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Exacerbation of COPD and COPD overlap heart failure and noninvasive ventilatory support: impact on endothelial function and cardiac autonomic modulation and relationship among cardiovascular outcomes and clinical and functional aspects

Abstract

In chronic obstructive pulmonary disease (COPD), periods of exacerbations are frequent and associated with hospitalizations, reduced functional capacity, and risk for cardiovascular disease. The impairment of endothelial function (EF) and cardiac autonomic modulation (CAM) in this population has been previously demonstrated, however, the coexistence of COPD and chronic heart failure (HF) is high, and the impact of this overlapping, as well as the influence of factors clinical and functional exacerbation, still lacks evidence. Additionally, it is known that the noninvasive ventilatory support (NIV) is beneficial in COPD and HF exacerbations evaluated on the optical of several outcomes, however, for these cardiovascular outcomes proposed and in the coexistence of diseases, the impact of NIV lacks scientific basis. Objective: To investigate the impact of the coexistence of COPD + HF and the effect of NIV on the FE and MAC, as well as the existence of a relationship of these outcomes with clinical and functional in the exacerbation stage. Design and methodology: Prospective longitudinal and interventional study with comparative control. The study population will consist of 32 individuals diagnosed with isolated COPD (GDPOC, n=16) or associated with HF (GDPIC, n=16). The assessment will include measures of the main outcomes of FE by flow-mediated vasodilation of the brachial artery and arterial stiffness and MAC by heart rate variability (HRV), an assessment of the quality of life, functional capacity and cognitive and laboratory tests in three distinct stages: (1). Acute condition (24-48 hours of exacerbation) pre-intervention with NIV; (2). The post-intervention acute condition with NIV and (3). Chronic condition: 30 days after the first evaluation. NIV will be provided in the bilevel mode for at least 30 minutes and maximal 1 hour. The hypothesis for this study is that endothelial and cardiac autonomic function will be more impaired in overlap patients when compared to isolated COPD patients and that the application of NIV in this exacerbation phase will result in acute beneficial responses to endothelial and cardiac autonomic function. Another hypothesis is the existence of an association of cardiovascular outcomes among themselves as well as with clinical and functional aspects. This new knowledge will contribute to future interventional proposals to the most appropriate management of these diseases that represent significant causes of disability and mortality worldwide with an increasing trend due to an aging population. (AU)

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Scientific publications (26)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
KABBACH, ERIKA ZAVAGLIA; HEUBEL, ALESSANDRO DOMINGUES; DA LUZ GOULART, CASSIA; DI LORENZO, VALERIA AMORIM PIRES; PHILLIPS, SHANE A.; BORGHI-SILVA, AUDREY; MENDES, RENATA GONCALVES. Association of exercise capacity and endothelial function in patients with severe exacerbations of chronic obstructive pulmonary disease. SCIENTIFIC REPORTS, v. 11, n. 1, . (15/26501-1, 15/12763-4)
