Document Detail


Cardiopulmonary response to exercise in patients with liver cirrhosis and impaired pulmonary gas exchange.
MedLine Citation:
PMID:  21764574     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Maximal exercise capacity and pulmonary gas exchange are both commonly impaired in liver cirrhosis. Apart from rare cases of hepatopulmonary syndrome, it is still unknown whether these moderate pulmonary gas exchange abnormalities can alter aerobic capacity of cirrhotic patients. Resting pulmonary function tests and symptom-limited cardiopulmonary exercise testing were prospectively investigated in 30 patients with liver cirrhosis exhibiting a widened alveolar-arterial oxygen gradient (P(A-a)O(2) > 30 mm Hg at peak exercise) without pulmonary vascular dilatations at contrast-enhanced echocardiography. Data were compared with those of 30 normoxemic cirrhotic controls (matched for age, gender, body mass index, etiology and severity of liver disease, smoking habits, hemoglobin level, and beta-blocker therapy). Resting cardiopulmonary parameters were within normal range in both groups except carbon monoxide lung transfer (TLCO, 60.4 ± 2.9 vs 74.3 ± 2.8% in controls, p = 0.0004) and P(A-a)O(2) (28.8 ± 2 vs 15.3 ± 2 mm Hg in controls, p < 0.0001). Cirrhotics with impaired gas exchange during exercise exhibited a significant reduction in maximal oxygen uptake (VO(2)max, 1.18 ± 0.07 (53% predicted) vs 1.41 ± 0.07 L/min (62% predicted), p = 0.004), a higher ventilation level at ventilatory threshold (V(E)/VO(2), 39.2 ± 1.5 vs 35.3 ± 1.5, p = 0.01) without ventilatory limitation, and a greater dead space to tidal volume ratio (V(D)/V(T)max, 0.32 ± 0.01 vs 0.25 ± 0.01, p = 0.01). VO(2)max correlates negatively with V(D)/V(T)max (r(2) = 0.36; p < 0.0001). There were no differences in cardiac or metabolic response to exercise between groups. Taken together these findings suggest that clinically undetectable pulmonary vascular disorders can slightly contribute to further reduce exercise capacity of cirrhotic patients.
Authors:
Malcolm Lemyze; Sébastien Dharancy; Remy Nevière; Benoît Wallaert
Related Documents :
3741714 - Plasma catecholamines following exercise in hypertensives treated with pindolol: compar...
8824694 - The effect of acute vs chronic treatment with beta-adrenoceptor blockade on exercise pe...
7150874 - The effect of chlorpromazine, metyrapone, imipramine and skf 525-a on the hepatic first...
15542284 - Interaction between cardiac sympathetic drive and heart rate in heart failure: modulati...
17679104 - Variability in cusp size of human maxillary molars, with particular reference to the hy...
17626834 - Reduced stroke volume during exercise in postural tachycardia syndrome.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-14
Journal Detail:
Title:  Respiratory medicine     Volume:  -     ISSN:  1532-3064     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ltd.
Affiliation:
Department of Respiratory and Critical Care Medicine, Schaffner Hospital, Lens, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Rhinitis phenotypes correlate with different symptom presentation and risk factor patterns of asthma...
Next Document:  Nonalcoholic fatty liver disease is associated with an altered hepatocyte microRNA profile in LDL re...