Fraunhofer Institute for Toxicology and Experimental Medicine
Previous research, such as the CLAIM study (DOI: 10.1016/S2213-2600(18)30054-7) has shown that dual bronchodilation can improve heart function in COPD. Now, an investigator-initiated trial conducted at Fraunhofer ITEM has gone a step further: it systematically explored how quickly these effects occur and how the autonomic nervous system is involved.
In a randomized cross-over design, 32 patients with severe lung hyperinflation received either a single dose of dual bronchodilation with Tiotropium/Olodaterol or placebo, followed by 14 days of daily Tiotropium/Olodaterol. Using cardiopulmonary magnetic resonance imaging (MRI) and additional lung function tests, heart filling, lung volume, and blood flow were precisely measured. The results showed that the lungs responded immediately. After the first inhalation, residual volume decreased significantly and the airways opened. Filling of the left ventricle increased compared to placebo after the single dose, but a clear improvement relative to baseline was observed only after two weeks of daily treatment.
For the first time, this study also examined sympathetic nervous system activity. After a single dose, only a very small, statistically non-significant increase was observed. Thus, there is no indication of a relevant immediate activation of the cardiovascular system by dual bronchodilation. The results were published in the journal ERJ Open Research (DOI: 10.1183/23120541.01282-2025).
