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

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Title: ACE and response to pulmonary rehabilitation in COPD: two observational studies
Authors: Kon, SSC
Jolley, CJ
Shrikrishna, D
Montgomery, HE
Skipworth, JRA
Puthucheary, Z
Moxham, J
Polkey, MI
Man, WDC
Hopkinson, NS
Item Type: Journal Article
Abstract: Introduction Skeletal 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. Methods Two studies are described; in the first, the response of 168 COPD patients (mean FEV1 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 angiotensin converting enzyme inhibitors (ACE-I) or angiotensin receptor antagonists (ARB). Results In 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, 78(78)m respectively (p>0.05). In the second study, 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)kgm-2 vs 16.5(14.9,18.4) kgm-2 (p<0.001). However change in fat free mass, walking distance or quality of life in response to pulmonary rehabilitation did not differ between groups. Conclusion While these data support a positive association of ACE-I/ARB treatment and body composition in COPD, neither treatment to reduce ACE activity nor ACE(I/D) genotype influence response to pulmonary rehabilitation.
Issue Date: 1-Mar-2017
Date of Acceptance: 13-Jan-2017
URI: http://hdl.handle.net/10044/1/43988
DOI: https://dx.doi.org/10.1136/bmjresp-2016-000165
ISSN: 2052-4439
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Open Respiratory Research
Volume: 4
Copyright Statement: © 2017 The Authors. Published by the BMJ Publishing Group Limited. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Sponsor/Funder: Medical Research Council (MRC)
Medical Research Council (MRC)
Medical Research Council (MRC)
Funder's Grant Number: G0701628
G0701628/1
MR/J000620/1
Keywords: COPD Pathology
Pulmonary Rehabilitation
Publication Status: Published
Article Number: e000165
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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