Effects of Inhaled Furosemide after Indomethacin Premedication on Bronchial Hyperresponsiveness in Patients with Chronic Congestive Heart Failure

Abstract

We studied the effects of inhaled furosemide (40mg) on bronchial responsiveness to acetylcholine (ACh) in patients with chronic congestive heart failure who had been premedicated with indomethacin (75mg/day) for five days. The measurement of bronchial responsiveness was performed by inhaling doses of ACh and calculating the provocative concentration of ACh needed to cause a 20% fall in FEVI_1.0 (PC20-ACh). Inhaled furosemide (N=11) had no effect on resting pulmonary function but did cause a significant increase in the median value of PC20-ACh, from 7.58 to 11.9mg/ml (p<0.01).
Irrespective of premedication with indomethacin, inhaled furosemide reduces bronchial hyperresponsiveness to ACh in patients with chronic congestive heart failure.
Therefore, we speculate that the mechanism of bronchial hyperresponsiveness noticed in our patients is not related to prostaglandins such as PGE₂ or PGI₂.