Altered cardiovascular autonomic regulation after salmeterol treatment in asthmatic children
Tuomas T. Jartti
Department of Paediatrics, Turku University Hospital, Finland,
Department of Clinical Physiology, Turku University Hospital, Finland,
Search for more papers by this authorTimo J. Kaila
Department Clinical Pharmacology, Turku University Hospital, Finland,
Search for more papers by this authorKari U. O. Tahvanainen
Department of Clinical Physiology, Tampere University Hospital, Finland,
Search for more papers by this authorTom A. Kuusela
Department of Applied Physics, Laboratory of Electronics, University of Turku, Finland,
Search for more papers by this authorTimo T. Vanto
Department of Paediatrics, Turku University Hospital, Finland,
Search for more papers by this authorIlkka A. T. Välimäki
Department of Paediatrics, Turku University Hospital, Finland,
Cardiorespiratory Research Unit, University of Turku, Finland
Search for more papers by this authorTuomas T. Jartti
Department of Paediatrics, Turku University Hospital, Finland,
Department of Clinical Physiology, Turku University Hospital, Finland,
Search for more papers by this authorTimo J. Kaila
Department Clinical Pharmacology, Turku University Hospital, Finland,
Search for more papers by this authorKari U. O. Tahvanainen
Department of Clinical Physiology, Tampere University Hospital, Finland,
Search for more papers by this authorTom A. Kuusela
Department of Applied Physics, Laboratory of Electronics, University of Turku, Finland,
Search for more papers by this authorTimo T. Vanto
Department of Paediatrics, Turku University Hospital, Finland,
Search for more papers by this authorIlkka A. T. Välimäki
Department of Paediatrics, Turku University Hospital, Finland,
Cardiorespiratory Research Unit, University of Turku, Finland
Search for more papers by this authorAbstract
The effects of therapeutic 4 weeks' inhaled salmeterol treatment on the cardiovascular and respiratory autonomic nervous regulation was studied in 11 asthmatic children using inhaled corticosteroid medication. The study followed a randomized, double-blind, placebo-controlled cross-over design. The salmeterol dose was 50 μg twice daily. The 4-week salmeterol treatment increased baseline heart rate, low-frequency/high-frequency (LF/HF) variability ratio of R–R intervals, LF variability of systolic arterial pressure (SAP) and maximum tidal volume during the deep breathing test, as well as morning and evening peak expiratory flow (PEF) values. The 4-week salmeterol treatment decreased baseline HF variability of R–R intervals. As a response to the acute 600 μg of salbutamol, the changes in heart rate, HF variability of R–R intervals and diastolic blood pressure were significantly smaller after 4 weeks' salmeterol treatment. In conclusion, 4 weeks' therapeutic salmeterol treatment decreases basal cardiovagal reactivity, increases sympathetic dominance in the cardiovascular autonomic balance and improves pulmonary function. A tolerance develops in the cardiovascular response but not in the bronchodilatory response.
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