Effects of Inhaled Tiotropium on Left Ventricular Diastolic Function in Chronic Obstructive Pulmonary Disease Patients after Pulmonary Resection

Nojiri, Takashi; Yamamoto, Keiji; Maeda, Hitoshi; Takeuchi, Yukiyasu; Funakoshi, Yasunobu; Maekura, Ryoji; Okumura, Meinoshin

doi:10.5761/atcs.oa.11.01787

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…Tiotropium also reduces arterial stiffness [80]. Other potential CV benefits of LAMAs include reduction in exacerbations and an improvement in left-ventricular diastolic function, although not left-ventricular ejection fraction (LVEF) [79].…”

Section: Muscarinic Antagonistsmentioning

confidence: 99%

Cardiovascular disease and COPD: dangerous liaisons?

2018

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Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently occur together and their coexistence is associated with worse outcomes than either condition alone. Pathophysiological links between COPD and CVD include lung hyperinflation, systemic inflammation and COPD exacerbations. COPD treatments may produce beneficial cardiovascular (CV) effects, such as long-acting bronchodilators, which are associated with improvements in arterial stiffness, pulmonary vasoconstriction, and cardiac function. However, data are limited regarding whether these translate into benefits in CV outcomes. Some studies have suggested that treatment with long-acting β2-agonists and long-acting muscarinic antagonists leads to an increase in the risk of CV events, particularly at treatment initiation, although the safety profile of these agents with prolonged use appears reassuring. Some CV medications may have a beneficial impact on COPD outcomes, but there have been concerns about β-blocker use leading to bronchospasm in COPD, which may result in patients not receiving guideline-recommended treatment. However, there are few data suggesting harm with these agents and patients should not be denied β-blockers if required. Clearer recommendations are necessary regarding the identification and management of comorbid CVD in patients with COPD in order to facilitate early intervention and appropriate treatment.

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Section: Muscarinic Antagonistsmentioning

confidence: 99%

Cardiovascular disease and COPD: dangerous liaisons?

2018

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“…LAMA, long-acting muscarinic antagonist; LABA, long-acting β2-agonist. (14) because tiotropium improved the left ventricular diastolic function in the chronic phase after pulmonary resection (18). However, Ueda et al reported that preoperative treatment with tiotropium for ≥7 days improved lung function prior to thoracic surgery, but no effect on respiratory complications was seen (19).…”

Section: Discussionmentioning

confidence: 99%

Long‑acting muscarinic antagonist and long‑acting β2‑agonist therapy to optimize chronic obstructive pulmonary disease prior to lung cancer surgery

et al. 2018

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Bronchodilators are essential for the perioperative management of patients with chronic obstructive pulmonary disease (COPD) undergoing surgery for lung cancer. The objective of the present study was to examine whether the usage of a long-acting β2-agonist (LABA) with a long-acting muscarinic antagonist (LAMA) could optimize preoperative lung function and reduce the risk for postoperative pulmonary complications. Thirty-two consecutive patients with moderate-to-severe COPD who underwent a lobectomy for lung cancer and received preoperative LAMA (n=19) or LAMA/LABA (n=13) therapy between January 2005 and December 2015 were enrolled in this retrospective study. The improvement of preoperative pulmonary function and the postoperative morbidity were compared between the patients with preoperative LAMA, and LAMA/LABA therapy. Increases in the forced expiratory volume in one second (FEV) were significantly larger in the LAMA/LABA group than in the LAMA group (0.26±0.05 l vs. 0.07±0.05 l; P=0.0145). More patients in the LAMA/LABA group than in the LAMA group showed a marked improvement of >10% in %FEV after bronchodilators (85 vs. 32%; P=0.0046). The incidence of postoperative pneumonia was significantly lower in the LAMA/LABA group than in the LAMA group (0 vs. 26%; P=0.044). In conclusion, the present study showed that preoperative LAMA/LABA therapy was associated with larger improvements in preoperative pulmonary function and less postoperative pneumonia than LAMA therapy. These results may lead to greater improvements in FEV and less postoperative pneumonia by encouraging preoperative LAMA/LABA therapy in this patient population.

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“…68 There is evidence with Tiotropium to suggest that it improves left ventricular diastolic function in COPD patients. 69 Data from large scale RCT indicates that Tiotropium is associated with decreased all-cause cardiovascular and respiratory mortality. 53…”

Section: Inhaled Therapiesmentioning

confidence: 99%

Implications of Managing Chronic Obstructive Pulmonary Disease in Cardiovascular Diseases

Deshmukh

Khanna

2021

Tuberc Respir Dis

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Globally, cardiovascular diseases and Chronic Obstructive Pulmonary Disease (COPD) are the leading causes of non-communicable disease burden. Overlapping symptoms such as breathlessness and fatigue, coupled with a lack of awareness about COPD among physicians, are important reasons for under-diagnosis and resultant sub-optimal care in COPD. Much has been published earlier on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of prevalence and the impact of COPD management in commonly encountered cardiac diseases is lacking. This study aimed at summarizing the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We have also discussed the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched Pubmed, Scopus, EMBASE, and Google Scholar for studies published between 1981 to May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has a high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. Clinical implications of the diagnosis of COPD in cardiac disease includes recognition of hyperinflation (a treatable trait), implementation of AECOPD prevention strategies, and reducing the risk of overuse of diuretics. Pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. Appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thereby reducing the risk of mortality, improving exercise tolerance, and quality of life.

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Effects of Inhaled Tiotropium on Left Ventricular Diastolic Function in Chronic Obstructive Pulmonary Disease Patients after Pulmonary Resection

Cited by 8 publications

References 26 publications

Cardiovascular disease and COPD: dangerous liaisons?

Cardiovascular disease and COPD: dangerous liaisons?

Long‑acting muscarinic antagonist and long‑acting β2‑agonist therapy to optimize chronic obstructive pulmonary disease prior to lung cancer surgery

Implications of Managing Chronic Obstructive Pulmonary Disease in Cardiovascular Diseases

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