Document Detail

Results of exercise stress testing in patients with diffuse pulmonary arteriovenous malformations.
MedLine Citation:
PMID:  19636485     Owner:  NLM     Status:  MEDLINE    
Patients with diffuse pulmonary arteriovenous malformations (PAVMs) are subject to frequent complications and need to be followed closely. As part of this follow-up, we have employed exercise stress testing (EST) as an aid to assess their status. Twenty patients from a cohort of 35 with diffuse PAVMs have undergone EST using a standard cycle ergometer test. All patients had previously undergone pulmonary angiography, noncontrast chest computed tomography (CT), and repair of large focal PAVMs, prior to EST. Mean room air oxygen saturation at baseline and at maximum exercise (85% of maximum heart rate) were tabulated. Serial studies in six children and young adults were plotted by year and compared using the patient as their own control. Fourteen females and six males ranging in age from 4 to 50 years (mean 22 years) were studied. Baseline mean oxygen saturation was 84% and fell to 73% at maximum exercise. There was no significant difference between those with unilateral and bilateral involvement (P = 0.09). In four of the six patients with serial EST, the baseline and exercise oxygen saturations were quite stable. In the two patients who became symptomatic, with age, growth, and more activity, complete embolization of one or more segments of the lung improved their EST and functionality. Based on our previous work in patients with diffuse PAVMs, EST appears to offer a relatively safe and noninvasive method for assessing these patients. Our limited experience with serial EST suggests a good correlation with decreased functionality in these patients.
Joshua Murphy; Paola Pierucci; Deborah Chyun; Katharine J Henderson; Jeffrey Pollak; Robert I White; John Fahey
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-07-28
Journal Detail:
Title:  Pediatric cardiology     Volume:  30     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-25     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  978-84     Citation Subset:  IM    
Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
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MeSH Terms
Analysis of Variance
Arteriovenous Malformations / physiopathology*,  radiography
Child, Preschool
Exercise Test / methods*
Middle Aged
Oxygen / blood
Pulmonary Artery / abnormalities*,  radiography
Pulmonary Veins / abnormalities*,  radiography
Retrospective Studies
Tomography, X-Ray Computed
Grant Support
Reg. No./Substance:

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