Changes in microcirculation and functional status during exacerbation of COPD

Principal Investigator: prof. dr. Martijn Spruit, Researcher: dr. Chris Burtin

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by the development of exacerbations,  episodes of sudden and continued worsening of symptoms of dyspnea, cough, and/or sputum that is beyond normal day-to-day variations, and may warrant a change in regular medication.  Severe exacerbations often involve reduced health status leading to hospitalizations.

Recent findings suggest that patients with COPD are at increased risk for myocardial infarction and stroke during periods of acute exacerbation.  These findings might be related to acute endothelial changes associated to increased systemic inflammation. Changes in the microcirculation can be explored noninvasively by studying retinal blood vessels that are visualized in fundus images.

Muscle weakness and physical inactivity are associated to poor functional status and recurrent hospital admissions, independent of pulmonary impairment, which makes patients with frequent exacerbations prone to enter a vicious cycle. Simple functional screening tests during hospital stay might enable us to quantify the impact of a hospitalization on functional status and to identify patients at risk for repeated exacerbations.

The aims of this study are to:

• Investigate the influence of acute exacerbations of COPD on retinal microcirculation (primary aim).
• Investigate the influence of acute exacerbations of COPD on functional status (primary aim).
• Investigate the prognostic value of retinal vessel caliber assessment in terms of  hospitalizations and mortality during 2 years of follow-up.
• Investigate the prognostic value of assessment of functional status during an acute exacerbation of COPD in terms of hospital admission and mortality during 2 years follow-up.