Dataset Information

Inhaled β-agonist does not modify sympathetic activity in patients with COPD.

ABSTRACT:

Background

Neurohumoral activation is present in COPD and might provide a link between pulmonary and systemic effects, especially cardiovascular disease. Because long acting inhaled β-agonists reduce hyperinflation, they could reduce sympathoexcitation by improving the inflation reflex. We aimed to evaluate if inhaled therapy with salmeterol reduces muscle sympathetic nerve activity (MSNA) evaluated by microneurography.

Methods

MSNA, heart rate, blood pressure, and respiration were continually measured. After baseline recording of 20 minutes, placebo was administered; after further 45 minutes salmeterol (50 μg) was administered which was followed by a further 45 minutes of data recording. Additionally, lung function, plasma catecholamine levels, arterial pulse wave velocity, heart rate variability, and baroreflex sensitivity were evaluated. Following 4 weeks of treatment with salmeterol 50 μg twice daily, measurements were repeated without placebo administration.

Results

A total of 32 COPD patients were included. Valid MSNA signals were obtained from 18 patients. Change in MSNA (bursts/100 heart beats) following acute administration of salmeterol did not differ significantly from the change following placebo (-1.96 ± 9.81 vs. -0.65 ± 9.07; p = 0.51) although hyperinflation was significantly reduced. Likewise, no changes in MSNA or catecholamines were observed after 4 weeks. Heart rate increased significantly by 3.8 ± 4.2 (p < 0.01) acutely and 3.9 ± 4.3 bpm (p < 0.01) after 4 weeks. Salmeterol treatment was safe and well tolerated.

Conclusions

By using microneurography as a gold standard to evaluate sympathetic activity we found no change in MSNA following salmeterol inhalation. Thus, despite an attenuation of hyperinflation, the long acting β-agonist salmeterol does not appear to reduce nor incite sympathoexcitation.

Trial registration

This study was registered with the European Clinical Trials Database (EudraCT No. 2011-001581-18) and ClinicalTrials.gov ( NCT01536587 ).

SUBMITTER: Haarmann H

PROVIDER: S-EPMC4460951 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Publications

Inhaled β-agonist does not modify sympathetic activity in patients with COPD.

Haarmann Helge H Mohrlang Cordula C Tschiesner Uta U Rubin David B DB Bornemann Thore T Rüter Karin K Bonev Slavtcho S Raupach Tobias T Hasenfuß Gerd G Andreas Stefan S

BMC pulmonary medicine 20150430

<h4>Background</h4>Neurohumoral activation is present in COPD and might provide a link between pulmonary and systemic effects, especially cardiovascular disease. Because long acting inhaled β-agonists reduce hyperinflation, they could reduce sympathoexcitation by improving the inflation reflex. We aimed to evaluate if inhaled therapy with salmeterol reduces muscle sympathetic nerve activity (MSNA) evaluated by microneurography.<h4>Methods</h4>MSNA, heart rate, blood pressure, and respiration wer ...[more]

PMID: 25924990

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Dataset Information

Inhaled β-agonist does not modify sympathetic activity in patients with COPD.

Background

Methods

Results

Conclusions

Trial registration

Publications

Inhaled β-agonist does not modify sympathetic activity in patients with COPD.

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