Abstract
Purpose: We investigated whether dual bronchodilator therapy (glycopyrrolate/formoterol fumarate (GFF, Bevespi Aerosphere®)) would increase exercise tolerance during high intensity constant work rate (CWR) cycle ergometry. We also determined its separate contributions to altering ventilatory requirement (dead space ventilation (VD/VT)) and ventilatory capacity (dynamic hyperinflation (change in inspiratory capacity)). Methods: 48 COPD patients (62.9±7.8y; 33 male; GOLD spirometry 1/2/3, n=2/35/11) performed a randomized, double blind, placebo (PL) controlled, two-week crossover, single center trial. Gas exchange and inspiratory capacity (IC) were assessed during CWR tests at 80% incremental exercise peak work rate. Transcutaneous PCO2 measurement was used for VD/VT estimation. Results: Post-albuterol FEV1 was 1.86±0.58L (64% predicted); FEV1 was 0.18±0.21L greater after GFF than after PL (P Conclusions: GFF increased exercise tolerance in COPD patients; the increase was greatest in severe COPD and was accompanied by attenuated dynamic hyperinflation; VD/VT change did not alter the ventilatory requirement.
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