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. 2018 Feb;196(1):15-18.
doi: 10.1007/s00408-017-0079-1. Epub 2017 Dec 20.

Sensitivity of Lung Resistance and Compliance to Beta-Blocker Induced Bronchoconstriction and Long Acting Beta-Agonist Withdrawal in COPD

Free PMC article

Sensitivity of Lung Resistance and Compliance to Beta-Blocker Induced Bronchoconstriction and Long Acting Beta-Agonist Withdrawal in COPD

Sunny Jabbal et al. Lung. .
Free PMC article


Little is known about impulse oscillometry (IOS) in COPD. IOS is an effort independent measure of lung resistance and reactance (compliance). We assessed how frequency dependence of resistance (R) and reactance (X) changed in response to bronchoconstriction with carvedilol followed by long acting beta-agonist (LABA) withdrawal. N = 12 patients with moderate to severe COPD were analysed, who had ≥ 100 ml fall in FEV1 with carvedilol. Compared to baseline taking ICS/LABA there were 21, 59, and 135% significant changes in resistance at 5 Hz (R5), reactance at 5 Hz (X5), and reactance area (AX), respectively, with carvedilol, while after LABA withdrawal only AX showed a further significant increase to 210% (i.e. reduced compliance). Hence changes in lung compliance rather than resistance play a more important role in the beta-2 receptor-mediated responses in COPD.

Keywords: Beta-blocker; Bronchoconstriction; COPD; IOS; Oscillometry.

Conflict of interest statement

Conflict of interest

Dr. Jabbal reports personal fees and non-financial support from Chiesi Pharma, personal fees and non-financial support from Pfizer, non-financial support and other from Napp, personal fees and non-financial support from AstraZeneca, personal fees from Boehringer Ingelheim, non-financial support from TEVA, outside the submitted work. Dr. Lipworth reports grants, personal fees and non-financial support from Chiesi, grants, personal fees, non-financial support and other from Boehringer Ingelheim, grants and personal fees from Meda, grants, personal fees and non-financial support from Teva, grants from Janssen, grants from AstraZeneca, grants from Roche, personal fees from Dr Reddys, personal fees from Cipla, personal fees from Lupin, personal fees from Sandoz, grants from Sanofi, outside the submitted work.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


Fig. 1
Fig. 1
Comparison of percentage change from baseline (on ICS/LABA without beta-blocker) in reactance (i.e. compliance: AX, X5) and resistance (R5, R20), and forced expiratory volume in 1 s (FEV1). Asterisk denotes P < 0.05 versus baseline, cross denotes P < 0.05 versus ICS/LABA

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