Physical Activity Clinical Trial
Official title:
Changes in Microcirculation and Functional Status During Exacerbation of COPD
This study investigates the influence of acute exacerbation of chronic obstructive pulmonary disease (COPD) on retinal microcirculation, on functional status and also investigates the prognostic value of retinal vessel caliber assessment in terms of hospitalization and mortality during 2 years of follow-up.
Recent findings suggest that patients with chronic obstructive pulmonary disease (COPD) are
at increased risk for myocardial infarction and stroke during periods of acute exacerbation.
These findings might be related to acute endothelial changes associated to increased systemic
inflammation. Changes in the microcirculation can be explored noninvasively by studying
retinal blood vessels that are visualized in fundus images. The retinal blood vessels have
anatomical and physiological features that are comparable with the coronary circulation.
Patients with COPD experience quadriceps muscle weakness, which worsens during
hospitalization by ~1% per day. This is the result of physical inactivity, in combination
with increased oxidative stress and systemic inflammation. Physical inactivity is induced by
the hospital environment, but is also related to symptoms of dyspnea caused by increased work
of breathing and oxygen desaturation.
Muscle weakness and physical inactivity are associated to poor functional status and
recurrent hospital admissions, independent of pulmonary impairment, which makes those
patients with frequent exacerbations prone to enter a vicious cycle.
Simple functional screening tests during hospital stay might enable us to quantify the impact
of a hospitalization on functional status and to identify patients at risk for repeated
exacerbations.
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