Document Detail


Bronchodilator effect on ventilatory, pulmonary gas exchange, and heart rate kinetics during high-intensity exercise in COPD.
MedLine Citation:
PMID:  19711095     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Respiratory mechanical abnormalities in patients with chronic obstructive pulmonary disease (COPD) may impair cardiodynamic responses and convective oxygen delivery during exercise, resulting in slower ventilatory, pulmonary gas exchange (PGE), and heart rate (HR) kinetics compared with normal. We reasoned that bronchodilators and the attendant reduction of operating lung volumes should accelerate ventilatory, PGE, and HR kinetics in the transition from rest to high-intensity exercise. Twelve clinically stable COPD patients undertook constant-work rate cycle testing at 75% of each individual's maximum work capacity after receiving either combined nebulized bronchodilators (BD) or placebo (PL), randomly. Mean response time (MRT) and amplitude of slow component for oxygen uptake (V'O(2)), carbon dioxide production (V'CO(2)), ventilation (V'(E)), and HR together with operating dynamic end-expiratory lung volume (EELV) were measured. Resting and exercise EELV decreased significantly by 0.38 L after BD compared with PL. After BD, V'O(2), V'CO(2), V'(E), and HR MRT accelerated (p < 0.05) by an average of 12, 22, 27, and 22 s, respectively (i.e., 15, 18, 22 and 27%, respectively). The slow component for V'O(2) declined by an average of 55 ml/min compared with PL. Speeded MRT for V'O(2) correlated with indices of reduced lung hyperinflation, such as resting EELV (r = -0.64, p = 0.025) and EELV at isotime (r = -0.77, p = 0.0032). The results confirm an important interaction between abnormal dynamic respiratory mechanics and indices of cardio-circulatory function in the rest-to-exercise transition in COPD patients.
Authors:
Pierantonio Laveneziana; Paolo Palange; Josuel Ora; Dario Martolini; Denis E O'Donnell
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-08-27
Journal Detail:
Title:  European journal of applied physiology     Volume:  107     ISSN:  1439-6327     ISO Abbreviation:  Eur. J. Appl. Physiol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954790     Medline TA:  Eur J Appl Physiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  633-43     Citation Subset:  IM    
Affiliation:
Respiratory Investigation Unit, Department of Medicine, Kingston General Hospital, Queen's University, 102 Stuart Street, Kingston, ON K7L 2V6, Canada. pier_lav@yahoo.it
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00354354
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MeSH Terms
Descriptor/Qualifier:
Aged
Bronchodilator Agents / administration & dosage*
Canada
Exercise*
Female
Heart Rate / drug effects*
Humans
Italy
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / drug therapy,  physiopathology*
Pulmonary Gas Exchange / drug effects*
Pulmonary Ventilation / drug effects*
Respiratory Mechanics / drug effects
Chemical
Reg. No./Substance:
0/Bronchodilator Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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