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

Abstract

Madalina Macrea,1 Atul Malhotra,2 Richard ZuWallack,3 Krisann Oursler,4 Richard Casaburi5 1Department of Pulmonary and Sleep Medicine, Salem Veterans Affairs Medical Center, University of Virginia, Charlottesville, VA, USA; 2Department of Pulmonary, Critical Care and Sleep Medicine, University of California at San Diego, San Diego, CA, USA; 3Department of Pulmonary, Critical Care, and Sleep Medicine St. Francis Hospital, Hartford, CT, USA; 4Department of Geriatrics and Infection Disease, Salem Veterans Affairs Medical Center, Carilion Virginia Tech School of Medicine, Roanoke, VA, USA; 5Division 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, USACorrespondence: Madalina Macrea, Department of Pulmonary and Sleep Medicine, Salem Veterans Affairs Medical Center, Salem, VA, 24153, USA, Tel [phone] ext 6609, Email [email protected]: 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: flow-mediated dilation, chronic obstructive pulmonary disease, obstructive sleep apnea, physical activity

Keywords

• flow-mediated dilation
• chronic obstructive pulmonary disease
• obstructive sleep apnea
• physical activity