Noninvasive ventilation acutely improves endothelial function in exacerbated COPD patients

Author(s)

Heubel, Alessandro Domingues ^[1] ; Kabbach, Erika Zavaglia ^[1] ; Schafauser, Nathany Souza ^[1] ; Phillips, Shane Aaron ^[2] ; Pires Di Lorenzo, Valeria Amorim ^[1] ; Silva, Audrey Borghi ^[1] ; Mendes, Renata Goncalves ^[1]

Affiliation

^[1] Univ Fed Sao Carlos, Dept Phys Therapy, Cardiopulm Physiotherapy Lab, Sao Carlos, SP - Brazil

^[2] Univ Illinois, Dept Phys Therapy, Chicago, IL - USA

• Document type: Journal article
• Source: RESPIRATORY MEDICINE; v. 181, MAY 2021.
• Web of Science Citations: 0

Abstract

Purpose: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with an elevated risk of cardiovascular events, which can be linked to endothelial dysfunction. In this study, we aimed to investigate whether noninvasive ventilation (NIV) acutely changes endothelial function in hospitalized AECOPD patients. Methods: Twenty-one AECOPD patients were assessed in a hospital ward setting from 24 to 48 h after admission. NIV was applied using a ventilator with bilevel pressure support. Before and after NIV protocol, patients were evaluated regarding (1) endothelium-dependent function, assessed non-invasively using the flow-mediated dilation (FMD) method; (2) arterial blood gas analysis. Other baseline evaluations included clinical and anthropometric data, and laboratory tests. Results: The total group showed a significant improvement in FMD as a result of NIV effect (P = 0.010). While arterial carbon dioxide and oxygen were not altered, oxygen saturation increased after NIV (P = 0.045). The subgroup comparison of responders (FMD >= 1%) and non-responders (FMD < 1%) showed significant baseline differences in body mass index (BMI) (P = 0.019) and predicted forced expiratory volume in one second (FEV1) (P = 0.007). In univariate and multivariate analyses, both BMI and FEV1 were determinant for endothelial response to NIV. Conclusion: NIV acutely improves endothelial function in hospitalized AECOPD patients. Overweight and COPD severity may represent important characteristics for the magnitude of peripheral vascular response. (AU)

• FAPESP's process: 15/26501-1 - Study of limiting factors to physical exercise and adjunct effects to rehabilitation on cardiorespiratory disease: a multicentre approach
• Grantee: Audrey Borghi Silva
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 15/12763-4 - 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
• Grantee: Renata Gonçalves Mendes
• Support Opportunities: Regular Research Grants