known to adversely affect patient’s health-related quality of
life.26 Additionally, reduced exercise capacity and dyspnea
are associated with increased mortality.27,28
It has been suggested that the most important factor limiting
exercise endurance in patients with COPD is dynamic
hyperinflation,7 which typically results in decrease inspiratory
capacity during exercise.29 The immediate functional
improvement in exercise endurance afforded by NVA237
(10% vs placebo on Day 1) is therefore potentially significant.
Increased IC with NVA237 may have facilitated
greater expansion of tidal volume, contributing to significant
improvements in dyspnea and exercise endurance.14