Effects of beta2-agonists during cardiopulmonary exercise test in COPD patients

M. Malerba, E. Boni, G. Romagnoni, B. Filippi, A. Politi, A. Giustina, C. Tantucci, V. Grassi

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Abstract

The aim of this study was to evaluate endocrine-metabolic, respiratory and cardiovascular effects of two beta2-sympathomimetic selective agents, such as broxaterol and salbutamol, before and during cardiopulmonary exercise test (CPX). Twelve in-patients with chronic obstructive pulmonary disease (COPD) (with partially reversible airways obstruction) were included. Broxaterol (400 μg) and salbutamol (400 μg) were administered i.v., according to a double-blind, cross-over study. Before treatment and within 60 min after the administration of each agent, the patients underwent incremental CPX by bicycle ergometer to the maximum tolerable threshold. At these times the following variables were assessed: minute ventilation (V̇E), oxygen consumption (V̇O2), carbon dioxide production (V̇CO2), V̇E/V̇O2 ratio and O2 pulse, glycaemia, insulinaemia, plasma norepinephrine (NE) and epinephrine (E), arterial oxygen and carbon dioxide tension (PaO2 and PaCO2), plasma lactates, heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure. Spirometry was performed before and after the administration of each beta2-adrenoceptor agonist. CPX brought about a significant increase in V̇E, V̇O2, V̇CO2, and O2 pulse. Broxaterol or salbutamol administration did not significantly modify the increases caused by CPX. At rest, 60 min after treatment, both bronchodilators caused a significant rise in glycaemia. A significant reduction of PaO2 (after broxaterol) and PaCO2 (after salbutamol) was observed at rest. In contrast, both agents caused no modification to potassium and insulin levels. Broxaterol and salbutamol caused a significant improvement in forced expiratory volume in one second (FEV1), maximum forced expiratory flow (FEF(max)) and forced expiratory flow at 25-75% forced vital capacity (FEF(25-75%)). No significant difference was observed in the rise of HR for both agents; however, broxaterol brought about a significant reduction in DBP. Broxaterol and salbutamol caused a significant reduction in SBP at the maximum level of CPX. This study shows that broxaterol, as well as salbutamol, is an effective and safe bronchodilator, since it causes no cardiac and endocrine-metabolic alterations in COPD patients with partially reversible airways obstruction during CPX.

Lingua originaleInglese
pagine (da-a)389-393
Numero di pagine5
RivistaMonaldi Archives for Chest Disease
Volume49
Numero di pubblicazione5
Stato di pubblicazionePubblicato - 1994
Pubblicato esternamente

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