Examinando por Autor "Delgado Ortiz, Laura"
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Ítem Physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease: a cross-sectional analysis(Elsevier Masson s.r.l., 2022-05) Delgado Ortiz, Laura; Arbillaga Etxarri, Ane; Rodríguez Chiaradia, Diego A.; Gimeno Santos, Elena; Barberán García, Anael; Balcells, Eva; Rodríguez Roisin, Robert; Garcia Aymerich, JudithBackground: The cardiac autonomic function in patients with chronic obstructive pulmonary disease (COPD) has been poorly studied. Objectives: We aimed to 1) describe the cardiac autonomic function assessed by heart rate recovery (HRR) and chronotropic response (CR) during a 6-min walk test (6MWT) and afterward and 2) estimate the association of physical activity with HRR and CR in COPD patients. Methods: This cross-sectional analysis included 320 patients with mild to very severe COPD. Physical activity (steps, time in any/moderate-to-vigorous/vigorous physical activity, intensity and sedentary time) was measured during 1 week by accelerometer. CR and HRR were measured during a 6MWT and 5 min after, respectively, and their association with physical activity parameters was estimated by multivariable linear regression models. Results: Patients were 82% male and had a mean (SD) age 68 (8) years, post-bronchodilator FEV1 57 (18) % predicted, and walked a mean of 7716 (4139) steps/day. HRR was slow until 5 min after the 6MWT; the mean (SD) HRR was 15 (10), 22 (11), 25 (12), 25 (12) and 27 (12) bpm after 1, 2, 3, 4 and 5 min, respectively. The mean (SD) CR was 35% (16). After adjusting for relevant confounders, time in vigorous physical activity was significantly associated with a fast decrease in HRR (p = 0.044) and an increase in CR (p = 0.021). We found no independent association for other physical activity parameters. Conclusion: A cardiac autonomic dysfunction is present in patients with mild to very severe COPD and is inversely related to the practice of vigorous physical activity. Trial registration ClinicalTrials.gov NCT01897298.Ítem Real-world walking cadence in people with COPD(European Respiratory Society, 2024-03) Delgado Ortiz, Laura; Ranciati, Saverio; Arbillaga Etxarri, Ane; Balcells, Eva; Buekers, Joren; Demeyer, Heleen; Frei, Anja; Gimeno Santos, Elena; Hopkinson, Nicholas S.; Jong, Corina de; Karlsson, Niklas; Louvaris, Zafeiris; Palmerini, Luca; Polkey, Michael I.; Puhan, Milo A.; Rabinovich, Roberto A.; Rodríguez Chiaradía, Diego A.; Rodríguez Roisin, Robert; Torán, Pere; Vogiatzis, Ioannis; Watz, Henrik; Troosters, Thierry; García Aymerich, JudithIntroduction The clinical validity of real-world walking cadence in people with COPD is unsettled. Our objective was to assess the levels, variability and association with clinically relevant COPD characteristics and outcomes of real-world walking cadence. Methods We assessed walking cadence (steps per minute during walking bouts longer than 10 s) from 7days’ accelerometer data in 593 individuals with COPD from five European countries, and clinical and functional characteristics from validated questionnaires and standardised tests. Severe exacerbations during a 12-month follow-up were recorded from patient reports and medical registries. Results Participants were mostly male (80%) and had mean±SD age of 68±8 years, post-bronchodilator forced expiratory volume in 1 s (FEV1) of 57±19% predicted and walked 6880±3926 steps·day−1. Mean walking cadence was 88±9 steps·min−1, followed a normal distribution and was highly stable within-person (intraclass correlation coefficient 0.92, 95% CI 0.90–0.93). After adjusting for age, sex, height and number of walking bouts in fractional polynomial or linear regressions, walking cadence was positively associated with FEV1, 6-min walk distance, physical activity (steps·day−1, time in moderate-to-vigorous physical activity, vector magnitude units, walking time, intensity during locomotion), physical activity experience and health-related quality of life and negatively associated with breathlessness and depression (all p<0.05). These associations remained after further adjustment for daily steps. In negative binomial regression adjusted for multiple confounders, walking cadence related to lower number of severe exacerbations during follow-up (incidence rate ratio 0.94 per step·min−1, 95% CI 0.91–0.99, p=0.009). Conclusions Higher real-world walking cadence is associated with better COPD status and lower severe exacerbations risk, which makes it attractive as a future prognostic marker and clinical outcome.