MENDES, R. G.; SCHAFAUSER, N.; ROSCANI, M.; OLIVEIRA KAWAKAMI, D.; HEUBEL, A. D.; KABBACH, E. Z.; LEONARDI, N.; CASTELLO-SIMOES, V.; DI LORENZO, V.; SILVA, A. B.. The Underappreciated Connection Between Different Aspects of Muscle and Cardiovascular Function During Exacerbation of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, v. 205, p. 2-pg., . (15/12763-4, 15/26501-1)
LEONARDI, N.; KABBACH, E. Z.; SCHAFAUSER, N. S.; HEUBEL, A. D.; SENTANIN, A. C.; CASTELLO-SIMOES, V.; DI LORENZO, V. A. P.; SILVA, A. B.; MENDES, R. G.. Hospital Rehabilitation Using Elastic Bands Provides Early Improvements and Maintenance of Endothelial Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD): a Randomized Controlled Trial. American Journal of Respiratory and Critical Care Medicine, v. 205, p. 1-pg., . (15/12763-4, 15/26501-1, 21/03493-4)
LEONARDI, N.; KABBACH, E. Z.; HEUBEL, A. D.; SCHAFAUSER, N. S.; KAWAKAMI, D. M.; CASTELLO-SIMOES, V.; DI LORENZO, V. A. P.; BORGHI-SILVA, A.; MENDES, R.. Who are the COPD patients who have reduced exercise capacity during recovery from hospitalization for acute exacerbation of COPD (AECOPD)? A longitudinal observational study. European Respiratory Journal, v. 60, p. 2-pg., . (21/03493-4, 15/26501-1, 15/12763-4)
LEONARDI, NAIARA TAIS; KAWAKAMI, DEBORA MAYUMI OLIVEIRA; HURST, JOHN R.; CRUZ, JOANA; MENDES, RENATA GONSALVES. Performance-based outcome measures to assess functionality in hospitalised patients with COPD exacerbations: a systematic review of the measurement properties. EUROPEAN RESPIRATORY REVIEW, v. 32, n. 169, p. 17-pg., . (15/12763-4, 21/03493-4, 15/26501-1)
AGNOLETO, ALINE; HEUBEL, ALESSANDRO; KABBACH, ERIKA; BORGHI-SILVA, AUDREY; PHILLIPS, SHANE; DI LORENZO, VALERIA PIRES; ROSCANI, MELIZA; JAENISCH, RODRIGO; MENDES, RENATA. Arterial stiffness, hemodynamic and functional profile at exacerbation and recovery in COPD. European Respiratory Journal, v. 52, p. 2-pg., . (15/26501-1, 15/12763-4)
MENDES, R. G.; SCHAFAUSER, N. S.; KABBACH, E. Z.; HEUBEL, A. D.; SGARBOSA, N.; LEONARDI, N.; SILVA, A. B.. Phenotypes Investigation in Exacerbated Chronic Obstructive Pulmonary Disease: Does the Greatest Impact and Symptoms Reflect in Worse Cardiac Autonomic Modulation?. American Journal of Respiratory and Critical Care Medicine, v. 201, p. 1-pg., . (15/12763-4, 15/26501-1)
KABBACH, ERIKA; HEUBEL, ALESSANDRO; BARBOSA, JESSICA; AGNOLETO, ALINE; DIAS, NATHALIA; BORGHI-SILVA, AUDREY; ROSCANI, MELIZA; MENDES, RENATA. Acute exacerbation in COPD and relationship between cardiovascular risk and functional profile. European Respiratory Journal, v. 52, p. 2-pg., . (15/12763-4, 15/16043-6)
MENDES, R. G.; HEUBEL, A. D.; KABBACH, E. Z.; SCHAFAUSER, N.; PHILLIPS, S.; PIRES-DI-LORENZO, V.; SILVA, A. B.. Identifying Endothelial Vascular Responders to Noninvasive Ventilation in Patients with Exacerbation of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, v. 203, n. 9, p. 1-pg., . (15/12763-4, 15/26501-1)
