Acute effect of salbutamol on the cardiovascular system during exercise in patients with moderate or severe asthma: a randomized, double-blind, and cross-over study

ABSTRACT Salbutamol is a β2-agonist of short duration commonly used in patients with asthma to prevent symptoms during or after exercise. Hemodynamic changes at rest are well described. However, there is little data on the effects on heart rate (HR) and blood pressure (BP) during exercise and recovery phase in patients with moderate or severe asthma A randomized, double-blind, cross-over study was conducted, including 15 individuals with moderate and severe asthma, mean age 46.4±9.3 years. Patients underwent a maximal 2-day exercise test with 400 mcg salbutamol or 4 placebo puffs. Throughout the protocol, HR, BP, perceived exertion and peak of expiratory flow (PEF) were monitored. After the use of salbutamol, the PEF value increased by a mean of 28.0±47.7L/m, remaining increased at 5, 10 and 15 minutes of passive recovery compared to placebo (p0.05). These results suggest that the use of salbutamol is safe and that HR does not need to be adjusted to prescribe exercise intensity following salbutamol administration in subjects with moderate or severe asthma.

摘要 沙丁胺醇（Salbutamol）是一种短效β₂受体激动剂，常用于哮喘患者以预防运动中或运动后出现的症状。静息状态下的血流动力学变化已有充分报道，但目前关于沙丁胺醇对中重度哮喘患者运动及恢复阶段的心率（heart rate, HR）、血压（blood pressure, BP）的影响数据仍较为匮乏。本研究采用随机双盲交叉试验设计，纳入15名中重度哮喘患者，平均年龄为46.4±9.3岁。所有受试者接受为期2天的最大负荷运动试验，分别吸入400μg沙丁胺醇或4揿安慰剂。试验全程监测受试者的心率、血压、自觉劳累程度及呼气峰流速（peak expiratory flow, PEF）。吸入沙丁胺醇后，受试者的呼气峰流速均值升高28.0±47.7L/m，相较于安慰剂组，被动恢复阶段的5、10及15分钟时该指标仍维持升高（P<0.05）。本研究结果提示，沙丁胺醇的使用安全性良好，且对于中重度哮喘患者，在吸入沙丁胺醇后制定运动强度时无需调整心率水平。