医学
内皮功能障碍
慢性阻塞性肺病
全身炎症
内科学
有氧运动
祖细胞
反应性充血
炎症
人口
动脉硬化
心脏病学
交叉研究
内皮
最大VO2
物理疗法
血压
病理
心率
血管舒张
干细胞
安慰剂
替代医学
环境卫生
生物
遗传学
作者
Daniel Neunhäuserer,Alessandro Patti,David Niederseer,Bernhard Kaiser,Janne Cadamuro,Bernd Lamprecht,Andrea Ermolao,Michael Studnicka,Josef Niebauer
标识
DOI:10.1016/j.amjmed.2020.07.004
摘要
Background Exercise training is a cornerstone of the treatment of chronic obstructive pulmonary disease (COPD) in all disease stages. Data about the training effects with supplemental oxygen in nonhypoxemic patients remains inconclusive. In this study we set out to investigate the training and oxygen effects on inflammatory markers, vascular function, and endothelial progenitor cells in this population of increased cardiovascular risk. Methods In this prospective, randomized, double-blind, crossover study, 29 patients with nonhypoxemic COPD performed combined endurance and strength training 3 times a week while breathing medical air or supplemental oxygen for the first 6-week period, and were then reallocated to the opposite gas for the following 6 weeks. Exercise capacity, inflammatory biomarkers, endothelial function (peripheral arterial tone analysis), and endothelial progenitor cells were assessed. Data were also analyzed for a subgroup with endothelial dysfunction (reactive hyperemia index <1.67). Results Following 12 weeks of exercise training, patients demonstrated a significant improvement of peak work rate and an associated decrease of blood fibrinogen and leptin. Eosinophils were found significantly reduced after exercise training in patients with endothelial dysfunction. In this subgroup, peripheral arterial tone analysis revealed a significant improvement of reactive hyperemia index. Generally, late endothelial progenitor cells were found significantly reduced after the exercise training intervention. Supplemental oxygen during training positively influenced the effect on exercise capacity without impact on inflammation and endothelial function. Conclusions This is the first randomized controlled trial in patients with COPD to show beneficial effects of exercise training not only on exercise capacity, but also on systemic/eosinophilic inflammation and endothelial dysfunction.
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