Background: Major lung resection decreases ventilatory capacity and reduces exercise tolerance, impairing postoperative quality of life. But we have often seen respiratory symptoms improve during several years of post...
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Background: Major lung resection decreases ventilatory capacity and reduces exercise tolerance, impairing postoperative quality of life. But we have often seen respiratory symptoms improve during several years of postoperative followup. In the current study, we evaluated postoperative changes in cardiopulmonary function on exertion of patients with, lung cancer surviving for more than three years, and the corresponding changes of their respiratory symptoms. Methods: The effects of pulmonary resection on cardiopulmonary function were evaluated in eight patients with lung cancer. Pulmonary function tests and hemodynamic study at rest and during exercise were performed before, in the early (4 to 6 months) and late (42 to 48 months) postoperative phases after major lung resection. Results: None of the eight patients had any remarkable symptoms before lung resection. In the early postoperative study, the general condition of five patients deteriorated compared with their preoperative status. In the late postoperative study, four patients showed an improvement of their daily activities from the early postoperative phase. Pulmonary function in the late postoperative phase did not show major changes except for airway resistance and percentage of carbon monoxide diffusing capacity as compared with the early phase, which showed deterioration as compared with the preoperative period. Cardiac index and stroke volume index were significantly decreased during exercise on maximal effort in the late postoperative phase compared with other phases. These results suggest that the peak blood now per unit of remaining lung during exercise becomes lower with time after lung resection, indicating deterioration of the condition of the pulmonary vascular bed. The deterioration was also revealed from the pressure-flow curve. Conclusions: The condition of the pulmonary vascular bed after major lung resection does not improve, even in the late postoperative phase, although clinical symptoms we
Background Few studies have investigated the clinical advantages of surgical correction with the morphologic left ventricle (MLV) instead of the morphologic right ventricle as a systemic ventricle (SV) in patients wit...
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Background Few studies have investigated the clinical advantages of surgical correction with the morphologic left ventricle (MLV) instead of the morphologic right ventricle as a systemic ventricle (SV) in patients with congenital heart disease. Methods Twenty-four healthy control subjects (group A1), 6 patients with isolated congenitally corrected transposition of the greet arteries (TGA) (group A2), 16 patients with TGA who had undergone an arterial switch operation (group B1), 18 patients with TGA who had undergone a venous switch operation (group B2), 9 patients with atrioventricular and ventriculoarterial discordance who had undergone a double switch operation (group C1), and 6 patients with atrioventricular and ventriculoarterial discordance who had undergone a conventional external conduit operation From the MLV to the pulmonary artery (group C2), performed treadmill exercise testing. Their heart rate (HR), oxygen uptake ((V)over dotO(2)), and oxygen pulse (O-2 pulse), which reflects individual stroke volume, were measured, and contractile function was assessed by echocardiography. Results The peak HR for the patients after a definitive operation were significantly lower than that in group Al and was correlated with peak(V)over dotO(2) (r = .67 P < .0001). The peak(V)over dotO(2) and peak O-2 pulse for the groups A2 and B2 were significantly lower than those for the groups Al and B1, respectively. The peak O-2 pulse data were strongly correlated with those of peak(V)over dotO(2) (r = 0.91, P < .0001). The left ventricular ejection fraction was significantly lower in groups B1 and C1 than in group Al and was correlated with peak(V)over dotO(2) (r = .50, P < .01). No significant differences in (V)over dotO(2), HR, and O-2 pulse at peak exercise were observed between groups C1 and C2. Conclusions Chronotropic incompetence and an impaired response of the stroke volume of the MRV during exercise are partly responsible for the reduced exercise capacity in groups A2
The aim of the study was to establish patterns of respiratory function in Northern Ireland and to examine the relationship between physical activity, physical fitness and respiratory function. We identified 1600 adult...
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The aim of the study was to establish patterns of respiratory function in Northern Ireland and to examine the relationship between physical activity, physical fitness and respiratory function. We identified 1600 adults over 16 yr using 2 stage probability sampling. Physical activity was measured using a questionnaire, physical fitness from oxygen uptake while walking on a treadmill, and respiratory function using spirometry. The main outcome measures were a physical activity profile based on computer assisted interview, physical fitness by predicted VO(2)max, Forced Vital Capacity (FVC) and Forced Expiratory Volume (FEV1). We found that the main findings were of relationships between activity and FVC and FEV 1 which remained after adjustment for possible confounders in men, and between fitness and FVC and FEV 1 in both men and women although these were not sustained after adjustment for possible confounder.
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