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Europace 2004 6(6):602-607; doi:10.1016/j.eupc.2004.07.010
© 2004 by European Society of Cardiology
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Comparison of the effects of ipratropium bromide and salbutamol on autonomic heart rate control

Dayimi Kayaa, Irfan Barutcub,*, Ali Metin Esenb, Ersel Onratc, Ayse Ormand and Mehmet Unlud

aDepartment of Cardiology, Ege Saglik Hospital Izmir, Turkey; bDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital Istanbul, Turkey; cDepartment of Cardiology, Afyon Kocatepe University, School of Medicine Afyon, Turkey; dDepartment of Chest Disease, Afyon Kocatepe University, School of Medicine Afyon, Turkey

AIMS: B2-agonists and anticholinergic drugs may alter cardiac autonomic modulation. The aim of this study was to investigate the effects of inhaled salbutamol and ipratropium bromide on heart rate variability (HRV).

METHODS AND RESULTS: A randomized, double-blind, crossover design study was conducted on 13 healthy volunteers. Salbutamol, ipratropium or placebo was administered in three different testing sessions. Time domain parameters; mean R–R interval (mean-RR), the standard deviation of R–R interval (SDNN) and the root mean square of successive R–R interval differences (RMSSD) and power spectral analysis of HRV were assessed in the supine position and during handgrip exercise before and after taking each drug. In time domain analyses, ipratropium administration resulted in a reduced mean-RR, SDNN and RMSSD during handgrip exercise compared with baseline values (775 ± 30 ms vs. 748 ± 21 ms, P < 0.05; 57 ± 5 ms vs. 50 ± 5 ms, P < 0.05; 30 ± 2 ms vs. 26 ± 2 ms, P < 0.01, respectively). This effect was not detected with salbutamol or placebo administration. In frequency domain analyses, salbutamol but not ipratropium and placebo inhalation increased high frequency power/total power during handgrip exercise compared with baseline (0.09 ± 0.02 vs. 0.12 ± 0.02, P < 0.05).

CONCLUSION: Ipratropium inhalation may alter autonomic control of the heart rate in therapeutic doses during mild sympathetic stimulation in healthy subjects, while salbutamol does not show these effects.

Key Words: ipratropium, salbutamol, heart rate variability, handgrip exercise, autonomic nervous system

*Corresponding author. 19 mayis mahallesi sarikanarya sok. Muhsinbey Apt. No: 25/17-Kozyatagi, Istanbul, Turkey. Tel.: +90 216 384 64 13; fax: +90 216 339 04 41. E-mail address: irfanbarutcu{at}yahoo.com (I. Barutcu).


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