Inhaled corticosteroid improves bronchial reactivity and decreases symptoms in patients with mitral stenosis.

Abstract

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.