The effect of tiotropium/olodaterol on lung, right ventricular function and serum troponin I levels in patients with moderate chronic obstructive pulmonary disease

<bold>BACKGROUND:</bold> Dual bronchodilation has shown a positive effect on cardiac function in patients with chronic obstructive pulmonary disease (COPD). <bold>AIMS AND OBJECTIVES:</bold> To evaluate the efficacy of tiotropium/olodaterol (TIO/OLO) fixed-dose combination on lung, right ventricular function and serum troponin I in patients with moderate COPD. <bold>METHODS:</bold> Plethysmography, cardiac magnetic resonance imaging and serum troponin I were evaluated in patients with newly diagnosed moderate COPD before treatment with TIO/OLO and after 12 weeks. <bold>RESULTS:</bold> Thirty-four subjects were enrolled, 25 completed the study. After 12 weeks residual volume (RV) decreased from 158% (IQR 41.5) to 141% (IQR 39) (p=0.025), RV-to-total lung capacity (TLC) ratio from 133% (IQR 22) to 122% (IQR 27.5) (p=0.004) and functional residual capacity-to-TLC ratio from 118% (IQR 18) to 113% (IQR 12.5) (p=0.015). The median right ventricular ejection fraction at baseline was 59% (IQR 11) and did not change significantly. Right ventricular global longitudinal strain improved from -22.72% (IQR 6.44) to -23.97% (IQR 7.51) (p=0.021). Right ventricular end-systolic, end-diastolic and stroke volumes (all indexed for body surface area) did not change during the study. All patients had normal serum troponin I levels at baseline which decreased after 12 weeks (from 1.27 [IQR 0.51] to 1.09 pg/ml [IQR 0.23], p=0.034). <bold>CONCLUSION:</bold> COPD treatment with TIO/OLO not only improves lung function but also might have a positive effect on right ventricular strain and reduce serum troponin I levels. Due to cardiovascular involvement in COPD early use of dual bronchodilation is very important.