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

Background: Arterial stiffness, a strong predictor of cardiovascular mortality, is abnormally elevated in patients with COPD. Nile 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. CHEST 2010; 137(3):585-592