TY - JOUR T1 - Hemodynamic effects of inhaled fenoterol and ipratropium in patients with obstructive pulmonary diseases JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P3979 AU - Frederik Trinkmann AU - Julian Klein AU - Julia Michels AU - Martin Borggrefe AU - Joachim Saur Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P3979.abstract N2 - Rationale: Selective b2-agonists and anticholinergics are widely used in patients with obstructive pulmonary diseases. Although an increased cardiovascular risk could be found for both classes, little is known about the hemodynamic effects of bronchodilator therapy. The aim of our study was to evaluate influences of inhaled fenoterol and ipratropium on cardiac function parameters.Methods: 42 patients undergoing routine bodyplethysmography and diagnostic indication for administration of bronchodilators were included. Inhalation of fenoterol and ipratropium was performed using a pressurized metered-dose inhaler (BerodualĀ®). Lung function was reassessed within 15 minutes. Hemodynamic evaluation was performed using non-invasive inert gas rebreathing.Results: Cardiac output (CO) and stroke volume (SV) both increased significantly from 4.0 to 4.3 l/min and 53 to 57 ml (p=0.005 each). The change of neither CO nor SV did alter between different grades of obstruction classified according to ATS/ERS recommendations (p=0.95 and p=0.98, ANOVA). There was no difference between patients significantly improving (n=14) and not improving in lung function defined as an increase in FEV1 > 200 ml and 12% (CO p=0.81 and SV p=0.58, t-test).Conclusion: Inhalation of short acting bronchodilators significantly alters cardiac function and may therefore play an important role for the increased cardiovascular risk. This is consistent with previous findings in smaller cohorts mostly using b2-agonists. However, the mechanisms and clinical impact still are unclear. Further studies are necessary to evaluate the value of hemodynamic monitoring and possible relations to clinical outcome parameters. ER -