Document Detail


Assessment of pulmonary artery systolic pressures by stress Doppler echocardiography after bilateral lung transplantation.
MedLine Citation:
PMID:  18187089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Even after successful single-lung transplantation (SLTx) or bilateral lung transplantation (BLTx), patients continue to have peripheral muscle weakness and exercise impairment. After SLTx, exercise limitation is also attributed to persistent or recurrent pulmonary vascular abnormalities with elevated pulmonary arterial pressures at rest or during exercise. Therefore, the aim of this study was to evaluate systolic pulmonary artery pressures (PASPs) at rest and during supine bicycle exercise, exercise capacity and cardiopulmonary function in post-BLTx patients. METHODS: Nine patients underwent BLTx due to end-stage pulmonary arterial hypertension (PAH) and 37 age- and gender-matched control subjects underwent a physical examination, electrocardiographic (ECG) test, a 6-minute walk test, a lung function test, a cardiopulmonary exercise test and echocardiographic assessment at rest and during exercise. RESULTS: Exercise capacity was significantly reduced in the BLTx group, with an impaired 6-minute walk test and maximal oxygen uptake and workload. Ventilatory factors did not appear to limit exercise capacity. Right and left ventricular size and pump function and PASP values at rest were normal in both groups, but exceeded 40 mm Hg in 3 of 9 BLTx recipients and in 1 of 37 controls during exercise at low workloads. Mean PASP during exercise was only slightly higher in the BLTx group (40 +/- 5 vs 36 +/- 4 mm Hg, p = not statistically significant). CONCLUSIONS: Reduced exercise capacity of patients after BLTx due to end-stage pulmonary hypertension is not attributed to persistent or recurrent manifest pulmonary hypertension or cardiopulmonary dysfunction. Nevertheless, latent pulmonary hypertension with exaggerated pulmonary artery pressures during exercise may occur in some patients.
Authors:
Marie-Theres Kasimir; Derliz Mereles; Clemens Aigner; Peter Jaksch; Andreas Benz; Sandra Kreuscher; Walter Klepetko; Ekkehard Grünig
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  27     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-11     Completed Date:  2008-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  66-71     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, General Hospital Vienna, Medical University of Vienna, Vienna, Austria. marie-theres.kasimir@meduniwien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Echocardiography, Doppler / methods*
Echocardiography, Stress / methods*
Exercise Test
Exercise Tolerance / physiology
Female
Follow-Up Studies
Humans
Hypertension, Pulmonary / physiopathology,  surgery*
Lung Transplantation / methods*
Male
Prognosis
Pulmonary Artery / physiopathology,  ultrasonography*
Pulmonary Wedge Pressure / physiology*
Respiratory Function Tests
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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