{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:42:08Z","timestamp":1784238128635,"version":"3.55.0"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science Fund of the Lithuanian University of Health Sciences"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Dual bronchodilation in chronic obstructive pulmonary disease (COPD) has demonstrated beneficial effects on health-related quality of life (HRQoL) and exercise-related outcomes. Real-world evidence in treatment-na\u00efve COPD remains limited. Materials and Methods: Forty-six COPD patients and 23 age-, gender-, BMI-, and cardiovascular comorbidity\u2013matched controls underwent spirometry, plethysmography, symptom-limited incremental cardiopulmonary exercise testing (CPET), and the 36-item Short-Form Health Survey (SF-36). Following baseline assessment, COPD patients received tiotropium\/olodaterol as part of routine practice. Thirty-two patients underwent repeated examinations at 12 weeks. Baseline differences between the COPD and control groups were assessed, and longitudinal changes in pulmonary function, CPET, and SF-36 were evaluated in COPD patients. Results: Compared with controls, COPD patients had lower peak oxygen uptake (VO2; 17.4 \u00b1 4.4 vs. 22.8 \u00b1 4.5 mL\/kg\/min, p &lt; 0.001) and oxygen pulse (11.5 \u00b1 3.5 vs. 14.0 \u00b1 2.4 mL\/beat, p = 0.003), failed to reach 80% of predicted values, and exhibited worse ventilatory efficiency (p &lt; 0.001). SF-36 scores in the COPD group were lower across all domains. After 12 weeks of tiotropium\/olodaterol, pulmonary function improved significantly. CPET was performed at comparable efforts at both visits. Peak VO2 increased from 70 \u00b1 15 to 75 \u00b1 16% predicted (p = 0.044), and peak oxygen pulse from 74 \u00b1 16 to 79 \u00b1 16% predicted (p = 0.015). VE\/MVV decreased from 0.77 \u00b1 0.23 to 0.69 \u00b1 0.15 (p = 0.03). Higher baseline VE\/MVV predicted a larger improvement after treatment (B = 0.71, p &lt; 0.001), while beta-blocker use had no effect on the change of VE\/MVV. SF-36 physical functioning and health change scores improved (both p &lt; 0.01). Conclusions: At diagnosis, COPD was associated with impaired exercise physiology and reduced HRQoL. Dual bronchodilation improved exercise responses and perceived physical functioning. Beta-blocker use was not associated with changes in breathing reserve, supporting the use of cardioselective agents when indicated.<\/jats:p>","DOI":"10.3390\/medicina62030531","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:46:31Z","timestamp":1773326791000},"page":"531","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-World Impact of Initial Dual Bronchodilation on Exercise Physiological Response and Health-Related Quality of Life in Newly Diagnosed, Treatment-Na\u00efve Chronic Obstructive Pulmonary Disease"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1275-1169","authenticated-orcid":false,"given":"Ieva","family":"Dimiene","sequence":"first","affiliation":[{"name":"Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deimante","family":"Hoppenot","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5418-3269","authenticated-orcid":false,"given":"Airidas","family":"Rimkunas","sequence":"additional","affiliation":[{"name":"Laboratory of Pulmonology, Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neringa","family":"Vaguliene","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8933-5283","authenticated-orcid":false,"given":"Kristina","family":"Bieksiene","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Zemaitis","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kestutis","family":"Malakauskas","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6130-0712","authenticated-orcid":false,"given":"Skaidrius","family":"Miliauskas","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/S0873-2159(15)30266-X","article-title":"Outcomes for COPD pharmacological trials: From lung function to biomarkers","volume":"14","author":"Cazzola","year":"2008","journal-title":"Rev. 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