Effects of formoterol on exercise tolerance in severely disabled patients with COPD

Neder, J. Alberto; Fuld, Jonathan; Overend, Tim; Thirlwell, J.; Carter, Roger; Stevenson, Robin; Ward, Susan A.

doi:10.1016/j.rmed.2007.06.006

Cited by 43 publications

(33 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These agents include the twice-daily β 2 -agonists, formoterol and salmeterol, and the once-daily anticholinergic, tiotropium. Long-acting bronchodilators may improve exercise tolerance [2][3][4] as a result of bronchodilation and reduction of both static and dynamic hyperinflation.…”

Section: Introductionmentioning

confidence: 99%

Bronchodilator effects of indacaterol and formoterol in patients with COPD

Beier

Beeh

Brookman

et al. 2009

Pulmonary Pharmacology & Therapeutics

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Bronchodilator effects of indacaterol and formoterol in patients with COPD

Beier

Beeh

Brookman

et al. 2009

Pulmonary Pharmacology & Therapeutics

View full text Add to dashboard Cite

show abstract

“…(26) In addition, most of the patients mechanics during walking in patients with COPD and that allow us to reflect on the mechanisms underlying the heterogeneity of the responses to pharmacological and nonpharmacological interventions that characterizes this population, (1,(6)(7)(8)(9)(10) although the methods employed in the present study do not allow us to draw definitive conclusions regarding this issue. transforms into progressively higher lung volumes that are typically located in the least compliant portion of the pressure-volume curve.…”

Section: Discussionmentioning

confidence: 94%

“…One of the consequences of such changes is that there is a significant increase in the work of breathing and a reduction in the ability of the diaphragm to generate effective pressures, leading to a progressive neuromechanical dissociation and dyspnea. (2,(6)(7)(8)(9)(10) Dyspnea can also be induced by EFL per se, probably through reflexes originating from the dynamic compression of the intrathoracic airways. (27) The findings of the present study corroborate the concept that DH plays an important role as an etiological factor for exercise limitation in patients with moderate to severe COPD.…”

Section: Discussionmentioning

confidence: 99%

“…(6)(7)(8) However, nearly all of the studies evaluating DH during exercise in patients with COPD paradoxically employed a cycle ergometer, having generally evaluated DH in response to constant workload protocols. (6)(7)(8)(9)(10) Nevertheless, ventilatory demand and exerciseinduced hypoxemia are known to be greater during walking, and there are distinct patterns of recruitment of accessory respiratory muscles. (11)(12)(13) In contrast, cycle ergometer exercise tends to trigger greater leg fatigue, ventilatory rates that are sufficiently high for the DH process to be truly limiting being therefore more difficult to achieve.…”

Section: Introductionmentioning

confidence: 99%

“…In order to mimic constant workload cycle ergometer tests and allow the extrapolation of 15 extensively demonstrated in patients with COPD. (6)(7)(8)(9)(10) Two maneuvers were performed at rest, at the end of the initial period and every 2 min after the beginning of the constant speed test, in order to obtain reproducible values (< 10% difference in relation to the highest value, at each stage). We defined DH as any reduction in IC in relation to the initial values at rest.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comportamento da hiperinsuflação dinâmica em teste em esteira rolante em pacientes com DPOC moderada a grave

