PT  - JOURNAL ARTICLE
AU  - Frederik Trinkmann
AU  - Julian Klein
AU  - Julia Michels
AU  - Martin Borggrefe
AU  - Joachim Saur
TI  - Hemodynamic effects of inhaled fenoterol and ipratropium in patients with obstructive pulmonary diseases
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P3979
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P3979.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P3979.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - 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 (Berodual®). 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.