Correlations between daily physical activity, functional capacity and vascular health in patients with COPD
Correlações entre a atividade física diária, capacidade funcional e saúde vascular em pacientes com DPOC
Augusto Baumhardt Guidoti, Fernanda Beatriz Costa Delacoste, Bruna Eibel, Cintia Laura Pereira de Araujo, Pedro Dal Lago
Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) often leads to complications such as endothelial dysfunction and increased arterial stiffness, which may contribute to cardiovascular morbidity. While active lifestyles have been shown to mitigate these risks, the connection between daily physical activity, functional capacity, and vascular health in COPD patients remains underexplored. Aim: this study evaluates the link between endothelial function, arterial stiffness, functional capacity, and daily physical activity in COPD patients. Methods: we measured endothelial function in COPD patients using the reactive hyperemia index (RHI) via peripheral arterial tonometry (PAT) and arterial stiffness through pulse wave velocity (PWV) and the augmentation index adjusted for 75 beats per minute (AIx75). We also assessed functional capacity with the six-minute walking test (6MWT) and monitored daily activity using accelerometers. Results: among 22 participants (average age 66.5 years, body mass index (BMI) 27.5 kg/m2, forced expiratory volume in one second (FEV1) 34.8% predicted, daily step count ranged from 1,660 to 3,561 in 17 subjects. Endothelial dysfunction was noted in six subjects, and arterial stiffness was observed in four subjects. Daily step count significantly correlated with 6MWT distance (p= 0.004). Still, no correlation was found between the number of steps per day and measures of arterial stiffness by PAT (AIx75, %, p= 0.609), PWV (m/s, p= 0.266), and endothelial function (RHI) with PAT (p= 0.700). Conclusion: despite a positive correlation between the 6MWT distance and daily step count, our findings do not indicate a relationship between daily physical activity and measures of vascular function (endothelial function and arterial stiffness) in COPD patients with mild or absent vascular impairment.
Keywords
Resumo
Introdução: a Doença Pulmonar Obstrutiva Crônica (DPOC) frequentemente leva a complicações como disfunção endotelial e aumento da rigidez arterial, o que pode contribuir para a morbidade cardiovascular. Embora estilos de vida ativos tenham sido mostrados para mitigar esses riscos, a conexão entre atividade física diária, capacidade funcional e saúde vascular em pacientes com DPOC permanece pouco explorada. Objetivo: este estudo avalia a associação entre função endotelial, rigidez arterial, capacidade funcional e atividade física diária em pacientes com DPOC. Métodos: medimos a função endotelial em pacientes com DPOC usando o índice de hiperemia reativa (IHR) através de tonometria arterial periférica (TAP) e rigidez arterial através da velocidade da onda de pulso (VOP) e do índice de aumento ajustado para 75 batimentos por minuto (IA75). Também avaliamos a capacidade funcional com o teste de caminhada de seis minutos (TC6’) e monitoramos a atividade diária usando acelerômetros. Resultados: entre os 22 participantes (idade média de 66,5 anos, índice de massa corporal (IMC) 27,5 kg/m2, volume expiratório forçado no primeiro segundo (VEF1) 34,8% do previsto, a contagem diária de passos variou de 1.660 a 3.561 em 17 sujeitos. Disfunção endotelial foi encontrada em seis sujeitos, e rigidez arterial foi observada em quatro sujeitos. A contagem diária de passos correlacionou significativamente com a distância do TC6’ (p= 0,004), mas não foi encontrada correlação entre o número de passos por dia e medidas de rigidez arterial pelo TAP (IA75, %, p= 0,609), VOP (m/s, p= 0,266) e função endotelial (IHR) com TAP (p= 0,700). Conclusão: apesar de uma correlação positiva entre a distância percorrida no TC6’ e a contagem diária de passos, nossos achados não indicam uma relação entre a atividade física diária e as medidas de função vascular (função endotelial e rigidez arterial) em pacientes com DPOC e comprometimento vascular leve ou ausente.
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Submetido em:
01/12/2023
Aceito em:
29/08/2024
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