Skip to main content

Main menu

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • ERS Guidelines
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • Peer reviewer login
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • ERS Guidelines
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • Peer reviewer login
  • Alerts
  • Subscriptions

Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD

D.E. O'Donnell, T. Flüge, F. Gerken, A. Hamilton, K. Webb, B. Aguilaniu, B. Make, H. Magnussen
European Respiratory Journal 2004 23: 832-840; DOI: 10.1183/09031936.04.00116004
D.E. O'Donnell
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
T. Flüge
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
F. Gerken
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A. Hamilton
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
K. Webb
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
B. Aguilaniu
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
B. Make
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
H. Magnussen
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Figures

  • Tables
  • Fig. 1.—
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig. 1.—

    Changes in constant-load exercise endurance time (ET) are shown from baseline (day −5) for placebo (○) and tiotropium (•). Data are presented as mean±sem. *: p<0.05 between groups.

  • Fig. 2.—
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig. 2.—

    Intensity of dyspnoea (“breathing discomfort”) during constant-load cycle exercise was significantly reduced at isotime after treatment with tiotropium (b) as compared to placebo (a). Tiotropium allowed patients to exercise significantly longer before reaching the same level of intolerable dyspnoea. ET: exercise endurance time; ▪: day −5; ▴: day 0; ♦: day 21; •: day 42. *: p<0.05 during treatment (days 0, 21 and 42) as compared to baseline (day −5).

  • Fig. 3.—
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig. 3.—

    Operating lung volumes at rest and during exercise at baseline (▪---) and after 42 days (•––) of treatment with placebo (a; n=91) and tiotropium (b; n=96). TLC: total lung capacity; IRV: inspiratory reserve volume; EILV: end-inspiratory lung volume; VT: tidal volume; EELV: end-expiratory lung volume; IC: inspiratory capacity.

  • Fig. 4.—
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig. 4.—

    Inter-relationships between improvements in response to treatment with tiotropium (n=96), i.e. differences (Δ) calculated as values at day 42 minus values at day −5 baseline. ET: endurance time; BorgISO: exertional dyspnoea intensity at isotime; ICISO: inspiratory capacity at isotime; % pred: % predicted.

Tables

  • Figures
  • Table 1

    Subject characteristics at study entry (day −15) and at pretreatment baseline (pulmonary function: pre-dose on day 0; exercise: day −5)

    TiotropiumPlacebo
    Study entryBaselineStudy entryBaseline
    Subjects n9691
    Sex, M:F68:2870:21
    Age yrs61.5±5.959.4±8.0
    Body mass index kg·m−226.8±4.626.2±5.0
    Smoking history pack-yrs50.2±22.452.1±30.7
    Current smokers n3742
    Pulmonary function
     DL,CO mL·min−1·mmHg−1 (% pred)15.0±5.7 (56±19)15.4±5.9 (56±20)
     FEV1 L (% pred)1.22±0.45 (41±13)1.25±0.46 (42±13)1.27±0.45 (41±12)1.29±0.45 (42±12)
     FVC L (% pred)2.64±0.82 (71±16)2.73±0.80 (74±17)2.79±0.81 (73±17)2.92±0.86 (75±17)
     FEV1/FVC %46.2±9.945.7±10.345.5±9.444.6±9.4
     SGaw 1·cmH2O−1·s−10.036±0.0210.038±0.0260.037±0.0230.036±0.017
     IC L2.23±0.782.19±0.692.20±0.682.18±0.62
     FRC L (% pred)5.27±1.00 (161±30)5.30±1.04(161±28)5.37±1.24 (160±30)5.37±1.16 (160±29)
     TLC L (% pred)7.51±1.34 (120±17)7.49±1.34 (120±18)7.57±1.42 (118±15)7.54±1.37 (118±15)
     RV L (% pred)4.49±0.94 (199±42)4.42±0.99 (197±43)4.45±1.21 (197±48)4.37±1.11 (196±48)
    Peak exercise#
     Work rate W78±3259±2479±3060±22
     V'O2 L·min−11.26±0.451.22±0.421.28±0.351.26±0.36
     V'O2 mL·kg−1·min−116.0±4.615.5±4.316.7±4.316.4±4.5
     Heart rate beats·min−1123±19120±19127±20125±20
     V'E L·min−142.3±15.741.4±13.744.3±13.744.2±14.6
     Sa,O2 %92.7±4.693.5±3.7
    • Data are presented as mean±sd unless otherwise stated

    • M: male

    • F: female

    • DL,CO: diffusing capacity for carbon monoxide

    • FEV1: forced expiratory volume in one second

    • FVC: forced vital capacity

    • SGaw: specific airway conductance

    • IC: inspiratory capacity

    • FRC: functional residual capacity

    • TLC: total lung capacity

    • RV: residual volume

    • V'O2: oxygen consumption

    • V'E: minute ventilation

    • Sa,O2: oxygen saturation measured by pulse oximetry

    • #: symptom-limited incremental exercise at study entry and constant-load exercise at baseline (measurements are averages of the last 30 s of loaded exercise)

  • Table 2

    Baseline (day −5) measurements during constant-load exercise at 75% maximal work capacity (Wmax)

    TiotropiumPlacebo
    Subjects n9691
    Work rate W59±2460±22
    Endurance time s467±270517±310
    V'E L·min−1
     Rest13.2±3.513.3±3.5
     Isotime40.5±13.842.7±14.4
     Peak41.4±13.744.2±14.6
    fR breaths·min−1
     Rest18.2±4.518.4±4.8
     Isotime29.9±5.829.4±6.5
     Peak30.9±5.830.8±6.8
    VT L
     Rest0.76±0.230.76±0.27
     Isotime1.38±0.451.48±0.47
     Peak1.36±0.431.46±0.46
    IC L
     Rest2.25±0.682.33±0.62
     Isotime1.85±0.601.94±0.56
     Peak1.80±0.611.92±0.55
    IRV L
     Rest1.49±0.621.56±0.56
     Isotime0.46±0.330.47±0.32
     Peak0.43±0.400.46±0.33
    Dyspnoea Borg
     Rest0.9±1.10.7±0.9
     Isotime6.2±2.45.4±2.2
     Peak6.8±2.36.4±2.1
    • Data are presented as mean±sd

