Cibler la dysfonction cardiaque chez les patients avec la MPOC afin d'améliorer la capacité d'exercice et la qualité de vie

 

Benjamin Smith

Université McGill

 

Domaine : santé circulatoire et respiratoire

Programme chercheurs-boursiers cliniciens - Junior 1

Concours 2015-2016

Chronic obstructive pulmonary disease (COPD) is a common disorder that is associated with exercise limitation. Exercise limitation in COPD predicts death and is associated with reduced quality of life. Understanding the mechanisms of exercise limitation in COPD represents an important gap in knowledge toward the ultimate goal of targeting these mechanisms to improve health and quality of life.

Exercise limitation in COPD is associated with an under-filled heart. The goals of my research program are to i) determine if the forces required to breathe in COPD contribute directly to an under-filled heart, resulting in exercise limitation; and ii) determine if this mechanism is associated with reduced health-related quality of life at the population-level. I hypothesize that greater forces required to breathe in COPD, which are transmitted directly to the heart's surface, will be associated with higher levels of heart stress biomarkers, heart under-filling, and exercise limitation, as well as reduced quality of life at the population-level.

To test this hypothesis I will first recruit a sample of people with COPD and controls. These participants will undergo detailed measurements of breathing forces (pleural pressures) at rest and during exercise, along with measures of heart stress (cardiac natriuretic peptides), heart volumes (cardiac magnetic resonance imaging, total plasma volume), and exercise capacity (bicycle test). The second component of my research program will use data from a large, on-going Canadian study of COPD to determine if measures of altered breathing, heart stress, and heart function are associated with exercise limitation and reduced quality of life (questionnaire).

My proposed research will help to identify new therapeutic targets for future trials aiming to improve clinically meaningful outcomes in COPD. It will also build Canadian research capacity by supporting an early-career clinician-researcher with a strong track-record of productivity, and strengthen research collaborations across Quebec and Canada.