Chemosensitivity, Cardiovascular Risk, and the Ventilatory Response to Exercise in COPD

PLoS One. 2016 Jun 29;11(6):e0158341. doi: 10.1371/journal.pone.0158341. eCollection 2016.

Abstract

COPD is associated with elevated cardiovascular risk and a potentiated ventilatory response to exercise. Enhanced carotid chemoreceptor (CC) activity/sensitivity is present in other clinical conditions, has been shown to contribute to sympathetic vasoconstrictor outflow, and is predictive of mortality. CC activity/sensitivity, and the resulting functional significance, has not been well examined in COPD. We hypothesized that CC activity/sensitivity would be elevated in COPD, and related to increased pulse wave velocity (a marker of CV risk) and the ventilatory response to exercise.

Methods: 30 COPD patients and 10 healthy age-matched controls were examined. Participants performed baseline cardiopulmonary exercise and pulmonary function testing. CC activity was later evaluated by the drop in ventilation with breathing 100% O2, and CC sensitivity was then assessed by the ventilatory response to hypoxia (ΔVE/ΔSpO2). Peripheral arterial stiffness was subsequently evaluated by measurement of pulse wave velocity (PWV) using applanation tonometry while the subjects were breathing room air, and then following chemoreceptor inhibition by breathing 100% O2 for 2 minutes.

Results: CC activity, CC sensitivity, PWV and the ventilatory response to exercise were all increased in COPD relative to controls. CC sensitivity was related to PWV; however, neither CC activity nor CC sensitivity was related to the ventilatory response to exercise in COPD. CC inhibition by breathing 100% O2 normalized PWV in COPD, while no effect was observed in controls.

Conclusion: CC activity and sensitivity are elevated in COPD, and appear related to cardiovascular risk; however, CC activity/sensitivity does not contribute to the potentiated ventilatory response to exercise.

MeSH terms

  • Aged
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular System / physiopathology
  • Case-Control Studies
  • Exercise Test
  • Exercise*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oxygen
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulse Wave Analysis
  • Respiration
  • Respiratory Function Tests*
  • Risk
  • Vascular Stiffness / physiology

Substances

  • Oxygen

Grants and funding

This research was supported by a grant from the Canadian Institutes of Health Research (grant # 310994; http://www.cihr-irsc.gc.ca/e/193.html). MS is supported by a Heart and Stroke Foundation of Canada New Investigator Salary Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.