title: Effects of exercise and beta 2-agonists on lung function in chronic obstructive pulmonary disease.
abstract: The effects of inhaled bronchodilators at rest and during exercise were studied in 15 subjects with chronic obstructive pulmonary disease. In a crossover study against placebo, albuterol caused a significant increase in expiratory flow and reduced lung hyperinflation and dyspnea at rest, but this was not associated with differences in symptoms with exercise or any relevant parameter of physical performance. Dynamic hyperinflation occurred during exercise similarly after placebo or albuterol and was associated with a reduction of forced expiratory flows. This, in turn, was correlated with the bronchoconstrictor effect of deep inhalation determined at rest. In a parallel group study, expiratory flow was increased by 3-wk treatment with salmeterol (n = 9) but not with placebo (n = 6). However, in neither group was the response to exercise different from baseline. These results suggest that in chronic obstructive pulmonary disease effective pharmacological bronchodilation at rest may not be predictive of benefits of exercise tolerance. This may be related to the occurrence of airway narrowing during exercise, particularly when a deep inhalation at rest is followed by a decrease in expiratory flow.
authors.affiliation: Laboratorio di Fisiopatologia Respiratoria, Clinica Malattie Apparato Respiratorio, Università di Pavia, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, 27100 Pavia, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Corsico
authors.forename: Paola
authors.initials: P
authors.lastname: Fulgoni
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Beccaria
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Zoia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barisione
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pellegrino
authors.forename: Vito
authors.initials: V
authors.lastname: Brusasco
authors.forename: Isa
authors.initials: I
authors.lastname: Cerveri
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage*; D016084:Bronchoconstriction / Q000187:drug effects; D018592:Cross-Over Studies; D004417:Dyspnea / Q000188:drug therapy / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005541:Forced Expiratory Volume / Q000187:drug effects; D005652:Functional Residual Capacity / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D015656:Respiratory Mechanics / Q000187:drug effects; D012146:Rest
chemical_list: D000318:Adrenergic beta-Agonists; D000420:Albuterol