Introduction

Cardiovascular disease is among the most prevalent concomitant chronic diseases in COPD. Physical activity (PA) modifies endothelial function and is commonly impaired in COPD. However, studies directly investigating the effects of increased PA on endothelial function in COPD are lacking. We investigated the effect of changes in PA on endothelial function in patients with severe to very severe COPD. Furthermore, we determined which variables modify this effect.

Materials and methods

This is a secondary outcome analysis from a randomised controlled trial investigating the effects of combined PA counselling and pedometer-based feedback in COPD. We analysed the change in PA based on three visits during one year. We measured PA using a validated triaxial accelerometer, and endothelial function using flow-mediated dilation.

Results

Data was analysed from 54 patients, which provided 101 change scores. Multiple regression modelling, including adjustment for baseline step count, showed strong evidence for an association between changes in flow-mediated dilation and changes in PA (p < 0.001). The analysis of several effect modificators showed no evidence of any influence on the interaction between PA and endothelial function: smoking status (p = 0.766), severity of airflow obstruction (p = 0.838), exacerbation frequency (p = 0.227), lung diffusion capacity of carbon monoxide % pred. (p = 0.735).

Conclusion

We found strong evidence that increasing steps per day ameliorates the heavily impaired endothelial function in patients with severe and very severe COPD. Further studies should examine which factors influence this relationship in a positive or negative manner.

中文翻译：

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再多做几个步骤就能改善重度和非常重度 COPD 的内皮功能

介绍

心血管疾病是 COPD 最常见的伴随慢性疾病之一。体力活动 (PA) 会改变内皮功能，并且在 COPD 中通常会受损。然而，缺乏直接研究 PA 增加对 COPD 内皮功能影响的研究。我们研究了 PA 变化对重度至极重度 COPD 患者内皮功能的影响。此外，我们确定了哪些变量会改变这种效果。

材料和方法

这是一项随机对照试验的次要结果分析，该试验调查了结合 PA 咨询和基于计步器的反馈对 COPD 的影响。我们根据一年中的 3 次访问分析了 PA 的变化。我们使用经过验证的三轴加速度计测量 PA，并使用流量介导的扩张测量内皮功能。

结果

分析了 54 名患者的数据，提供了 101 个变化评分。多元回归模型，包括对基线步数的调整，显示了流动介导的扩张变化与 PA 变化之间存在关联的有力证据（p < 0.001）。对几种效应调节因子的分析表明，没有证据表明对 PA 和内皮功能之间的相互作用有任何影响：吸烟状态 (p = 0.766)、气流阻塞的严重程度 (p = 0.838)、恶化频率 (p = 0.227)、肺扩散能力一氧化碳 % pred。(p = 0.735)。

结论

我们发现强有力的证据表明，每天增加步数可以改善重度和非常重度 COPD 患者严重受损的内皮功能。进一步的研究应该检查哪些因素以积极或消极的方式影响这种关系。