MENDES, R. G.; HEUBEL, A. D.; KABBACH, E. Z.; AGNOLETO, A.; DOS SANTOS, P. B.; BORGHI-SILVA, A.; SENTANIN, A.; DI-LORENZO, V. A. P.; ROSCANI, M. G.. Dyspnea and Functional Capacity Are Associated with Interventricular Septum Thickness in COPD Patients. American Journal of Respiratory and Critical Care Medicine, v. 199, p. 2-pg., . (15/12763-4, 15/16043-6)
MENDES, R. G.; KABBACH, E. Z.; HEUBEL, A. D.; TOMAZ, C.; SENTANIN, A.; BORGHI-SILVA, A.. Endothelial Function and Functional Capacity at Exacerbation and Early Recovery in Chronic Obstructive Pulmonary Disease (COPD) Patients. American Journal of Respiratory and Critical Care Medicine, v. 199, p. 1-pg., . (15/12763-4, 15/26501-1)
AGNOLETO, A. G.; KABBACH, E. Z.; BONANCA, A. M.; BARBOSA, J. F.; DIAS, N. R. F.; CABIDDU, R.; DI LORENZO, V. A. P.; BORGHI-SILVA, A.; MENDES, R. G.. Increased Parasympathetic Cardiac Modulation In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: How Should We Interpret It?. American Journal of Respiratory and Critical Care Medicine, v. 195, p. 1-pg., . (15/12763-4, 15/16043-6)
SIMOES, RODRIGO P.; MENDES, RENATA G.; CASTELLO-SIMOES, VIVIANE; CATAI, APARECIDA M.; ARENA, ROSS; BORGHI-SILVA, AUDREY. Use of Heart Rate Variability to Estimate Lactate Threshold in Coronary Artery Disease Patients during Resistance Exercise. JOURNAL OF SPORTS SCIENCE AND MEDICINE, v. 15, n. 4, p. 649-657, . (15/12763-4, 15/04101-1)
KABBACH, E. Z.; HEUBEL, A. D.; SCHAFAUSER, N. S.; GOULART, C. L.; BORGHI-SILVA, A.; MENDES, R. G.. Walking Performance Accounts for Endothelial Function in Severe Exacerbation of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, v. 203, n. 9, p. 1-pg., . (15/12763-4, 15/26501-1)
HEUBEL, ALESSANDRO DOMINGUES; KABBACH, ERIKA ZAVAGLIA; SCHAFAUSER, NATHANY SOUZA; PHILLIPS, SHANE AARON; PIRES DI LORENZO, VALERIA AMORIM; SILVA, AUDREY BORGHI; MENDES, RENATA GONCALVES. Noninvasive ventilation acutely improves endothelial function in exacerbated COPD patients. RESPIRATORY MEDICINE, v. 181, . (15/26501-1, 15/12763-4)
HEUBEL, ALESSANDRO; BORGHI-SILVA, AUDREY; KABBACH, ERIKA; AGNOLETO, ALINE; BARBOSA, JESSICA; ROSCANI, MELIZA; PIRES-DI-LORENZO, VALERIA; MENDES, RENATA. Does overweight/obesity influence cardiac autonomic modulation and functional performance in COPD exacerbation?. European Respiratory Journal, v. 52, p. 2-pg., . (15/12763-4, 15/26501-1)
HEUBEL, ALESSANDRO D.; KABBACH, ERIKA Z.; LEONARDI, NAIARA T.; SCHAFAUSER, NATHANY S.; KAWAKAMIA, DEBORA M. O.; SENTANIN, ANNA CLAUDIA; DI LORENZOA, VALERIA A. PIRES; SILVA, AUDREY BORGHI; HURST, JOHN R.; MENDES, RENATA G.. Respiratory and peripheral muscle strength influence recovery of exercise capacity after severe exacerbation of COPD? An observational prospective cohort study. HEART & LUNG, v. 58, p. 7-pg., . (15/26501-1, 15/12763-4)
SCHAFAUSER, NATHANY SOUZA; OLIVEIRA HENRIQUES, JORGE MANUEL; KABBACH, ERIKA ZAVAGLIA; HEUBEL, ALESSANDRO DOMINGUES; VIDAL DE OLIVEIRA, BRUNA SHARA; PIRES DI LORENZO, VALERIA AMORIM; ROSCANI, MELIZA GOI; BORGHI-SILVA, AUDREY; MENDES, RENATA GONCALVES. Decision tree models as a classifier of endothelial function based on strength, pulmonary and cardiac function in COPD: Preliminary analysis. European Respiratory Journal, v. 56, p. 2-pg., . (15/12763-4, 15/26501-1)
