Physiology COPD
Cardiac output and brain perfusion and architecture during exercise in patients with chronic obstructive pulmonary disease- REFLEX-COPD.
PhD project of Dr Ayushman Gupta, Clinical Research Fellow in Respiratory Medicine. Supervisors: Professor Charlotte Bolton, Professor Sue Francis, Professor Paul Greenhaff. Funded by the NIHR Nottingham BRC Respiratory Theme.
This PhD projects aims to assess the mechanisms of comorbidities in chronic obstructive pulmonary disease (COPD), a predominantly smoking related lung disease. Heart disease and memory problems are prevalent in COPD, incurring significant burden to morbidity and mortality. The underlying mechanisms are poorly understood, though one proposed hypothesis is that people with COPD may have large arterial vessel stiffness, which contributes to damage of small vessels, e.g. blood supply to the brain, resulting in organ impairment.
This project aims to determine the impact of COPD on the physiology of the muscle, heart and brain during supine, low-intensity exercise compared to age and gender matched non-COPD volunteers. This project builds on previous work at the University of Nottingham, which showed that exercise when used as a stressor, can highlight abnormalities in brain physiology which were not apparent at rest when comparing older with younger healthy individuals. This work has involved developing exercise protocols, using an MRI compatible ergometer (Ergospect Cardio Step) to recruit a large muscle mass during supine exercise inside an MR scanner. This provides novel insight of changes in cardiac output and brain perfusion and oxygen extraction during exercise. As well as this, brain, heart and muscle architecture and composition measurements are being made that will allow, for example, assessment of regional and whole-body fat and muscle volumes in COPD patients compared to control volunteers.
