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Effect of the combination of a short-acting β2-agonist plus an anticholinergic drug on the efficacy of coronary blood flow measured by applanation tonometry in chronic obstructive pulmonary disease

Background: bronchodilators are the major class of drugs prescribed for chronic obstructive pulmonary disease (COPD). Meanwhile, treatment strategies for obstructive lung disease using bronchodilators are continually discussed and reviewed, in particular, with regard to their potential effect on cardiovascular system. Aim: to evaluate the effect of the combination of a short-acting β2-agonist plus an anticholinergic medication (fenoterol 50 μg/dose + ipratropium bromide 20 μg/dose, 2 doses) on the efficacy of coronary blood flow in COPD patients. Patients and Methods: spirometry with bronchodilator testing (at least 12 hours after using the medication) was performed in 30 COPD patients. The efficacy of coronary blood flow was assessed by central subendocardial viability ratio (C_SEVR) measured by applanation tonometry which was performed before and 15, 30, and 60 min after using the bronchodilator. Oxygen saturation was measured at all stages of the study. Results: the combination of fenoterol and ipratropium bromide resulted in the increase of C_SEVR by 9.5 [3.3; 10.8]% in patients with low oxygen saturation at baseline due to heart rate reduction, diastolic lengthening, and oxygen level improvement. The timing of the effect was determined by the reversibility of bronchial obstruction. No effects of the combination of fenoterol and ipratropium bromide on central and peripheral blood pressure were reported. Conclusion: low oxygen saturation at baseline and reversible bronchial obstruction in COPD patients allow for a favorable predicted systemic effect of the combination of fenoterol and ipratropium bromide. When using in therapeutic dosages and according to recommended dosage regimen, this combination improves bronchopulmonary function, oxygen saturation, and the efficacy of coronary blood flow measured by applanation tonometry. KEYWORDS: chronic obstructive pulmonary disease, applanation tonometry, central subendocardial viability ratio, SEVR, bronchial obstruction, oxygen saturation. FOR CITATION: Punin D.A. Effect of the combination of a short-acting β2-agonist plus an anticholinergic drug on the efficacy of coronary blood flow measured by applanation tonometry in chronic obstructive pulmonary disease. Russian Medical Inquiry. 2020;4(4):199–206. DOI: 10.32364/2587-6821-2020-4-4-199-206.