Please use this identifier to cite or link to this item: https://repositorio.ufscar.br/handle/ufscar/15580
DOI: https://doi.org/10.1016/j.rmed.2020.106173
Title: Non-invasive ventilation improves exercise tolerance and peripheral vascular function after high-intensity exercise in COPD-HF patients
Subject: COPD;Endothelial function;Exercise test;Heart failure;Ventilation
Description: Aim: Evaluate the acute effects of non-invasive positive pressure ventilation (NiPPV) during high-intensity exercise on endothelial function in patients with coexisting chronic obstructive pulmonary disease (COPD) and heart failure (HF). Methods: This is a randomized, double blinded, sham-controlled study involving 14 COPD-HF patients, who underwent a lung function test and Doppler echocardiography. On two different days, patients performed incremental cardiopulmonary exercise testing (CPET) and two constant-work rate tests (80% of CPET peak) receiving Sham or NiPPV (bilevel mode - Astral 150) in a random order until the limit of tolerance (Tlim). Endothelial function was evaluated by flow mediated vasodilation (FMD) at three time points: 1) Baseline; 2) immediately post-exercise with NiPPV; and 3) immediately post-exercise with Sham. Results: Our patients had a mean age of 70 ± 7 years, FEV1 1.9 ± 0.7 L and LVEF 41 ± 9%. NIPPV resulted in an increased Tlim (NiPPV: 130 ± 29s vs Sham: 98 ± 29s p = 0.015) and SpO2 (NiPPV: 94.7 ± 3.5% vs Sham: 92.7 ± 5.2% p = 0.03). Also, NiPPV was able to produce a significant increase in FMD (%) (NiPPV: 9.2 ± 3.1 vs Sham: 3.6 ± 0.7, p < 0.05), FMD (mm) (NiPPV: 0.41 ± 0.18 vs Sham: 0.20 ± 0.11, p < 0.05), Blood flow velocity (NiPPV: 33 ± 18 vs Baseline: 20 ± 14, p < 0.05) and Shear Stress (SS) (NiPPV: 72 ± 38 vs Baseline: 43 ± 25, p < 0.05). We found correlation between Tlim vs. ΔSS (p = 0.03; r = 0.57). Univariate-regression analysis revealed that increased SS influenced 32% of Tlim during exercise with NiPPV. Conclusion: NiPPV applied during high-intensity exercise can acutely modulate endothelial function and improve exercise tolerance in COPD-HF patients. In addition, the increase of SS positively influences exercise tolerance.
Authors: Goulart, Cássia da Luz
Caruso, Flávia Rossi
Araújo, Adriana Sanches Garcia de
Arêas, Guilherme Peixoto Tinoco
Moura, Silvia Cristina Garcia de
Catai, Aparecida Maria
Mendes, Renata Gonçalves
Phillips, Shane A.
Arena, Ross
Silva, Andréa Lúcia Gonçalves da
Silva, Audrey Borghi
URI: https://repositorio.ufscar.br/handle/ufscar/15580
Other Identifiers: https://doi.org/10.1016/j.rmed.2020.106173
Sponsorship: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Sponsor ID: Processo nº 2015/26501–1, Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Código de Financiamento 001 - CAPES
Processo nº 141803/ 2019 -3 - Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Processo nº 2018/03233-0, Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Rights: Attribution-NonCommercial-NoDerivs 3.0 Brazil
Date:  
Available Data: 10-Feb-2022
Format:  
Type: Dataset
Publisher: Universidade Federal de São Carlos
Language :  
Appears in Collections:Repositório dados - UFSCar



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