Safety of bronchodilator reversibility test in elderly subjects: a prospective study

Abstract

A b s t r a c tIntroduction: The reversibility test measures an increase in ventilation parameters after the administration of 400 µg of a short-acting β-agonist (SABA). It is worth noting that a typical dosage, applied as a rescue medicine for bronchospastic dyspnoea, is significantly less, i.e., 100-200 µg. Aim: To assess the effects of inhaled 400 µg fenoterol (in the bronchodilator reversibility test) on the heart rate and the development of tachyarrhythmias in subjects aged 65 and above. Material and methods: A total of 53 subjects (45 women) aged 77; 68-82 (median; interquartile range) in stable clinical condition were included in the study. Data including medical history, physical examinations, blood biochemistry, chest X-ray, 12-lead electrocardiogram, 24-hour Holter ECG monitoring, bronchodilator test, and echocardiography were obtained. During the Holter ECG monitoring, the bronchodilator test using 400 µg fenoterol (Berotec pMDI) was performed. Results: A slight but statistically significant (p = 0.02) increase in heart rate from 71 to 75 per min (median) was noted after the administration of fenoterol. No statistically significant differences were found in the number of extrasystolic beats of either supraventricular (p = 0.42) or ventricular origin (p = 0.50). In addition, the subjects did not show any potentially dangerous arrhythmias or significant signs of coronary artery disease. However, there was a significant increase in the number of supraventricular beats in the subjects who were not taking β-blockers. Conclusions: The use of 400 µg fenoterol in a bronchodilator reversibility test in elderly subjects does not entail any significant cardiovascular risk.

Discriminative potential of exhaled breath condensate biomarkers with respect to chronic obstructive pulmonary disease

“…However, the use of EBC in the course of COPD diagnosis has still to be determined. In fact, spirometry and EBC are both non-invasive methods and bronchodilation responsiveness testing is considered safe [ 53 ]. EBC needs a well-equipped laboratory, and the clinician will have results well after the collection, whereas spirometry results are immediate.…”