et al. 2012

View full text Add to dashboard Cite

Objective: To characterize the presence, extent, and patterns of dynamic hyperinflation (DH) during treadmill exercise testing in patients with moderate to severe COPD. Methods: This was a cross-sectional study involving 30 non-hypoxemic patients (FEV 1 = 43 ± 14% of predicted) who were submitted to a cardiopulmonary exercise test on a treadmill at a constant speed (70-80% of maximum speed) to the tolerance limit (Tlim). Serial inspiratory capacity (IC) maneuvers were used in order to assess DH. Results: Of the 30 patients studied, 19 (63.3%) presented with DH (DH+ group), having greater pulmonary function impairment at rest than did those without DH (DH− group). None of the variables studied correlated with exercise tolerance in the DH− group, whereas Tlim, IC, and perception of dyspnea during exercise did so correlate in the DH+ group (p < 0.05). In the DH+ group, 7 and 12 patients, respectively, presented with a progressive and a stable pattern of DH (ΔIC Tlim,2min = −0.28 ± 0.11 L vs. 0.04 ± 0.10 L; p < 0.01). Patients with a progressive pattern of DH presented with higher perception of dyspnea/Tlim rate and lower exercise tolerance than did those with a stable pattern (354 ± 118 s and 465 ± 178 s, respectively; p < 0.05). Conclusions: The presence of DH is not a universal phenomenon during walking in COPD patients, even in those with moderate to severe airflow limitation. In the patients who presented DH, a progressive pattern of DH had a greater impact on exercise tolerance than did a stable pattern of DH.Keywords: Pulmonary disease, chronic obstructive; Exercise; Exercise test; Inspiratory capacity. ResumoObjetivo: Caracterizar a presença, extensão e padrões de hiperinsuflação dinâmica (HD) durante teste em esteira rolante em pacientes com DPOC moderada a grave. Métodos: Estudo transversal com 30 pacientes não hipoxêmicos (VEF 1 = 43 ± 14% do previsto) submetidos a teste cardiopulmonar de exercício em esteira rolante em velocidade constante (70-80% da velocidade máxima) até o limite da tolerância (Tlim). Manobras seriadas de capacidade inspiratória (CI) foram utilizadas para avaliação da HD. Resultados: Dos 30 pacientes estudados, 19 (63,3%) apresentaram HD (grupo HD+), que apresentaram maior comprometimento funcional em repouso do que os pacientes sem HD (grupo HD−). Nenhuma das variáveis obtidas relacionou-se com a tolerância ao exercício no grupo HD−, enquanto Tlim, CI e percepção de dispneia ao esforço foram significativamente correlacionados no grupo HD+ (p< 0,05). No grupo HD+, 7 e 12 pacientes, respectivamente, apresentaram padrão progressivo e estável de HD (ΔCI Tlim,2min = −0,28 ± 0,11 L e 0,04 ± 0,10 L; p < 0,01). Pacientes com padrão progressivo de HD apresentaram maior relação percepção de dispneia/Tlim e menor tolerância ao exercício do que aqueles com padrão estável (354 ± 118 s e 465 ± 178 s, respectivamente; p < 0,05). Conclusões: A HD não é um fenômeno universal durante a caminhada em pacientes com DPOC, mesmo que apresentem obstrução ao fluxo aéreo de graus moderado a acentuado. ...

show abstract

Chronisch-obstruktive Lungenerkrankung

2012

View full text Add to dashboard Cite

Data about the clinical presentation of chronic obstructive pulmonary disease (COPD) have resulted in a new classification of the disease. The degree of airflow limitation has been amended by symptoms and exacerbation rate. The standard pharmacotherapy of stable COPD is in transition, as fixed combinations of long acting beta agonists and long acting anticholinergics are in the late stages of clinical development. On this background inhaled corticosteroids will need to be re-evaluated. Roflumilast is a recently approved therapeutic option that primarily diminishes exacerbation frequency in patients with chronic bronchitis and severe airflow obstruction (FEV(1) < 50%). In COPD patients with acute exacerbations procalcitonin levels can be used to guide antibiotic therapy. Comparable clinical outcomes can be achieved while using significantly less amounts of antibiotics.

show abstract

Effects of formoterol on exercise tolerance in severely disabled patients with COPD

Abstract: Inhaled formoterol 12 microg twice daily is effective in ameliorating DH, daily dyspnoea and exercise intolerance even in patients with advanced COPD.

Cited by 43 publications

References 47 publications

Bronchodilator effects of indacaterol and formoterol in patients with COPD

Bronchodilator effects of indacaterol and formoterol in patients with COPD

Comportamento da hiperinsuflação dinâmica em teste em esteira rolante em pacientes com DPOC moderada a grave

Chronisch-obstruktive Lungenerkrankung

Contact Info

Product

Resources

About