Continuous indacaterol treatment improves autonomic cardiac regulation in COPD patients

Autonomic heart rate control is significantly altered with sympathetic predominance in COPD patients [van Gestel A. et al.,2012]. Long-acting beta-agonists (LABA) may potentially influence on autonomic cardiac regulation. Aim: to evaluate effect of LABA indacaterol on autonomic control of heart rate in patients with COPD. Study design: prospective, open. 25 outpatients with COPD B,C groups (GOLD 2013) were included in the study. Methods: vital signs, spirometry and autonomic heart control via heart rate variability evaluation ("SphygmoCor", AtCor Medical, Australia) were assessed. Data were collected at baseline and after 3 months treatment with indacaterol 150 mg (Onbrez Breezhaler) inhalation once daily. All patients had started indacaterol treatment no less than1month before baseline assessment. Mean FEV1 was 54.0±16.7% pred. (M±m), FEV1/FVC - 68,1±3.7%, systolic pulmonary artery pressure (SPAP) - 28,5±1,8 mm Hg and TAPSE index - 18.6±0.7. Results: Indacaterol caused significant correction of HRV abnormal sympathetic predominance in COPD patients. Absolute low frequency power decreased by 222.3±87.6 ms2(p=0.03), normalized high frequency power increased by 10.7±3.3 n.u. (p=0.01), LF/HF ratio decreased by 1.49±0.43 (p=0.04). No significant changes of vital signs and spirometry data were found. Conclusion: continuous indacaterol treatment improves autonomic heart regulation in patients with COPD.