Inhaled corticosteroid improves bronchial reactivity and decreases symptoms in patients with mitral stenosis.
OBJECTIVE
To determine if treatment with inhaled budesonide forte can diminish increased bronchial hyperreactivity and improve symptoms in patients with mitral valve stenosis.


METHODS
The study was randomized, double blind, and placebo controlled.


METHODS
Outpatient/university hospital.


METHODS
Twelve subjects, 8 female and 4 male, who qualified for mitral valve replacement. All subjects presented with increased bronchial reactivity to histamine at the time of the study.


METHODS
Patients received placebo or budesonide forte twice a day (1,200 mg/d) for 6 weeks. During the study, patients were treated with the same doses of diuretics and other medications that could affect bronchial reactivity.


METHODS
Spirometry, provocative concentration of histamine causing a 20% fall in the FEV1 (PC20H), symptom scores.


RESULTS
In the treated group, the initial PC20H was 0.82+/-0.72 mg/mL; in the placebo group 1.39+/-1.3 mg/mL. After 6 weeks of treatment, PC20H was significantly higher (3.07+/-2.28 mg/mL; p > 0.01) in the budesonide-treated group and remained unchanged in the placebo group (1.49+/-0.91). Symptom scores were significantly lower after administration of budesonide forte (mean change, 4.0+/-2.6).


CONCLUSIONS
Six weeks of treatment with budesonide forte significantly decreased bronchial reactivity to histamine and improved symptoms in patients with mitral valve stenosis.
Cieslewicz
G
G
Department of Cardiosurgery, Silesian School of Medicine, Zabrze, Poland.
Juszczyk
G
G
Foremny
J
J
Hamelmann
E
E
Religa
Z
Z
Zembala
M
M
Gelfand
E W
EW
D000280:Administration, Inhalation; D000287:Administration, Topical; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001980:Bronchi / Q000187:drug effects / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity / Q000188:drug therapy* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D005938:Glucocorticoids; D006632:Histamine / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D019819:Budesonide; D006632:Histamine