KABBACH, E. Z.; HEUBEL, A. D.; SCHAFAUSER, N.; LEONARDI, N. T.; SILVA, A. B.; MENDES, R. G.. How Is the Endothelial Function Response to Non Invasive Ventilation in Hopitalised Patients With Chronic Obstructive Pulmonary Disease and Heart Failure Exacerbation. American Journal of Respiratory and Critical Care Medicine, v. 207, p. 1-pg., . (15/12763-4, 15/26501-1)
LEONARDI, N. T.; KAWAKAMI, D. OLIVEIRA; SILVA, A. B.; CRUZ, J.; MENDES, R. G.. Measurement Properties of Functionality Performance-based Outcome Measures for Hospitalized Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Cosmin Systematic Review. American Journal of Respiratory and Critical Care Medicine, v. 207, p. 1-pg., . (15/12763-4, 21/03493-4, 15/26501-1)
MENDES, R.; KABBACH, E. Z.; SENTANIN, A.; HEUBEL, A. D.; SCHAFAUSER, N. S.; LEONARDI, N. T.; DI LORENZO, V. A. P.; SILVA, A. B.. The Effect of Short-Term Resistance Training in Patients Hospitalized with Acute Exacerbation of Chronic Obstructive Pulmonary Disease on Vascular Reactivity Within 30 Days of Discharge. American Journal of Respiratory and Critical Care Medicine, v. 201, p. 1-pg., . (15/12763-4, 15/26501-1)
MENDES, R. G.; LEONARDI, N. T.; KABBACH, E. Z.; HEUBEL, A. D.; SCHAFAUSER, N.; DI LORENZO, V.; SILVA, A. B.. One Month After Severe Acute Exacerbation of COPD: How Are the Clinical, Vascular and Functional Recovery?. American Journal of Respiratory and Critical Care Medicine, v. 201, p. 1-pg., . (15/12763-4, 15/26501-1)
HEUBEL, ALESSANDRO DOMINGUES; ROSCANI, MELIZA GOI; KABBACH, ERIKA ZAVAGLIA; AGNOLETO, ALINE GALVAO; CAMARGO, PATRICIA FARIA; DOS SANTOS, POLLIANA BATISTA; BORGHI-SILVA, AUDREY; MENDES, RENATA GONCALVES. Left Ventricular Geometry in COPD Patients ARE THERE ASSOCIATIONS WITH AIRFLOW LIMITATION, FUNCTIONAL CAPACITY, AND GRIP STRENGTH?. Journal of Cardiopulmonary Rehabilitation and Prevention, v. 40, n. 5, p. 4-pg., . (15/12763-4, 18/00860-3, 18/03314-0, 15/26501-1)
MENDES, R. G.; TOMAZ, C. D. R.; AGNOLETO, A.; KABBACH, E. Z.; HEUBEL, A. D.; BORGHI-SILVA, A.; ROSCANI, M. G.; DI-LORENZO, V. A. P.. Relationship Between Bode Index and Left Ventricular Function in COPD Patients with Acute Exacerbation. American Journal of Respiratory and Critical Care Medicine, v. 199, p. 2-pg., . (15/12763-4, 15/16043-6, 17/22080-7)
AGNOLETO, A. G.; KABBACH, E. Z.; MONTEIRO, C. I.; CABIDDU, R.; BARBOSA, J. F.; BORGHI-SILVA, A.; MENDES, R. G.. Do The Cardiac Neuroautonomic Adjustments Reflect Limitation In Activities Of Daily Living In Patients With Chronic Obstructive Pulmonary Disease?. American Journal of Respiratory and Critical Care Medicine, v. 195, p. 1-pg., . (15/12763-4, 15/16043-6)
PANTONI, C. B. F.; DI THOMMAZO-LUPORINI, L.; MENDES, R. G.; CARUSO, F. C. R.; CASTELLO-SIMOES, V; MEZZALIRA, D.; BORGHI-SILVA, A.. Effect of continuous positive airway pressure associated to exercise on the breathing pattern and heart rate variability of patients undergoing coronary artery bypass grafting surgery: a randomized controlled trial. Brazilian Journal of Medical and Biological Research, v. 54, n. 11, . (15/12763-4, 15/26501-1)

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