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No effect of the calcium antagonist, isradipine, on plasma catecholamines in irreversible chronic obstructive
N A Graudal1, A M Galløe, I Plum
1Department of Pulmonary Medicine P/Chest Clinic, Bispebjerg Hospital, Copenhagen, Denmark.
Insights
This study found that isradipine, a calcium antagonist, did not alter plasma catecholamine levels in patients with chronic obstructive pulmonary disease (COPD) during rest or exercise. The drug did not affect the exercise-induced increase in these critical stress hormones.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Calcium antagonists may reduce pulmonary artery pressure and improve cardiac function in COPD patients.
- This effect is hypothesized to lower plasma catecholamine levels.
- The impact of vasodilating calcium antagonists on catecholamines in COPD requires further investigation.
Purpose of the Study:
- To evaluate the effects of the calcium antagonist isradipine on resting and exercise plasma catecholamine levels in COPD patients.
- To determine if isradipine influences the body's response to physical exertion in individuals with severe respiratory insufficiency.
Main Methods:
- Eighteen patients with severe COPD (FEV1<1.01) were enrolled.
- Participants received either isradipine (5 mg) or a placebo in a randomized, controlled trial.
- Plasma catecholamine levels (noradrenaline and adrenaline) were measured at rest and during maximum exercise before and after treatment (2 hours and 3 months).
Main Results:
- Baseline exercise significantly increased plasma noradrenaline and adrenaline levels in COPD patients.
- No significant differences in resting or exercise plasma catecholamine levels were observed between the isradipine and placebo groups.
- The drug did not alter the exercise-induced rise in catecholamines at any time point.
Conclusions:
- The vasodilating calcium antagonist isradipine does not affect resting plasma catecholamine levels in COPD patients.
- Isradipine does not alter the exercise-induced increase in plasma catecholamines in this patient population.
- These findings suggest that isradipine's potential benefits in COPD do not involve modulation of the sympathetic nervous system's catecholamine response.
Abstract:
Calcium antagonists have been claimed to decrease the pulmonary artery pressure and increase oxygen uptake and cardiac output in patients with chronic obstructive pulmonary disease (COPD). This should tend to decrease the plasma levels of catecholamines. The purpose of the present study was to assess the effects of the vasodilating calcium antagonist, isradipine, on resting and exercise levels of catecholamines in patients with COPD. Eighteen patients with severe respiratory insufficiency (FEV1<1.01) were investigated. During maximum exercise, the baseline levels of plasma noradrenaline rose from 2.27 nmol/l (0.41-7.66: mean, range) to 3.86 nmol/l (1.3-12.2) (P = 0.0002) and plasma adrenaline rose from 0.39 nmol/l (0.07-1.02) to 0.64 nmol/l (0.07-1.77) (P = 0.0001). The patients were randomly allocated to receive either capsules of placebo or capsules of 5 mg of isradipine and were reinvestigated after 2 h and 3 months. There was no significant difference between the two groups concerning the change in plasma catecholamines, neither at rest nor at exhaustion. Furthermore, the increase in catecholamines during exercise in the two groups did not differ from each other, neither before administration of isradipine nor after. In conclusion, a vasodilating calcium antagonist did not alter the resting level or exercise induced increase in plasma catecholamines.