Inhaled Corticosteroid Improves Bronchial Reactivity and Decreases Symptoms in Patients With Mitral Stenosis

¹ From the Department of Cardiosurgery, Silesian School of Medicine Zabrze, Poland; and the Division of Basic Sciences, Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO
² From the Department of Cardiosurgery, Silesian School of Medicine Zabrze, Poland
³ From the Division of Basic Sciences, Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO

Erwin W. Gelfand, MD, Department of Pediatrics, National Jewish Medical and Research Center, 1400 Jackson St, Denver, CO 80206; e mail: gelfande{at}njc.org

Study objective: To determine if treatment with inhaled budesonide forte can diminish increased bronchial hyperreactivity and improve symptoms in patients with mitral valve stenosis.

Design: The study was randomized, double blind, and placebo controlled.

Setting: Outpatient/university hospital.

Patients: Twelve subjects, 8 female and 4 male, who qualified for mitral valve replacement. All subjects presented with increased bronchial reactivity to histamine at the time of the study.

Interventions: Patients received placebo or budesonide forte twice a day (1,200 mg/d) for 6 weeks. During the study, patients were treated with the same doses of diuretics and other medications that could affect bronchial reactivity.

Measurements: Spirometry, provocative concentration of histamine causing a 20% fall in the FEV₁ (PC₂₀H), symptom scores.

Results: In the treated group, the initial PC₂₀H was 0.82 ± 0.72 mg/mL; in the placebo group 1.39 ± 1.3 mg/mL. After 6 weeks of treatment, PC₂₀H was significantly higher (3.07 ± 2.28 mg/mL; p > 0.01) in the budesonide-treated group and remained unchanged in the placebo group (1.49 ± 0.91). Symptom scores were significantly lower after administration of budesonide forte (mean change, 4.0 ± 2.6).

Conclusions: Six weeks of treatment with budesonide forte significantly decreased bronchial reactivity to histamine and improved symptoms in patients with mitral valve stenosis.

Key Words: bronchial hyperreactivity • budesonide forte • mitral stenosis

Submitted on October 1, 1997
Accepted on March 25, 1998

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