المؤلفون: Yousef S. Aldabayan, Heidi A. Ridsdale, Ahmed M. Alrajeh, Abdulelah M. Aldhahir, Arthur Lemson, Jaber S. Alqahtani, Jeremy S. Brown, John R. Hurst

المصدر: Respiratory Research, Vol 20, Iss 1, Pp 1-11 (2019)

مصطلحات موضوعية: COPD, Aortic stiffness, And pulmonary rehabilitation, Diseases of the respiratory system, RC705-779

الوصف: Abstract Background Patients with chronic obstructive pulmonary disease (COPD) have elevated cardiovascular risk, and cardiovascular disease is a major cause of death in COPD. The current literature indicates that changes in cardiovascular risk during pulmonary rehabilitation (assessed using aortic stiffness) are heterogeneous suggesting that there may be sub-groups of patients who do and do not benefit. Objectives To investigate the characteristics of COPD patients who do and do not experience aortic stiffness reduction during pulmonary rehabilitation, examine how changes relate to physical activity and exercise capacity, and assess whether changes in aortic stiffness are maintained at 6 weeks following rehabilitation. Methods We prospectively measured arterial stiffness (aortic pulse-wave velocity), exercise capacity (Incremental Shuttle Walk Test) and physical activity (daily step count) in 92 COPD patients who started a six week pulmonary rehabilitation programme, 54 of whom completed rehabilitation, and 29 of whom were re-assessed six weeks later. Results Whilst on average there was no influence of pulmonary rehabilitation on aortic stiffness (pre- vs. post pulse-wave velocity 11.3 vs. 11.1 m/s p = 0.34), 56% patients responded with a significant reduction in aortic stiffness. Change in aortic stiffness (absolute and/or percentage) during rehabilitation was associated with both increased physical activity (rho = − 0.30, p = 0.042) and change in exercise capacity (rho = − 0.32, p = 0.02), but in multivariable analysis most closely with physical activity. 92% of the responders who attended maintained this response six weeks later. Conclusion Elevated aortic stiffness in COPD is potentially modifiable in a subgroup of patients during pulmonary rehabilitation and is associated with increased physical activity. Trial registration ClinicalTrials.gov Identifier: NCT03003208. Registered 26/12/ 2016.

وصف الملف: electronic resource

Relation: http://link.springer.com/article/10.1186/s12931-019-1135-6; https://doaj.org/toc/1465-993X

URL الوصول: https://doaj.org/article/0c9cd3baf51b412c9e7529371a470f57

المؤلفون: Jaber S Alqahtani, Heidi A Ridsdale, Jeremy S. Brown, Arthur Lemson, Abdulelah M Aldhahir, John R. Hurst, Ahmed M. Alrajeh, Yousef S Aldabayan

المصدر: Respiratory Research
Respiratory Research, Vol 20, Iss 1, Pp 1-11 (2019)

مصطلحات موضوعية: Male, 0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Physical activity, Walk Test, Disease, Pulse Wave Analysis, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, Vascular Stiffness, 0302 clinical medicine, Forced Expiratory Volume, Internal medicine, medicine, COPD, Humans, And pulmonary rehabilitation, Pulmonary rehabilitation, Prospective Studies, Exercise, Aorta, Aged, Cause of death, lcsh:RC705-779, Aged, 80 and over, Rehabilitation, business.industry, Research, Aortic stiffness, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, 030104 developmental biology, 030228 respiratory system, Cardiology, Arterial stiffness, Female, business, Follow-Up Studies

الوصف: Background Patients with chronic obstructive pulmonary disease (COPD) have elevated cardiovascular risk, and cardiovascular disease is a major cause of death in COPD. The current literature indicates that changes in cardiovascular risk during pulmonary rehabilitation (assessed using aortic stiffness) are heterogeneous suggesting that there may be sub-groups of patients who do and do not benefit. Objectives To investigate the characteristics of COPD patients who do and do not experience aortic stiffness reduction during pulmonary rehabilitation, examine how changes relate to physical activity and exercise capacity, and assess whether changes in aortic stiffness are maintained at 6 weeks following rehabilitation. Methods We prospectively measured arterial stiffness (aortic pulse-wave velocity), exercise capacity (Incremental Shuttle Walk Test) and physical activity (daily step count) in 92 COPD patients who started a six week pulmonary rehabilitation programme, 54 of whom completed rehabilitation, and 29 of whom were re-assessed six weeks later. Results Whilst on average there was no influence of pulmonary rehabilitation on aortic stiffness (pre- vs. post pulse-wave velocity 11.3 vs. 11.1 m/s p = 0.34), 56% patients responded with a significant reduction in aortic stiffness. Change in aortic stiffness (absolute and/or percentage) during rehabilitation was associated with both increased physical activity (rho = − 0.30, p = 0.042) and change in exercise capacity (rho = − 0.32, p = 0.02), but in multivariable analysis most closely with physical activity. 92% of the responders who attended maintained this response six weeks later. Conclusion Elevated aortic stiffness in COPD is potentially modifiable in a subgroup of patients during pulmonary rehabilitation and is associated with increased physical activity. Trial registration ClinicalTrials.gov Identifier: NCT03003208. Registered 26/12/ 2016.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bc88e2ba4f34dd7aedc3437eb47f9052
https://doi.org/10.1186/s12931-019-1135-6

المؤلفون: Anant R.C. Patel, Richa Singh, John R. Hurst, Jeremy S. Brown, Simon E. Brill, Alexander J. Mackay

المصدر: Respiratory Research

مصطلحات موضوعية: Spirometry, Male, Respiratory questionnaire, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pediatrics, Peak expiratory flow rate, Health-related Quality of Life, Time Factors, Exacerbation, Health Status, Severity of Illness Index, Interquartile range, Predictive Value of Tests, Internal medicine, Surveys and Questionnaires, Severity of illness, medicine, Humans, Prospective Studies, Prospective cohort study, Lung, Aged, Inflammation, Bronchiectasis, medicine.diagnostic_test, business.industry, Research, Pneumonia, Recovery of Function, Middle Aged, medicine.disease, Anti-Bacterial Agents, Treatment Outcome, Predictive value of tests, Disease Progression, Female, Inflammation Mediators, business, Biomarkers, Cohort study

الوصف: Background Exacerbations of non-cystic fibrosis bronchiectasis cause significant morbidity but there are few detailed data on their clinical course and associated physiological changes. The biology of an exacerbation has not been previously described. The purpose of this study was to describe changes in lung function, symptoms, health status and inflammation during the development and recovery from community-treated exacerbations. Methods This was a prospective observational cohort study of 32 outpatients with non-cystic fibrosis bronchiectasis conducted between August 2010 and August 2012. Patients completed a symptom diary card and measured their peak expiratory flow rate (PEFR) daily. Exacerbations were defined as oral antibiotic treatment taken for a worsening of respiratory symptoms. Symptoms and peak flow at exacerbation were analysed, and further measurements including the COPD Assessment Test (CAT) and inflammatory markers were also compared to baseline values. Results At baseline, health status was significantly related to lung function, prognostic severity and systemic inflammation. 51 exacerbations occurred in 22 patients. Exacerbation symptoms began a median (interquartile range) of 4 (2, 7) days before treatment started and the median exacerbation duration was 16 (10, 29) days. 16% had not recovered by 35 days. At exacerbation, mean PEFR dropped by 10.6% (95% confidence interval 6.9-14.2, p

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8a467f689037b498292e25be61733a1d