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Pulmonary Rehabilitation and Cardiovascular Risk in COPD
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A2164 - Pulmonary Rehabilitation and Cardiovascular Risk in COPD
Author Block: Y. Aldabayan1, A. Al rajah2, A. Lemson3, H. Ridsdale4, N. Ochei4, B. Nwaneri4, N. Orr4, J. Brown2, J. Hurst2; 1UCL Respiratory, Royal Free Campus, University College London, UK, london, United Kingdom, London, United Kingdom, 2UCL Respiratory, Royal Free Campus, University College London, UK, london, United Kingdom, 3Radboud University, NL, Netherlands, 4Central and North West London NHS Foundation Trust, london, United Kingdom.
Introduction: COPD is a leading cause of mortality. In part, this derives from an enhanced risk of cardiovascular events with up to one-third dying from cardiovascular disease (CVD). Without new interventions, COPD will be the third most common cause of death by 2030. Arterial stiffness measured by aortic Pulse Wave Velocity (aPWV) is a gold-standard predictor and biomarker of elevated cardiovascular risk in COPD patients, as it is in healthy populations. Pulmonary Rehabilitation (PR), an exercise and education programme, is an established intervention for COPD patients but the influence of PR on CV risk in COPD remain unclear1.
Aim: To investigate whether age, lung function, and the number of exacerbations within the preceding 12 months differ between participants who do and do not achieve CV reduction from PR.
Method: 30 COPD patients who completed a six-week PR programme with pre and post aPWV measures were included. Data was tested for normality and expressed as either mean (SD) or median (IQR). Based on the change in aPWV, patients were grouped into responders (greater than 0.5 m/s decrease), no change (within 0.5 m/s of baseline) or non-responders (greater than 0.5m/s increase). To compare age, FEV1, and number of exacerbations we used unpaired t-tests and Mann-Whitney tests as appropriate.
Results:
16 males and 14 females with mean age of 72.6±8.2 years were included. 50% were responders, 20% no change and 30 % were non-responders. We found no significant difference between responders and the other groups combined in mean age (74.7±8.3 vs 71.8±8 years, p= 0.158), or FEV1 (0.53±0.22 vs 0.51±0.14L, p= 0.098), and median number of exacerbations (1 (3) vs 1 (2) /year, p= 0.562). However, when non-responders were compared with the other groups combined, we did find a significant difference in FEV1 between the groups (1.08±0.36 vs. 1.41±0.39L, p= 0.035).
Conclusion:
Our results suggest that patients with better lung function are more likely to have a greater CV response to pulmonary rehabilitation.
References:
1. Aldabayan, et al. : a systematic review. COPD Research and Practice 2017;3(1):7. doi: 10.1186/s40749-017-0026-9
Author Block: Y. Aldabayan1, A. Al rajah2, A. Lemson3, H. Ridsdale4, N. Ochei4, B. Nwaneri4, N. Orr4, J. Brown2, J. Hurst2; 1UCL Respiratory, Royal Free Campus, University College London, UK, london, United Kingdom, London, United Kingdom, 2UCL Respiratory, Royal Free Campus, University College London, UK, london, United Kingdom, 3Radboud University, NL, Netherlands, 4Central and North West London NHS Foundation Trust, london, United Kingdom.
Introduction: COPD is a leading cause of mortality. In part, this derives from an enhanced risk of cardiovascular events with up to one-third dying from cardiovascular disease (CVD). Without new interventions, COPD will be the third most common cause of death by 2030. Arterial stiffness measured by aortic Pulse Wave Velocity (aPWV) is a gold-standard predictor and biomarker of elevated cardiovascular risk in COPD patients, as it is in healthy populations. Pulmonary Rehabilitation (PR), an exercise and education programme, is an established intervention for COPD patients but the influence of PR on CV risk in COPD remain unclear1.
Aim: To investigate whether age, lung function, and the number of exacerbations within the preceding 12 months differ between participants who do and do not achieve CV reduction from PR.
Method: 30 COPD patients who completed a six-week PR programme with pre and post aPWV measures were included. Data was tested for normality and expressed as either mean (SD) or median (IQR). Based on the change in aPWV, patients were grouped into responders (greater than 0.5 m/s decrease), no change (within 0.5 m/s of baseline) or non-responders (greater than 0.5m/s increase). To compare age, FEV1, and number of exacerbations we used unpaired t-tests and Mann-Whitney tests as appropriate.
Results:
16 males and 14 females with mean age of 72.6±8.2 years were included. 50% were responders, 20% no change and 30 % were non-responders. We found no significant difference between responders and the other groups combined in mean age (74.7±8.3 vs 71.8±8 years, p= 0.158), or FEV1 (0.53±0.22 vs 0.51±0.14L, p= 0.098), and median number of exacerbations (1 (3) vs 1 (2) /year, p= 0.562). However, when non-responders were compared with the other groups combined, we did find a significant difference in FEV1 between the groups (1.08±0.36 vs. 1.41±0.39L, p= 0.035).
Conclusion:
Our results suggest that patients with better lung function are more likely to have a greater CV response to pulmonary rehabilitation.
References:
1. Aldabayan, et al. : a systematic review. COPD Research and Practice 2017;3(1):7. doi: 10.1186/s40749-017-0026-9
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