A Cross-Sectional Study Evaluating the Association of Brachial Artery Flow Mediated Vasodilation with Physical Activity Measured by Accelerometry in Patients with the Overlap of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease

Madalina Macrea; Atul Malhotra; Richard ZuWallack; Krisann Oursler; Richard Casaburi

doi:10.2147/COPD.S432243

A Cross-Sectional Study Evaluating the Association of Brachial Artery Flow Mediated Vasodilation with Physical Activity Measured by Accelerometry in Patients with the Overlap of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease

Int J Chron Obstruct Pulmon Dis. 2024 Mar 19:19:773-778. doi: 10.2147/COPD.S432243. eCollection 2024.

Authors

Madalina Macrea¹, Atul Malhotra², Richard ZuWallack³, Krisann Oursler⁴, Richard Casaburi⁵

Affiliations

¹ Department of Pulmonary and Sleep Medicine, Salem Veterans Affairs Medical Center, University of Virginia, Charlottesville, VA, USA.
² Department of Pulmonary, Critical Care and Sleep Medicine, University of California at San Diego, San Diego, CA, USA.
³ Department of Pulmonary, Critical Care, and Sleep Medicine St. Francis Hospital, Hartford, CT, USA.
⁴ Department of Geriatrics and Infection Disease, Salem Veterans Affairs Medical Center, Carilion Virginia Tech School of Medicine, Roanoke, VA, USA.
⁵ Division of Respiratory and Critical Care Physiology and Medicine, Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles Medical Center, Torrance, CA, USA.

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Overlap Syndrome (OS), the co-occurrence of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease. Clustering of patients in subgroups with similar pre-clinical manifestations (ie, endothelial dysfunction) may identify relevant therapeutic phenotype categories for patients with OS who are at high risk of CVD. We therefore conducted a cross-sectional pilot study of endothelial function in 7 patients with OS (Forced Expiratory Volume in 1 second/Forced Vital Capacity < 0.7) on continuous positive airway pressure therapy (n = 7) to assess the relationship between FMD and physical activity. We found a strong association between FMD and step counts (rho = 0.77, p = 0.04); and FMD and moderate physical activity (rho = 0.9, p = 0.005). Further, larger studies are needed to confirm that FMD may identify patients with OS at high risk of CVD who benefit from increased physical activity.

Keywords: chronic obstructive pulmonary disease; flow-mediated dilation; obstructive sleep apnea; physical activity.

MeSH terms

Accelerometry
Brachial Artery
Cardiovascular Diseases*
Cross-Sectional Studies
Exercise
Humans
Pilot Projects
Pulmonary Disease, Chronic Obstructive* / complications
Pulmonary Disease, Chronic Obstructive* / diagnosis
Pulmonary Disease, Chronic Obstructive* / therapy
Sleep Apnea, Obstructive* / complications
Sleep Apnea, Obstructive* / diagnosis
Sleep Apnea, Obstructive* / therapy
Syndrome
Vasodilation

Grants and funding

Dr. Madalina Macrea work was supported by the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service, Grant/Award Number: Career Development Award, 1IK2RX003535-01A2.