Right and left ventricular response to subcutaneous terbutaline in patients with chronic obstructive pulmonary disease: Radionuclide angiographic assessment of cardiac size and function

To assess the response of the right and left ventricles to the subcutaneous administration of terbutaline sulfate, a beta-2 selective agonist, we evaluated 14 patients with chronic obstructive pulmonary disease (COPD) with equilibrium radionuclide anglography (RNA). Prior to injection, eight patients (57%) had an abnormal right ventricular ejection fraction (RVEF), four (29%) had a low left ventricular ejection fraction (LVEF), and three (21%) had low ejection fractions of both ventricles. After terbutaline injection, RVEF increased in 13 of 14 patients (93%) by 17 ± 8% ( p < 0.001) while LVEF increased in all patients by 15 ± 7% ( p < 0.001). Both left and right ventricular end-diastolic volumes decreased ( p < 0.01), while stroke volume was unchanged. Cardiac output rose by 0.8 ± 1.3 L/min ( p < 0.05), primarily due to the increase in heart rate (10 bpm, p < 0.001), since stroke volume did not significantly change. We conclude that in patients with COPD subcutaneous terbutaline has significant beta-1 cardiac effects; it increases the heart rate and decreases cardiac size.