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Original Research: COPD |

Significant Improvement in Arterial Stiffness After Endurance Training in Patients With COPD

Isabelle Vivodtzev, PhD; Clémence Minet, MD; Bernard Wuyam, MD, PhD; Jean-Christian Borel, PhD; Gabrielle Vottero, MD; Denis Monneret, MSc; Jean-Philippe Baguet, MD, PhD; Patrick Lévy, MD, PhD; Jean-Louis Pépin, MD, PhD
Author and Funding Information

From the INSERM ERI17, Labotatoire HP2 (Hypoxie: Physiopathologie) (Drs Vivodtzev, Minet, Wuyam, Borel, Lévy, and Pépin), Grenoble; the UFR Médecine-Pharmacie and UFR STAPS, IFR 1, Labotatoire REX-S (Drs Vivodtzev, Wuyam, and Borel), Université Joseph Fourier; the Hôpital Sud, Pôle de Rééducation and Physiologie (Drs Vivodtzev, Minet, Wuyam, Borel, Lévy, and Pépin); the Département de Biologie Intégrée (Mr Monneret), Centre Hospitalier Universitaire de Grenoble; the Department of Cardiology (Dr Baguet), Centre Hospitalier Universitaire de Grenoble; and the Centre de réhabilitation pulmonaire (Dr Vottero), Clinique Les Rieux, Nyons, France.

Correspondence to: Jean-Louis Pépin, MD, PhD, Pôle de Rééducation and Physiologie, Laboratoire EFCR, CHU Michallon, BP217, 38043 Grenoble cedex 09 France; e-mail: JPepin@chu-grenoble.fr


Funding/Support: This study was supported by grants from ATRIR “Bourse André DION” (Nyons, France); Scientific council of AGIR@dom (Meylan, France), and by an unrestricted grant from GlaxoSmithKline (20,000 Euros).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(3):585-592. doi:10.1378/chest.09-1437
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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 (FEV1 = 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.

Trial registration:  clinicaltrials.gov; Identifier: NCT00404430

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