title: Ivabradine prevents heart rate acceleration in patients with chronic obstructive pulmonary disease and coronary heart disease after salbutamol inhalation.
abstract: Accelerated sinus rhythm is an important side effect of inhaled salbutamol which is especially harmful in patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD). Cross-over, randomized, open label study design. 20 patients (18 males and two females) with COPD stage II-IV and comorbide CHD NYHA class I-III were included. Spirometry with 400 mg salbutamol inhalation was performed at two consecutive days of the study. Patients in group I were prescribed 5 mg ivabradine per os 3 h before salbutamol inhalation solely on the first day of the study and patients of group II received 5 mg ivabradine only on the second day of the study. Salbutamol caused a significant increase of HR by 5.5 bpm (95% CI 0.8; 10.2, p < 0.03). After ivabradine ingestion salbutamol did not change HR significantly by -2.4 bpm (-7.0; 2.3, p = 0.33). The attenuation of HR elevation by ivabradine was significant, p < 0.01. Salbutamol alone increased FEV1 by 6.0% (2.7; 9.3, p < 0.01). This effect was not impaired by ivabradine (FEV1 increase by 7.7% (2.8; 12.6, p < 0.01 versus baseline, p = 0.5 versus no ivabradine). Ivabradine 5 mg per os prevents heart rate acceleration after inhalation of 400 mg salbutamol. Ivabradine has no impact on lung function in patients with moderate-to-very-severe COPD and CHD comorbidity.
authors.affiliation: Bashkir State Medical University, Lenin Str. 3, Ufa 450000, Russia. znaufal@mail.ru.
authors.forename: Rustem
authors.initials: R
authors.lastname: Zulkarneev
authors.forename: Naufal
authors.initials: N
authors.lastname: Zagidullin
authors.forename: Guzel
authors.initials: G
authors.lastname: Abdrahmanova
authors.forename: Uta C
authors.initials: UC
authors.lastname: Hoppe
authors.forename: Shamil
authors.initials: S
authors.lastname: Zagidullin