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Articles in PresS, published online ahead of print September 6, 2002
J Appl Physiol, 10.1152/jap.00490.2002
Submitted on June 4, 2002
Accepted on August 27, 2002
1 Laboratorio di Fisiopatologia Resepiratoria, Clinica Malattie Apparato Respiratorio, IRCCS Policlinico S. Matteo, Universita di Pavia, Pavia, Italy
2 Fisiopatologia Respiratoria, Dipartimento di Medicina Interna, Universita di Genova, Genova, Italy
3 Servizio di Fisiopatologia Respiratoria, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy
* To whom correspondence should be addressed. E-mail: i.cerveri{at}libero.it.
The effects of inhaled bronchodilators at rest and during exercise were studied in 15 subjects with chronic obstructive pulmonary disease (COPD). 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 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-week salmeterol (n=9) but not placebo (n=6). However, in neither group was the response to exercise different from baseline. These results suggest that in COPD effective pharmacological bronchodilation at rest may not be predictive of benefits on 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.
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