSIONS

Elevated arterial stiffness, high PWV turned the COPD patients to the high/very high-risk cluster. Rehabilitation resulted significant improvement in MIP, CWE, BHT, 6MWD, CAT with mild, but favorable changes in blood pressure, pulse, AIX, PWV. As a consequence of the four weeks rehabilitation period overall quality of life improved and cardiovascular risk showed a reduction tendency in COPD.