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Single-slice Functional Lung MRI During Metronome-Paced Tachypnea Detects Changes in Regional Ventilation Dynamics After a Single Dose of Dual Bronchodilator Treatment in COPD.

Robin A Müller·Andreas Voskrebenzev·Filip Klimeš·Marius M Klein·Frank Wacker·Jens Vogel-Claussen·Jens M Hohlfeld
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Abstract

Dual long-acting bronchodilators are a standard treatment in chronic obstructive pulmonary disease (COPD), aimed at alleviating dyspnea, improving exercise tolerance, and preventing exacerbations. Metronome-paced tachypnea (MPT) offers a feasible alternative to exercise testing for the evaluation of dynamic hyperinflation (DH) in COPD. Because MPT can be performed during MRI, its combination with single-slice phase-resolved functional lung (PREFUL) MRI provides a promising approach to investigate changes in regional ventilation dynamics induced by DH. This approach was evaluated in a randomized, investigator-blinded, placebo-controlled, single-dose (SD) crossover trial with a two-week extension of once daily dual bronchodilator medication, in which patients with stable COPD underwent PREFUL MRI during resting tidal breathing (RTB) and during MPT. During RTB, no significant improvements in MRI-derived parameters were observed after SD treatment compared with placebo. During MPT, however, regional ventilation, flow-volume loop correlation, its defect percentage, and end-expiratory lung area improved significantly after SD treatment compared to the placebo scan (all p&#x2009;<&#x2009;0.02). After multi-dose treatment, five out of six measured parameters improved during MPT, when compared to the baseline scan without bronchodilator treatment (all p&#x2009;<&#x2009;0.03). In contrast to RTB, PREFUL MRI during MPT was able to detect changes in COPD patients already after SD treatment. The combination of MPT and PREFUL MRI represents a promising method to evaluate the effects of dual bronchodilators on regional ventilation dynamics and hyperinflation.

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HumansPulmonary Disease, Chronic ObstructiveBronchodilator AgentsMagnetic Resonance ImagingCross-Over StudiesMaleAgedLungFemaleTachypneaMiddle AgedPulmonary VentilationForced Expiratory VolumeSalmeterol XinafoateAlbuterolAdrenergic beta-2 Receptor AgonistsMagnetic resonance imagingbronchodilatorhyperinflationtachypneaventilationJournal ArticleRandomized Controlled Trial

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Robin A M&#xfc;ller, Andreas Voskrebenzev, Filip Klime&#x161;, Marius M Klein, Frank Wacker, Jens Vogel-Claussen, Jens M Hohlfeld. 2026-08-12. Single-slice Functional Lung MRI During Metronome-Paced Tachypnea Detects Changes in Regional Ventilation Dynamics After a Single Dose of Dual Bronchodilator Treatment in COPD.. https://doi.org/10.1080/15412555.2026.2706659

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Journal Article; Randomized Controlled Trial resourceAdrenergic beta-2 Receptor Agonists subjectAged subjectAlbuterol subjectBronchodilator Agents subjectCross-Over Studies subjectFemale subjectForced Expiratory Volume subjectHumans subjectJournal Article subjectLung subjectMagnetic Resonance Imaging subjectMale subjectMiddle Aged subjectRandomized controlled trials studybronchodilator subject

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