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Resting heart rate and arterial stiffness relationship in patients with chronic obstructive pulmonary disease

University of British Columbia

Background: Patients with chronic obstructive pulmonary disease (COPD) are known to have an increased risk of ischemic heart disease. Persistently elevated resting heart rate and arterial stiffness, two common clinical manifestations in COPD, are known determinants of myocardial ischemia as well as predictors of cardiovascular events. Controversies exist on the effect of pulmonary rehabilitation on these ischemic heart disease risk factors. No study has explored the effect of pulmonary rehabilitation on the resting heart rate - arterial stiffness relationship in COPD. Objectives and Methods: The overall objectives of this dissertation were to provide a comprehensive investigation of the resting heart rate and arterial stiffness in patients with COPD, and explore the impact of pulmonary rehabilitation on their relationship in this population. We describe the association between resting heart rate and prior myocardial infarction in patients with chronic lung disease attending pulmonary rehabilitation (Chapter 2). We test the reliability of resting heart rate and arterial stiffness measurements in COPD patients (Chapters 3 and 4). We determine the association between resting heart rate and arterial stiffness (Chapter 5), and explore the potential beneficial effects of standard pulmonary rehabilitation on resting heart rate and/or arterial stiffness in COPD (Chapter 6). Summary of findings: We showed that an elevated resting heart rate is a potential indicator of prior myocardial infarction in patients with chronic lung disease (Chapter 2). Resting heart rate and arterial stiffness measurements have excellent and substantial reliability, respectively, under a standardized procedure in COPD patients (Chapters 3 and 4). The association between resting heart rate and arterial stiffness in control subjects is not present in patients with COPD (Chapter 5). Standard pulmonary rehabilitation in COPD reduces arterial stiffness, but not resting heart rate, and does not impact the resting heart rate - arterial stiffness relationship (Chapter 6). Conclusions: This dissertation provides new knowledge on resting heart rate and arterial stiffness, as well as on the potential beneficial effects of pulmonary rehabilitation on these two ischemic heart disease risk factors in COPD patients.

Text

2017-10-31

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/61405

Rehabilitation Sciences

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/