ACE and response to pulmonary rehabilitation in COPD: two observational studies

IntroductionSkeletal muscle impairment is an important feature of chronic obstructive pulmonary disease (COPD). Renin–angiotensin system activity influences muscle phenotype, so we wished to investigate whether it affects the response to pulmonary rehabilitation.MethodsTwo studies are described; in...

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Published in:BMJ open respiratory research 2017, Vol.4 (1), p.e000165-e000165
Main Authors: Kon, Samantha S C, Jolley, Caroline J, Shrikrishna, Dinesh, Montgomery, Hugh E, Skipworth, James R A, Puthucheary, Zudin, Moxham, John, Polkey, Michael I, Man, William D-C, Hopkinson, Nicholas S
Format: Article
Language:English
Subjects:
Body composition
Chronic Obstructive Pulmonary Disease
Endurance
Exercise
Genotype & phenotype
Musculoskeletal system
Patients
Physical fitness
Quality of life
Rehabilitation
Studies
Walking
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Summary:IntroductionSkeletal muscle impairment is an important feature of chronic obstructive pulmonary disease (COPD). Renin–angiotensin system activity influences muscle phenotype, so we wished to investigate whether it affects the response to pulmonary rehabilitation.MethodsTwo studies are described; in the first, the response of 168 COPD patients (mean forced expiratory volume in one second 51.9% predicted) to pulmonary rehabilitation was compared between different ACE insertion/deletion polymorphism genotypes. In a second, independent COPD cohort (n=373), baseline characteristics and response to pulmonary rehabilitation were compared between COPD patients who were or were not taking ACE inhibitors or angiotensin receptor antagonists (ARB).ResultsIn study 1, the incremental shuttle walk distance improved to a similar extent in all three genotypes; DD/ID/II (n=48/91/29) 69(67)m, 61 (76)m and 78 (78)m, respectively, (p>0.05). In study 2, fat free mass index was higher in those on ACE-I/ARB (n=130) than those who were not (n=243), 17.8 (16.0, 19.8) kg m−2 vs 16.5 (14.9, 18.4) kg/m2 (p
ISSN:2052-4439
2052-4439
DOI:10.1136/bmjresp-2016-000165