The transannular patch (TAP) repair used in the correction of tetralogy of Fallot (TOF) inevitably causes pulmonary regurgitation. We report herein the results of a long-term follow-up study conducted on 50 patients who had undergone a TAP repair 20-29 years earlier to evaluate the influence of pulmonary regurgitation on their ...

PURPOSE: To assess quantitative high-resolution CT (quantitative CT) as a diagnostic and prognostic tool in pulmonary lymphangioleiomyomatosis. METHODS: Spirometry, lung volumes, diffusing capacity, exercise physiology, and expiratory high-resolution CT (HRCT) examinations were performed on a cohort of ten patients with the diagnosis of lymphangioleiomyomatosis (LAM) referred to a tertiary care ...

Inhaled nitric oxide (NO) as a complementary treatment was studied in 10 neonates during extracorporeal membrane oxygenation (ECMO) therapy of various persistent pulmonary hypertension of the newborn (PPHN)-associated diseases. At individually different levels of inhaled NO (20-80 ppm), the mean Pao2 increased by 59.7% in 6 responders, but it remained ...

Pulmonary histiocytosis X (PHX) is a diffuse, smoking-related lung disease characterized pathologically by bronchocentric inflammation, cyst formation, and widespread vascular abnormalities and physiologically by exercise limitation. The major mechanism underlying exercise impairment in this disease has not been previously defined. Spirometry, lung volumes, lung mechanics, and exercise physiology were performed ...

The major objective of this lecture is to describe the effects of inhaling low levels of nitric oxide (NO) on the hemodynamic and gas exchange function of both the normal and diseased lung. Considerable attention will be paid to safety and hazards of inhaled NO therapy. During the past few ...

We attempted to determine if expired gas analysis during exercise testing has equal value to the unilateral pulmonary artery occlusion test (UPAO). Sixty-four lung cancer patients were evaluated. We performed UPAO and measured mean pulmonary artery pressure (PPA) and cardiac output (C.O.) 15 min later, and calculated total pulmonary vascular ...

Pulmonary extravascular water accumulation may be involved in exercise-induced hypoxaemia in highly aerobically trained athletes. We hypothesized that if such an alteration were present in elite athletes performing a maximal exercise test, the impairment of gas exchange would be worse during a second exercise test following the first one. Eight ...

STUDY DESIGN: Seventy patients (average age, 13.8 years) with adolescent idiopathic right thoracic scoliosis had full assessment of pulmonary functions and radiographic evaluation of spinal and thoracic cage deformities and their flexibilities. OBJECTIVES: To determine how measurements of spinal and thoracic cage deformities related to pulmonary function. SUMMARY OF BACKGROUND ...

The present study was undertaken to determine whether exercise-training for 6 weeks would inhibit pulmonary vasoconstriction induced by hypoxia in isolated, blood-perfused rat lungs. Hypoxic pulmonary vasoconstriction (HPV) and angiotensin II (AII)-induced pulmonary vasoconstriction were significantly less in the exercise-trained (ET) group than in the control (cont) group with all ...

To compare the short-term effects of postural drainage with clapping (PD) and autogenic drainage (AD) on oxygen saturation, pulmonary function, and sputum recovery, we studied ten patients with cystic fibrosis (CF) randomly treated with PD or AD on separate days. Pulse oximetry was monitored and sputum was collected during and ...

STUDY OBJECTIVE: To quantify simultaneously the pulmonary and gastrointestinal (GI) damage that occurs during uncomplicated surgery requiring cardiopulmonary bypass (CPB), and to examine the relationships between markers of such damage. DESIGN: Prospective, open. SETTING: Adult ICU of a national referral hospital. PATIENTS: Twenty patients undergoing elective CPB surgery. MEASUREMENTS AND ...

The purpose of this study was to evaluate the impact of an aortopulmonary shunt on exercise capacity in long-term survivors after total repair of tetralogy of Fallot (17.6(2.0) years' follow-up). Submaximal exercise tests, pulmonary function tests, lund diffusion tests for carbon monoxide, two-dimensional and Doppler echocardiography were performed in 12 ...

