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The Impact of Bronchodilator Therapy on Systolic Heart Failure with Concomitant Mild to Moderate COPD

1
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi Kamicho, Itabashi, Tokyo 173-8610, Japan
2
Division of Medical Technology Faculty of Nutrition, Kobe Gakuin University, Kobe 651-2180, Japan
3
Department of Clinical Medicine and Development, and Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka 565-0873, Japan
*
Author to whom correspondence should be addressed.
Diseases 2018, 6(1), 4; https://doi.org/10.3390/diseases6010004
Received: 30 October 2017 / Revised: 23 December 2017 / Accepted: 27 December 2017 / Published: 28 December 2017
(This article belongs to the Section Cardiology)
In older adults, chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure with reduced ejection fraction (HFrEF), and the high prevalence of this combination suggests that customized treatment is highly necessary in patients with COPD and HFrEF. To investigate whether the treatment of COPD with tiotropium, an anticholinergic bronchodilator, reduces the severity of heart failure in patients with HFrEF complicated by mild to moderate COPD, forty consecutive participants were randomly divided into two groups and enrolled in a crossover design study. Group A inhaled 18 μg tiotropium daily for 28 days and underwent observation for another 28 days. Group B completed the 28-day observation period first and then received tiotropium inhalation therapy for 28 days. Pulmonary and cardiac functions were measured on days 1, 29, and 56. In both groups, 28 days of tiotropium inhalation therapy substantially improved the left ventricular ejection fraction (from 36.3 ± 2.4% to 41.8 ± 5.9%, p < 0.01, in group A; from 35.7 ± 3.8% to 41.6 ± 3.8%, p < 0.01, in group B) and plasma brain natriuretic peptide levels (from 374 ± 94 to 263 ± 92 pg/mL, p < 0.01, in group A; from 358 ± 110 to 246 ± 101 pg/mL, p < 0.01, in group B). Tiotropium inhalation therapy improves pulmonary function as well as cardiac function, and reduces the severity of heart failure in patients with compensated HFrEF with concomitant mild to moderate COPD. View Full-Text
Keywords: heart failure with reduced ejection fraction; chronic obstructive pulmonary disease; tiotropium; anticholinergic bronchodilator heart failure with reduced ejection fraction; chronic obstructive pulmonary disease; tiotropium; anticholinergic bronchodilator
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Kato, M.; Komamura, K.; Kitakaze, M.; Hirayama, A. The Impact of Bronchodilator Therapy on Systolic Heart Failure with Concomitant Mild to Moderate COPD. Diseases 2018, 6, 4.

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