Cerebral and Cardiac Blood Flow During Exercise in Patients with COPD

  • Research type

    Research Study

  • Full title

    Cardiac output and brain perfusion and architecture during exercise in patients with chronic obstructive pulmonary disease (COPD) and healthy, age matched volunteers

  • IRAS ID

    251184

  • Contact name

    Charlotte Bolton

  • Contact email

    charlotte.bolton@nottingham.ac.uk

  • Sponsor organisation

    University of Nottingham

  • Duration of Study in the UK

    1 years, 11 months, 30 days

  • Research summary

    Summary of Research

    There is a growing body of evidence showing increased risk of heart disease and dementia in patients with chronic obstructive pulmonary disease (COPD). This is due to changes in the large and small blood vessels, which are suspected to disrupt blood flow to target organs. Furthermore, exercise seems to be protective against age related structural changes in the brain. To date, no studies have assessed real time physiology within the heart and brain during exercise and correlated exercise capacity to brain structure within COPD patients, a cohort known to have a poor exercise tolerance. In Nottingham, the development of novel wide-bore magnetic resonance imaging (MRI) techniques that allow exercise within the scanner, presents a unique opportunity to investigate in-vivo changes in physiological parameters during exercise. The low intensity exercise protocol will mimic the level of the participants’ activities of daily living and may enable us to detect subtle changes in blood flow that would not otherwise be evident at rest but which the volunteer may experience day to day. This is an experimental study to understand the impact of COPD on blood flow in the heart and brain during low intensity exercise and compare with age and gender-matched healthy volunteers. We also aim to determine correlations between fitness and brain architecture across all volunteers. This is a single site study carried out at Queens Medical, Nottingham City Hospital and University of Nottingham campus. We will recruit 20 COPD and 10 healthy volunteers that will undergo a series of tests across 4 visits (including screening visit). These include assessment of muscle strength and fatigability, incremental exercise test to establish peak cardiorespiratory fitness and use of MRI to assess structural integrity of the brain and heart and changes in physiological parameters at baseline and during exercise across both sets of participant groups.

    Summary of Results

    The Covid-19 pandemic stopped completely the study and it has proven impossible to restart. The procedures involving exercise at maximum effort were considered high risk and the patient group vulnerable. Therefore, the study was ended prior to its completion. Out of the participants recruited, 10 had completed the MRI visits before halting of the study. However, these were all patients and without control group data as a comparator, we were unable to reach any conclusions on implications of the results. We have however utilized the learning from the pre covid work and learnt greatly.

  • REC name

    Yorkshire & The Humber - South Yorkshire Research Ethics Committee

  • REC reference

    18/YH/0369

  • Date of REC Opinion

    31 Oct 2018

  • REC opinion

    Further Information Favourable Opinion