During exercise, pulmonary gas exchange in reptiles was predicted to differ from that in mammals because of their less complex lung structure, which might reduce ventilation-perfusion heterogeneity (V/QL) at the expense of pulmonary diffusion limitation. To investigate this, the multiple inert gas elimination technique was used in six Varanus exanthematicus ...

Normal reference values of the pulmonary diffusing capacity for carbon monoxide (DLCO), diffusing capacity of the membrane (DMCO), and pulmonary capillary blood volume (VC) were derived by a rebreathing technique in 44 normal, healthy, nonsmoking individuals ranging from 17 to 68 yr of age. Simultaneous measurements of DLCO, lung volumes, ...

Clinical exercise testing has been used mainly to assess the cardiac response to exercise. Integrative cardiopulmonary exercise tests (CPET) involving the measurement of the ventilatory, circulatory and metabolic response to exercise has largely been a research tool. We analysed the results of one hundred tests randomly chosen from a total ...

Postoperative pulmonary artery pressure and resistance were assessed during exercise in 32 patients late after repair of large ventricular septal defect with pulmonary hypertension. Nineteen patients had a preoperative pulmonary-to-systemic resistance ratio of between 0.15 and 0.50 (group 1) and 13 had a ratio between 0.50 and 0.96 (group 2). ...

RATIONALE AND OBJECTIVES: We assessed the value of quantitative high-resolution computed tomography (CT) as a diagnostic and prognostic tool in smoking-related emphysema. METHODS: We performed an inception cohort study of 14 patients referred with emphysema. The diagnosis of emphysema was based on a compatible history, physical examination, chest radiograph, CT ...

This study was designed to test the hypothesis that pulmonary artery pressure at rest and during exercise differs between patients with a transplanted heart and normal subjects and to determine the mechanisms responsible for the difference. Twenty-one patients who had undergone heart transplantation 1.5 to 27 months earlier without current ...

OBJECTIVE: To compare the effects of comprehensive pulmonary rehabilitation with those of education alone on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. DESIGN: Randomized clinical trial. SETTING: University medical center. PATIENTS: 119 outpatients with chronic obstructive pulmonary disease that was stable while patients received a standard ...

In patients with tetralogy of Fallot and absent pulmonary valve, the dilated pulmonary arteries sometimes result in bronchial compression and pulmonary symptoms due to airway obstruction, recurrent pulmonary infection, and development of bronchiectasis. After complete intracardiac repair, residual pulmonary disease may be expected to result in impaired cardiopulmonary performance during ...

Pulmonary diffusion capacity (DLCO) is reduced 2 h after various types of exercise, such as rowing, treadmill running, arm cranking and marathon running. The decrease in DLCO may involve alterations in the alveolar-capillary membrane as well as depletion of the central blood volume. We hypothesized that the reduction in DLCO ...

The ability to successfully exercise has been used to assess the cardiopulmonary risk of thoracotomy for lung cancer. Because of musculoskeletal, neurologic, peripheral vascular, or behavioral problems, not all patients presenting for pulmonary resection are capable of exercising. Using a multifactorial cardiopulmonary risk index (CPRI) consisting of a cardiac risk ...

Patients with sarcoidosis are known to have histologic pulmonary abnormalities despite normal lung fields or conventional pulmonary function or both. These patients permit a useful assessment of the alleged greater sensitivity of the various measurements made during incremental cardiorespiratory exercise testing. Abnormal responses on such testing may provide insight into ...

The pulmonary blood-gas barrier has a basic physiological dilemma. On the one hand it needs to be extremely thin for efficient gas exchange. On the other hand it also needs to be immensely strong because the stresses on the pulmonary capillary wall become extremely high when the capillary pressure rises ...

Nitric oxide (NO) is a potent endogenous vasodilator. Its role in the normal and stressed pulmonary circulation is unclear. To better understand the importance of endogenous NO in normal physiological responses, we studied the effects of altered NO availability on the change in pulmonary vascular tone that accompanies exercise. In ...

