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Bronchodilator responsiveness in patients with chronic heart failure
Armine G Minasian1, Frank J J van den Elshout, P N Richard Dekhuijzen
1Department of Pulmonary Diseases, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands. aminasian@rijnstate.nl
Heart & Lung : the Journal of Critical Care
|January 1, 2013
Summary
Inhaled bronchodilators improved pulmonary function and reduced dyspnea in chronic heart failure patients, particularly those with airway obstruction. Further research is needed to confirm clinical usefulness and safety.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Conflicting data exist regarding the efficacy of bronchodilators in improving pulmonary function and dyspnea in chronic heart failure (HF) patients.
- Chronic HF patients may experience pulmonary complications that can be exacerbated by airway obstruction (AO).
Purpose of the Study:
- To evaluate the impact of inhaled bronchodilators on pulmonary function and dyspnea in patients suffering from chronic heart failure (HF) with systolic dysfunction.
- To determine if bronchodilators can reverse airway obstruction in this patient population.
Main Methods:
- Retrospective observational study involving 116 chronic HF outpatients with systolic dysfunction.
- Spirometry and Borg dyspnea measurements were recorded before and after inhaling salbutamol (400 μg) and ipratropium (80 μg).
- Patients with co-existing chronic obstructive pulmonary disease (COPD) or asthma were excluded from the analysis.
Main Results:
- Bronchodilators fully reversed pre-existing airway obstruction (AO) in 39.1% of patients.
- Significant improvements were observed in most spirometric measurements post-bronchodilation, with greater FEV1 improvements in patients with persistent AO.
- A small but significant reduction in dyspnea was noted, alongside significant bronchodilator responsiveness in a subset of patients.
Conclusions:
- Inhaled bronchodilators may offer benefits in managing chronic heart failure (HF) patients, especially those with airway obstruction (AO).
- The potential role of bronchodilators in improving pulmonary function warrants consideration in HF management.
- Further studies are essential to establish the clinical utility and potential adverse effects of bronchodilators in this population.
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