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Titolo:
Exercise intolerance following heart transplantation - The role of pulmonary diffusing capacity impairment
Autore:
Al-Rawas, OA; Carter, R; Stevenson, RD; Naik, SK; Wheatley, DJ;
Indirizzi:
Univ Glasgow, Glasgow Royal Infirm, Dept Resp Med, Glasgow G31 2ER, Lanark, Scotland Univ Glasgow Glasgow Lanark Scotland G31 2ER ow G31 2ER, Lanark, Scotland Univ Glasgow, Glasgow Royal Infirm, Dept Cardiac Surg, Glasgow G31 2ER, Lanark, Scotland Univ Glasgow Glasgow Lanark Scotland G31 2ER ow G31 2ER, Lanark, Scotland
Titolo Testata:
CHEST
fascicolo: 6, volume: 118, anno: 2000,
pagine: 1661 - 1670
SICI:
0012-3692(200012)118:6<1661:EIFHT->2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC TRANSPLANTATION; GAS-EXCHANGE; VENTILATORY RESPONSE; TIME-COURSE; FAILURE; RECIPIENTS; ABNORMALITIES; OXYGEN;
Keywords:
cardiopulmonary exercise testing; exercise capacity; heart transplantation; pulmonary diffusing capacity; pulmonary function; pulmonary gas exchange;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Al-Rawas, OA Sultan Qaboos Univ, Coll Med, Dept Med, POB 35,Postal Code 123, Muscat, Oman Sultan Qaboos Univ POB 35,Postal Code 123 Muscat Oman Oman
Citazione:
O.A. Al-Rawas et al., "Exercise intolerance following heart transplantation - The role of pulmonary diffusing capacity impairment", CHEST, 118(6), 2000, pp. 1661-1670

Abstract

Study objectives: Although impairment of the diffusing capacity of the lung for carbon monoxide (DLCO) in heart transplant recipients is well-documented, there are limited data on its impact on exercise capacity in these patients. The aim of this study was to determine the effect of DLCO reduction on exercise capacity in heart transplant recipients. Design: Descriptive cohort study. Setting: A regional cardiopulmonary transplant center. Participants: Twenty-six heart transplant recipients who were studied before and after transplantation compared with 26 healthy volunteers. Measurements: Spirometry and static lung volumes were measured using body plethysmogaphy, DLCO was measured using the single-breath technique, and progressive cardiopulmonary exercise was performed using a bicycle ergometer,continuous transcutaneous blood gas monitoring, and on-line analysis of minute ventilation, oxygen uptake ((V) over dot O-2), and carbon dioxide production. Results: Before transplantation, the mean percent predicted for hemoglobin-corrected DLCO was reduced in patients (73.2%) compared to healthy controlsubjects (98.8%; p < 0.001) and declined significantly after transplantation (60.1%; p < 0.05). Although the mean maximal symptom-limited (V) over dot O-2 ((V) over dot O(2)max) increased after transplantation (increase, 41.3 to 48.6% of predicted; p < 0.05), it remained substantially lower than normal (92.9%; p < 0.001), There was a significant correlation between DLCO and (V) over dot O(2)max after transplantation (r = 0.61; p = 0.001), but not before transplantation (r = 0.09; p = 0.66). DLCO was also inversely correlated with other respiratory responses to exercise, including the following: the ventilatory response to exercise (r = -0.44; p < 0.05); dead space to tidal volume ratio (r = -43; p < 0.05); and the alveolar-arterial oxygen gradient (r = -0.45; p < 0.05), but there was no correlation between any ofthese variables and DLCO before transplantation. Conclusion: DLCO reduction after heart transplantation appears to represent persistent gas exchange impairment and contributes to exercise limitationin heart transplant recipients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 00:33:11