We evaluated whether the postexercise reduction of pulmonary diffusion capacity for carbon monoxide (DLco) is influenced by a second bout of rowing and whether it affects arterial O2 tension during maximal exercise. After exercise, DLco was reduced [from a median of 37 (range of 30-44) to 34 (27-40) ml.min-1.mmHg-1; n ...

To investigate pulmonary gas exchange during exercise in athletes, 10 high aerobic capacity athletes (maximal aerobic capacity = 5.15 +/- 0.52 l/min) underwent testing on a cycle ergometer at rest, 150 W, 300 W, and maximal exercise (372 +/- 22 W) while trace amounts of six inert gases were infused ...

Patients with pulmonary hypertension (PH) have a cardiac limitation characterized by a decreased resting stroke index (SI) and an inability to augment stroke volume with exercise. We tested the hypothesis that a noninvasive estimation of SI, either at rest or with exercise, could be used to identify the presence and ...

BACKGROUND AND PURPOSE: The purpose of this investigation was to measure the effects of a 10- to 14-day comprehensive, intensive hospital treatment program on peak exercise capacity, endurance capacity, respiratory function, weight change, and maximum inspiratory and expiratory mouth pressures in patients with cystic fibrosis with a pulmonary exacerbation. SUBJECTS: ...

Controlled studies have demonstrated that the correction of tissue hypoxia increases survival and reduces pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD) receiving oxygen therapy 15 h/day or longer. Long-term oxygen therapy (LTOT) is recommended to any patient with COPD who has a PaO2 of < or = ...

Integrative cardiopulmonary exercise testing has evolved from a specialized research laboratory tool into a valuable clinical test that is especially useful for assessment of symptoms of exertional dyspnea and exercise intolerance. There is increasingly convincing evidence that evaluation and quantitation of impairment are enhanced by use of exercise testing. In ...

To study the time course of exercise performance and the diffusion capacity after heart transplantation, we submitted two groups of patients to graded symptom-limited supine exercise. Patients in group 1 (n = 11) underwent operation 12.9 +/- 7.0 months before the study; those in group 2 (n = 10) underwent ...

Referrals to pulmonary physicians for polysomnography to evaluate snoring or the possibility of sleep apnea syndrome often evolve into a multidisciplinary clinical problem. We present a young woman with two congenital abnormalities (Marfan's syndrome and retrognathism) which both may affect her decreased exercise tolerance, daytime hypersomnolence, and fatigue. Polysomnography and ...

Changes of both central hemodynamics and peripheral circulation in non-exercising muscle were investigated in 17 patients after successful orthotopic heart transplantation during moderate supine isotonic leg-exercise. Changes of peripheral circulation were measured in 14 healthy controls. The cardiac output rose from 5.71 to 9.45 l/min, the right atrial pressure from ...

INTRODUCTION: Cardiopulmonary exercise testing (CPX) is considered a useful procedure in the evaluation of circulatory, ventilatory, or mixed origin of reduced exercise tolerance. Our study was designed to compare CPX and a standard clinical-instrumental approach in the evaluation of patients with cardiopulmonary disorders. METHODS: Fifty-seven patients (31 male, 26 female; ...

BACKGROUND: Theophylline is a well known bronchodilator which has been used for more than 50 years in the treatment of obstructive pulmonary diseases. In patients with severe chronic obstructive pulmonary disease whose cardiopulmonary performance is limited by their ventilatory capacity the administration of theophylline may improve exercise performance. METHODS: A ...

Previous approaches to the measurements of pulmonary diffusing capacity (DL) and pulmonary capillary blood flow (QC) utilized either the rebreathing or the single inhalation technique in conjunction with radioisotope gas and mass spectrometry. In the present study, we utilized a newly developed rapid infrared analyzer in conjunction with the slow ...

Non smoking, male professional firemen-divers (n = 20) underwent two pulmonary function tests (PFT) separated by 8-9 years. Measured data were compared to European Coal Steel Community recommended reference values to permit cross-sectional and then longitudinal studies. Higher vital capacity (VC) and forced expiratory volume in 1 s (FEV1; both ...

