Abstract
Aim: to evaluate protective effect of If blocker ivabradine on cardiac autonomic regulation after inhalation of salbutamol in patients with COPD and coronary heart disease(CHD).
Materials and methods: 23 patients with COPD stage II-IV and CHD NYHA class I-III were included in cross-over, randomized study.Spirometry test with 400 mg salbutamol inhalation was performed at two consecutive days. Patients in group I were prescribed 5 mg ivabradine per os 3 hours before salbutamol inhalation on the 1-st study day, patients of group II received 5 mg ivabradine on the 2-nd day. Cardiac autonomic regulation was assessed via heart rate variability (HRV).
HRV at baseline (b) and in folow-up(f) after salbutamol(S) inhalation alone and in combination with ivabradine(I)in patients with COPD and CHD
Results: salbutamol decreased the standard deviation of interbeat intervals SDNN and low-frequency LF power. If salbutamol inhalation was made after ivabradine ingestion then heart rate (HR) and LF/HF ratio decreased, normalized respiratory modulation power HF increased. Salbutamol increased FEV1 by 6.0%, p <0.01. Salbutamol with ivabradine increased FEV1 by 7.7%, p<0.01, p=0.5 vs. no ivabradine.
Conclusion:ivabradine 5 mg per os prevents alteration of cardiac autonomic regulation after inhalation of 400 mcg salbutamol in patients with COPD and CHD comorbidity.
- © 2012 ERS