    • V'E: minute ventilation

    • fR: breathing frequency

    • VT: tidal volume

    • IC: inspiratory capacity

    • IRV: inspiratory reserve volume

  • Table 3

    Treatment differences in lung function parameters for the tiotropium group as compared to the placebo group

    Trough ResponsePeak Response
    Day 21Day 42Day 0Day 21Day 42
    FEV1 L0.10±0.03***0.12±0.03***0.17±0.02#0.22±0.03#0.22±0.04#
    FVC L0.19±0.06***0.25±0.06#0.37±0.04#0.41±0.06#0.43±0.06#
    FEV1/FVC %0.8±0.60.3±0.60.5±0.61.5±0.7*1.4±0.8
    SGaw 1·cmH2O−1·sec−10.015±0.006*0.006±0.002**0.016±0.002#0.029±0.007#0.022±0.003#
    IC L0.10±0.05*0.10±0.05*0.20±0.04#0.25±0.06***0.24±0.06***
    RV L−0.23±0.10*−0.36±0.09***−0.50±0.08#−0.51±0.10#−0.56±0.10#
    FRC L−0.17±0.08*−0.30±0.08***−0.41±0.07#−0.41±0.08#−0.45±0.08#
    RV/TLC %−2.2±0.8**−3.0±0.8***−4.9±0.6#−5.8±0.9#−6.0±0.9#
    FRC/TLC %−1.6±0.6**−2.1±0.6***−3.5±0.5#−3.9±0.7#−4.0±0.7#
    TLC L−0.07±0.08−0.20±0.08*−0.21±0.08**−0.15±0.09−0.19±0.09*
    • Data are presented as tiotropium–placebo, means adjusted for centre and baseline±se

    • FEV1: forced expiratory volume in one second

    • FVC: forced vital capacity

    • SGaw: specific airway conductance

    • IC: inspiratory capacity

    • RV: residual volume

    • FRC: functional residual capacity

    • TLC: total lung capacity

    • *: p<0.05

    • **: p<0.01

    • ***: p<0.001

    • #: p<0.0001

  • Table 4

    Treatment differences in exercise test parameters for the tiotropium group compared with the placebo group

    Day 0Day 21Day 42
    Endurance time s40±2867±32*105±40**
    Rest
     Dyspnoea Borg−0.1±0.10.0±0.1−0.1±0.1
     IC L0.25±0.04#0.21±0.04#0.23±0.05#
     VT L0.03±0.02−0.02±0.020.00±0.03
     fR breaths·min−10.2±0.40.6±0.50.6±0.5
     V'E L·min−10.2±0.40.2±0.40.4±0.4
     IRV L0.22±0.05#0.23±0.05#0.23±0.05#
    Isotime exercise
     Dyspnoea Borg−0.5±0.2*−0.7±0.3*−0.9±0.3**
     IC L0.21±0.04#0.19±0.05#0.18±0.05***
     VT L0.09±0.03***0.15±0.03#0.11±0.03***
     fR breaths·min−1−0.6±0.5−0.7±0.6−0.5±0.6
     V'E L·min−11.8±0.7*3.3±1.1**3.0±0.8***
     IRV L0.13±0.04***0.08±0.04*0.08±0.04*
    Peak exercise
     Dyspnoea Borg−0.2±0.2−0.1±0.2−0.1±0.3
     IC L0.15±0.04***0.22±0.05#0.15±0.05**
     VT L0.10±0.03***0.11±0.03***0.10±0.03***
     fR breaths·min−10.10±0.480.33±0.500.59±0.54
     V'E L·min−12.9±0.8***4.0±1.1***4.1±0.7#
     IRV L0.07±0.040.14±0.05**0.07±0.05
    • Data are presented as tiotropium–placebo, means adjusted for centre and baseline±se

    • IC: inspiratory capacity

    • VT: tidal volume

    • fR: breathing frequency

    • V'E: minute ventilation

    • IRV: inspiratory reserve volume

    • *: p<0.05

    • **: p<0.01

    • ***: p<0.001

    • #: p<0.0001

PreviousNext
Back to top
View this article with LENS
Vol 23 Issue 6 Table of Contents
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD
D.E. O'Donnell, T. Flüge, F. Gerken, A. Hamilton, K. Webb, B. Aguilaniu, B. Make, H. Magnussen
European Respiratory Journal Jun 2004, 23 (6) 832-840; DOI: 10.1183/09031936.04.00116004

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD
D.E. O'Donnell, T. Flüge, F. Gerken, A. Hamilton, K. Webb, B. Aguilaniu, B. Make, H. Magnussen
European Respiratory Journal Jun 2004, 23 (6) 832-840; DOI: 10.1183/09031936.04.00116004
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Acknowledgments
    • References
  • Figures & Data
  • Info & Metrics
  • PDF
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

  • Novel strategy to identify genetic risk factors for COPD severity: a genetic isolate
  • Calculating gambling odds and lung ages for smokers
  • Atrophy and hypertrophy signalling in the diaphragm of patients with COPD
Show more Original Articles: COPD

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About the ERJ

  • Journal information
  • Editorial board
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • Podcasts
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Print ISSN:  0903-1936
Online ISSN: 1399-3003

Copyright © 2023 by the European Respiratory Society