Effect of tiotropium on heart rate variability in stable chronic obstructive pulmonary disease patients.
BACKGROUND
The chronic use of the long-acting anticholinergic agent, tiotropium, in chronic obstructive pulmonary disease (COPD) has been linked in some reports to an increase in adverse cardiovascular effects. Decreased heart rate variability (HRV) is a condition seen in COPD patients that has also been linked to poor cardiovascular outcome. We aimed in this study to investigate changes in HRV caused by tiotropium administration to COPD patients in order to determine whether changes occurred that might contribute to an increase in adverse cardiovascular events.


METHODS
Seventy patients with moderate-to-severe stable COPD were treated with once-daily dosing of tiotropium (two puffs of Spiriva Respimat, 2.5 μg solution) for 3 months. HRV, pulmonary function, and quality of life were measured before and after 1 and 3 months of therapy.


RESULTS
Pulmonary function and quality of life improved significantly, after both 1 and 3 months of therapy. No significant change in HRV parameters occurred, except for a significant decrease in the high-frequency and increase in the low-frequency component of HRV at the 1-month assessment.


CONCLUSIONS
Changes in HRV caused by tiotropium use are not sufficient to explain a possible increase in adverse cardiovascular events.
1 Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital , Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan .
Yao-Kuang
YK
Wu
Chun-Yao
CY
Huang
Mei-Chen
MC
Yang
Guo-Liang
GL
Huang
Sin-Yi
SY
Chen
Chou-Chin
CC
Lan
D000280:Administration, Inhalation; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018680:Cholinergic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D000069447:Tiotropium Bromide / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D000069447:Tiotropium Bromide
adverse event; anticholinergic agent; autonomic function; chronic obstructive pulmonary disease; heart rate variability; sympathetic system; tiotropium