Chronic obstructive pulmonary disease exacerbation: analysis of endothelial function and cardiac autonomic modulation and relationship with clinical and functional data

• Grant number: 15/16043-6
• Support type: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): February 01, 2016
• Effective date (End): January 31, 2018
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal researcher: Renata Gonçalves Mendes
• Grantee: Jessica Fernanda Barbosa
• Home Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

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, and these outcomes are considered as important indicators of cardiovascular function. However, it is not our knowledge of the existence of studies that have investigated the EF relationship with CAM and other important clinical and functional variables as dyspnea, peripheral muscle strength, cognitive function and quality of life. Objective: To investigate endothelial Function and Cardiac Autonomic Modulation and the existence of relationship of these outcomes among themselves and with clinical and functional at the stage of exacerbation of COPD. Methods: Observational study. The study population will be compose of individuals diagnosed with COPD (GDPOC) and exacerbation medically attested. The assessment will include measures of the main outcomes of FE by flow-mediated vasodilation of the brachial artery and the CAM by heart rate variability (HRV), and assessment of dyspnea, peripheral muscle strength, cognitive function and quality of life at least 24 hours and a maximum of 48 hours after start of standard therapy for COPD exacerbation. The hypothesis of this study is that there will be a negative relationship between the FMD and HRV variables reflecting the global cardiac modulation (STDRR, RRtri, TINN, LF, LF/HF and SD2) and a positive relationship with the HRV variables reflecting vagal modulation or complexity (RMSSD, AF, SD1, sample entropy and Shannon and correlation dimension) and a positive relationship with the clinical and functional variables of peripheral muscle strength, cognitive function and quality life and negative relationship with dyspnea. Considering that EF and CAM outcomes are important indicators of cardiovascular function, this knowledge will collaborate to new propose strategies for the management of this highly prevalent disease that is a major cause of disability and mortality.