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Introduction: Over the past several decades, the use of drug therapy in COPD has expanded, and provides an optimistic picture. Methyixanthines are used freely in COPD. Of them, Theophylline is an age old bronchodilator and anti-inflammatory agent while Acebrophylline is a newer one. Both are used as add on therapy in management of stable COPD patients on LAMA (long acting muscarinic antagonists like Tiotropium) in present day respiratory practice. This study was designed to compare the efficacy as well as tolerability/side-effects of these two drugs at recommended doses., Materials and Methods: An open randomized comparative longitudinal study was conducted on 40 moderate degree COPD patients over a period of one year. The patients were randomized into Group-1:receiving Acebrophylline 100mg twice daily and Group-2: receiving sustained release (SR) Theophylline 300mg once daily orally, in addition to 18μgm Tiotropium inhalation per day through metered dose inhaler. Spirometric variables, symptomatic benefit and adverse effects were recorded on three visits (day '0', '21' and '42'). All the data were analyzed by SPSS version 17., Results: A comparable clinical improvement of symptoms score and spirometric parameters with both the drugs has been observed (p-value>0.05). Amount of sputum, frequency of use of reliever medication and dyspnoea showed improvement with both the drugs but cardiovascular side effects are less with Acebrophylline., Conclusion: This study reaffirms the rationale of use of Methylxanthines as add on therapy with LAMA in COPD management and cardiac safety level with Acebrophylline was considerable.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) has considerable effects on cardiac functions primarily affecting the pulmonary vasculature and then right ventricle along with left ventricle. One of the important causes of increased morbidity and mortality associated with COPD is cor pulmonale. Echocardiography provides a rapid, non-invasive method to evaluate cardiac changes. Our aim was to evaluate RVfunction in COPD as per guidelines of American Society of Echocardiography with an aim to find a simpler way of predicting cardiac morbidity., Materials and Methods: A cross sectional observational study was conducted on 17 COPD patients attending Respiratory Medicine outdoor of R. G. KAR Medical College, Kolkata, India, through history taking, clinical examination, PFT (PFT) and Echocardiography. Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version-17., Results: Fractional area change of RV (FAC-%) was positively correlated with Forced Expiratory Volume in One Second (FEV1) (r = 0.4879), FEV1/ Forced Vital Capacity (FVC) ratio (r = 0.5048) and Peak Expiratory Flow Rate (PEFR) (r = 0.5361). There was strong negative correlation of Systolic Pulmonary Artery Pressure (SPAP) with FEV1/FVC ratio (r = -0.5553) and PEFR (r = - 0.4604). Right Index of Myocardial Performance (RIMP) of right ventricle was negatively correlated with FEV1/FVC ratio (r = - 0.598), PEFR (r = - 0.619), Forced Expiratory Flow (FEF) 25-75 (r = -0.515). Tricuspid annular plane systolic excursion (TAPSE) did not show any association with PFT parameters though it showed strong positive correlation with RV wall thickness., Conclusion: This study substantiates that FAC% and RIMP can be vital prognostic factors for RV function apart from SPAP, TAPSE to define RV dysfunction and predict morbidity in COPD.