Metabolic and cardiorespiratory effects of decreasing lung hyperinflation with budesonide/formoterol in COPD: a randomized, double-crossover, placebo-controlled, multicenter trial
| Autor: | Cherie A. Maguire, Michael DePietro, Miguel Divo, John Horton, Bartolome R. Celli |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Cardiac output Vital capacity medicine.medical_specialty Oxygen pulse Stroke volume Oxygen uptake Pulmonary Disease Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Double-Blind Method Forced Expiratory Volume Internal medicine medicine Budesonide Formoterol Fumarate Drug Combination Humans Lung volumes 030212 general & internal medicine Aged Oxygen saturation (medicine) lcsh:RC705-779 COPD Cross-Over Studies business.industry Research lcsh:Diseases of the respiratory system Middle Aged medicine.disease Bronchodilator Agents Treatment Outcome Cardiorespiratory Fitness 030228 respiratory system Budesonide/formoterol Cardiology Female Formoterol business Inspiratory Capacity Respiratory minute volume Follow-Up Studies medicine.drug |
| Zdroj: | Respiratory Research, Vol 21, Iss 1, Pp 1-9 (2020) Respiratory research, 21:26 Respiratory Research |
| Popis: | Background Studies suggest that acute decreases in lung hyperinflation at rest improves cardiac function and increases lung vascular perfusion from decompression of a compromised heart. In those studies, changes in resting oxygen uptake induced by medications, an alternative explanation for compensatory increased cardiac function, were not explored. Methods This double-blind, multicenter, double-crossover study enrolled adults with chronic obstructive pulmonary disease, resting hyperinflation, and > 10% improvement in inspiratory capacity after 2 inhalations of budesonide/formoterol 160/4.5 μg. Metabolic, cardiac, and ventilatory function were measured 60 min pre−/post-dose at each visit. Primary endpoint was change in resting oxygen uptake for budesonide/formoterol versus placebo. Results Fifty-one patients (median age: 63 years) received treatment. Compared with placebo, budesonide/formoterol significantly increased resting oxygen uptake (mean change from baseline: 1.25 vs 11.37 mL/min; P = 0.007) as well as tidal volume and minute ventilation. This occurred despite improvements in the inspiratory capacity, forced vital capacity, and expiratory volume in 1 s. No significant treatment differences were seen for oxygen saturation, respiratory rate, and resting dyspnea. There was a numerical increase in oxygen pulse (oxygen uptake/heart rate). Correlations between inspiratory capacity and oxygen pulse were weak. Conclusions Budesonide/formoterol treatment in resting hyperinflated patients with COPD results in significant deflation. The increase in oxygen uptake and minute ventilation at lower lung volumes, without changes in heart rate and with minimal improvement in oxygen pulse, suggests increased oxygen demand as a contributor to increased cardiac function. Trial registration ClinicalTrials.govidentifier: NCT02533505. |
| Databáze: | OpenAIRE |
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