Arterial PO2 measurement during exercise is an important part in the evaluation of pulmonary disease but requires an intra-arterial cannula. However, in clinical work it would be preferable to assess PO2 non-invasively. To evaluate such a technique, simultaneous measurements of transcutaneous PO2 (tcPO2) and arterial PO2 (PaO2), sampled from an ...

We compared the value of exercise testing and measurement of pulmonary haemodynamics (PH) in the pre-operative assessment of 5 patients (mean age: 64 years, 3 men) with clinical stage I or II bronchogenic carcinoma and severe chronic obstructive pulmonary disease. They were considered at high risk due to poor pulmonary ...

Nitric oxide (NO) is present in the exhaled breath of humans and experimental animals, but its physiologic role and cellular source(s) remain to be determined. Possible sites of origin are pulmonary endothelial cells and/or resident macrophages. Here we have tested the hypothesis that changes in cardiovascular status can alter the ...

It is known that pulmonary function is impaired during the course of HIV infection even in early stages. In order to estimate the resulting reduction of exercise capacity, different groups of HIV patients were investigated. Group 1 consisted of 20 patients without a history of respiratory disease and without actual ...

The clinical and haemodynamic effects of 12 weeks of treatment with torasemide, 5 mg/day, were measured in 24 men aged 51-60 years with symptoms of mild, chronic, congestive heart failure. Clinical status was assessed by NYHA functional class and haemodynamic effects were measured at rest and during supine bicycle exercise ...

Although long-term evaluations of patients after repair of total anomalous pulmonary venous connection have generally shown them to be clinically asymptomatic, assessment of their cardiovascular and pulmonary systems have been limited. Residual cardiopulmonary abnormalities undetected at rest may result in impaired function during exercise. To evaluate this hypothesis 9 patients ...

During exercise (especially in hypoxia), the alveolar-arterial O2 tension difference increases. This impairment of pulmonary gas exchange is caused partly by diffusion disequilibrium, but it has also been shown that an exercise-induced increase in ventilation-perfusion (VA/Q) inequality develops. Possible explanations of increased VA/Q mismatch include nonuniform pulmonary vasoconstriction, reduced gas ...

We examined 21 miners by means of standard chest radiography, high-resolution computerized tomography (HRCT), pulmonary function tests, and resting arterial blood gas levels. Using the ILO/UC classification of pneumoconiosis, 7 miners had category 1/0 or 2/1 simple coal workers' pneumoconiosis (CWP). By HRCT, nodules were identified in 12 miners; 4 ...

We have compared the maximal and endurance exercise capacities in 22 (15 male) adult cystic fibrosis (CF) patients with a resting oxygen saturation (SaO2) > or = 90%, with age and sex matched controls (CON). The maximum oxygen uptake (VO2max) and heart-rate were lower for the CF group whereas the ...

To evaluate the reliability of noninvasive oximeters during exercise in patients with cystic fibrosis (CF), we studied 9 patients during exercise tests, using 3 devices (Hewlett-Packard 47201A, Biox-Ohmeda 3700, Nellcor 100), comparing oximetry readings with arterial blood co-oximetry. Fifty samples from preexercise, exercise, and recovery were collected; and paired measurements ...

OBJECTIVE: To determine the mechanisms for exercise impairment in symptomatic patients with systemic sclerosis (SSc) using breath-by-breath expired-gas analysis with incremental exercise testing. DESIGN: Prospective, open trial. PATIENTS AND METHODS: Fifteen consecutive patients with SSc seen at the Medical University Hospital (a tertiary referral center) with complaints of exercise intolerance ...

The effects of theophylline on pulmonary function and gas exchange during rest, sleep, and exercise were assessed in 10 patients with severe but stable chronic obstructive pulmonary disease (COPD; median FEV1, 31% of predicted). The study was randomized, double blind, placebo controlled, and crossover in design, with each study period ...