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Lung Deflation and Cardiovascular Structure and Function in Chronic Obstructive Pulmonary Disease. A Randomized
Ian S Stone1,2, Neil C Barnes2,3, Wai-Yee James1
11 Department of Respiratory Medicine, The London Chest Hospital, Barts Health NHS Trust, London, United Kingdom.
American Journal of Respiratory and Critical Care Medicine
|November 10, 2015
Summary
Inhaled fluticasone furoate/vilanterol improved cardiac structure and function in patients with chronic obstructive pulmonary disease (COPD). This lung deflation therapy positively impacted cardiovascular health, suggesting a link between respiratory and cardiac improvements.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Patients with chronic obstructive pulmonary disease (COPD) experience significant cardiovascular morbidity due to structural alterations.
- COPD-related hyperinflation can negatively impact cardiac function and structure.
Purpose of the Study:
- To evaluate the effects of lung deflation using inhaled fluticasone furoate/vilanterol on cardiovascular structure and function.
- To assess changes in cardiac volumes and pulmonary artery pulsatility via cardiac magnetic resonance imaging.
Main Methods:
- A double-blind, placebo-controlled, crossover study involving 45 patients with hyperinflated COPD.
- Participants received either fluticasone furoate/vilanterol (100/25 µg) or placebo for 7–14 days, with a minimum 7-day washout period.
- Cardiac magnetic resonance was used to measure changes in right and left ventricular volumes, atrial volumes, and pulmonary artery pulsatility.
Main Results:
- Fluticasone furoate/vilanterol significantly increased right ventricular end-diastolic volume index and reduced residual lung volume compared to placebo.
- Beneficial effects were observed in left ventricular and left atrial volumes, alongside improved left atrial ejection fraction.
- Pulmonary artery pulsatility increased, while intrinsic myocardial function remained unchanged. The safety profile was comparable to placebo.
Conclusions:
- Pharmacological lung deflation with inhaled fluticasone furoate/vilanterol demonstrates beneficial effects on cardiac function and pulmonary vasculature in COPD patients.
- These findings suggest inhaled therapies may positively influence cardiovascular health in COPD.
- Further research is warranted to explore the long-term impact of sustained lung deflation on myocardial function.
Keywords:
cardiac functioncardiac magnetic resonancechronic obstructive pulmonary diseasefluticasone furoate/vilanterollung hyperinflationMore Related Videos
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