Mechanisms of Exercise Intolerance in Chronic Obstructive Pulmonary Disease

NCT02360865 | Completed

• 1 other identifier: H-2-2013-150 - project 2
• Study Type: interventional
• Target: 18
• Locations: 1 country
• Sites: 1

Brief Summary

1: Is endothelium function impaired in COPD? Other chronic cardiovascular diseases are associated with endothelial dysfunction, and the endothelium plays an important role in regulating vascular tone, tissue blood flow, coagulation and the inflammation process. Although the specific causes of endothelial dysfunction remain unclear, physical inactivity, chronic systemic inflammation and smoking are all known to be associated with endothelial abnormality. 2\. Is Muscular Sympathetic Nerve Activity (MSNA) increased in COPD? A balanced regulation of blood flow to skeletal muscles may be disturbed by pathophysiology and may therefore contribute to the exercise intolerance and skeletal muscle depletion seen in patients with COPD.Skeletal muscle blood flow is tightly regulated to match tissue oxygen demands and is thus adapted to meet energy requirements. During physical activity, the sympathetic nervous system is activated ("exercise pressor reflex"), resulting in increased ventilation, heart rate and a redistribution of cardiac output from inactive to active tissues. The redistribution of cardiac output to the body organs is heterogeneous. Blood flow to skeletal, respiratory and cardiac muscle increases as exercise intensity increases, whereas blood flow to gastrointestinal, renal and reproductive tissues decreases. As blood pressure during exercise remains largely unchanged, the redistribution of blood flow is caused by changes in vascular conductance. These conductance changes are caused by an overall vasoconstriction induced by the increased sympathetic outflow of noradrenaline (NA), and a vasodilation of vascular beds supplying the working skeletal -, cardiac- and respiratory muscle.

Conditions

COPD

Outcome Measures

Primary Outcomes (2)

• Endothelium function during acute exercise (one legged kicking) by Flow doppler

  Flow doppler

  On one experimental day during acute exercise (one legged knicking) and change from baseline

• Muscular Sympathetic Nerve Activity During acute exercise (handgrip and leg isometric leg extension) by Peroneal microneurography

  On one experimental day during acute exercise (handgrib and leg isometric leg extension) and change from baseline

Study Arms (2)

COPD

EXPERIMENTAL

Acute exercise bouts

Other: Exercise

Healthy

ACTIVE COMPARATOR

Acute exercise bouts

Other: Exercise

Interventions

Exercise OTHER

COPD; Healthy

Eligibility Criteria

• Age: 40 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Forced Expiratory Volume at on second/ Forced Vital Capacity fixed ratio \<0.70, - Forced Expiratory Volume at one second \<60% of predicted and Medical
• Research Council scale \> or equal to 3
• Arterial oxygen saturation at rest\> 90%,
• Body Mass Index \>18,
• Left Ventricle Ejection Fraction\> 45.

You may not qualify if:

• Unstable ischemic heart disease,
• severe heart valve failure,
• pulmonary emboli,
• severe heart failure,
• severe infections,
• musculoskeletal disorders,
• malignant disease,
• contraindicated medicine as anticoagulants.

Sponsors & Collaborators

• Rigshospitalet, Denmark: lead

Study Sites (1)

Centre of Physical Activity Research

Copenhagen, Capital Region, 2100, Denmark

Location

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive

Interventions

Exercise

Condition Hierarchy (Ancestors)

Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, PhD

Study Record Dates

• First Submitted: January 19, 2015
• First Posted: February 11, 2015
• Study Start: February 1, 2015
• Primary Completion: May 1, 2016
• Study Completion: May 1, 2016
• Last Updated: June 16, 2016

Record last verified: 2016-06

Locations

DK (1)