Pulmonary Arterial Pressure Response During Exercise

Study Overview
=================
Brief Summary
-----------------
Background: The extent of increase in systolic pulmonary arterial pressure (PAPs) during exercise in patients with COPD is unpredictable from lung function data. The non-invasive assessment of pulmonary hemodynamics during exercise and flow-mediated vasodilatation measurement may give useful data in the rehabilitation of COPD patients. Methods: Patients with stable, severe COPD and healthy, age-matched subjects (H) perform semi supine echocardiography with PAPs measurement. COPD patients perform ramp protocol with gas exchange detection. Serum hsCRP level is also determined in COPD patients. Endothel dysfunction is detected by flow mediated vasodilation measurement after arm strangulation with Doppler ultrasonography. Primary endpoint: The degree of pulmonary artery systolic pressure change during exercise? Secondary endpoint: The degree of right ventricular function change during exercise? Is endothel dysfunction manifested with pulmonary artery pressure rise? What is the correlation between the systemic inflammatory marker hsCRP and the degree of pulmonary artery pressure rise?

Detailed Description
-----------------
Background: The extent of increase in systolic pulmonary arterial pressure (PAPs) during exercise in patients with COPD is unpredictable from lung function data. The non-invasive assessment of pulmonary hemodynamics during exercise by semi-supine echocardiography and flow-mediated vasodilatation measurement may give useful data in the rehabilitation of COPD patients. Methods: Patients with stable, severe COPD and healthy, age-matched subjects (H) perform semi supine echocardiography with PAPs measurement. COPD patients perform ramp protocol with gas exchange detection. Serum hsCRP level is also determined in COPD patients. All of the subjects perform complete lung function with body pletysmography and diffusion capacity measurement. Endothel dysfunction is detected by flow mediated vasodilation measurement after arm strangulation with Doppler ultrasonography.

Official Title
-----------------
Pulmonary Arterial Pressure Response During Exercise in COPD and Healthy Subjects

Conditions
-----------------
COPD Patients, Healthy Subjects, Semi-supine Echo (SSE), Flow-mediated Vasodilatation (FMD), High Sensitive C-reactive Protein (hsCRP)

Intervention / Treatment
-----------------
* Other: Measure pulmonary artery pressure change during exercise
* Other: Pulmonary pressure response during exercise


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: COPD patients (age between 45 and 70) with moderate to severe obstruction (FEV1<60%pred) and healthy subjects (age between 45 and 70, (FEV1>80%pred, FEV1/FVC>70% Exclusion Criteria: Not in the age range Different FEV1 value Severe comorbidities

Ages Eligible for Study
-----------------
Minimum Age: 45 Years
Maximum Age: 70 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COPD patients<br>COPD patients with severe obstruction performed the tests. | Other: Measure pulmonary artery pressure change during exercise<br>* Semi-supine echocardiography test<br>* Other names: lung function, CPX, HsCRP;Other: Pulmonary pressure response during exercise<br>* Semi-supine echocardiography test<br>* Other names: Complete lung function, CPX, HsCRP;|
| Healthy subjects<br>Age-matched healthy subjects performed the same test also. | Other: Measure pulmonary artery pressure change during exercise<br>* Semi-supine echocardiography test<br>* Other names: lung function, CPX, HsCRP;Other: Pulmonary pressure response during exercise<br>* Semi-supine echocardiography test<br>* Other names: Complete lung function, CPX, HsCRP;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The degree of pulmonary artery pressure change during exercise? |  | 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Right ventricular function change? Correlation between systemic inflammation (hsCRP) and pulmonary artery pressure change? Endothelial dysfunction? |  | 2 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
COPD, healthy patients, PAP, CPX, SSE, hsCRP, FMD