EXERCISE TESTING IN PEDIATRIC HEART, HEART-LUNG, AND LUNG-TRANSPLANT RECIPIENTS
EXERCISE TESTING IN PEDIATRIC HEART, HEART-LUNG, AND LUNG-TRANSPLANT RECIPIENTS
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DOI：
10.1378/chest.107.5.1328
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发表时间：
1995-05-01
期刊：
影响因子：
9.6
通讯作者：
ARMITAGE, JM
中科院分区：
文献类型：
--
作者：
NIXON, PA;FRICKER, FJ;ARMITAGE, JM
对38例心脏移植(n=16)、心肺联合移植(n=13)和双肺移植(n=9)的患儿和41例健康儿童进行了递增运动心肺功能的检测。这四组在年龄上相似，但根据体重指数(BMI)评估，对照组和心脏移植接受者明显大于心肺和肺移植接受者。与心肺移植组(146天)和肺移植组(125天)相比，心脏移植组自移植以来的时间(601天)明显延长。与对照组相比，三个移植组的体能和最大摄氧量均显着降低(43%至预测值)。对照组的峰值心率(预测百分比)显著高于心脏移植受者(66%)、心肺移植受者(70%)和肺移植受者(77%)。对照组(72.9 L/m in)和心脏移植组(51.0 L/m in)的分钟通气量峰值明显高于心肺联合移植组(37.4 L/m in)和肺移植组(41.3 L/m in)。对照组的潮气量峰值高于三个移植组，峰值呼吸频率高于肺移植受者。相关分析显示，心脏移植受者的体能(PWC)与运动峰值心率和运动峰值分钟通气量显著相关，心肺联合移植受者的BMI、VEak和FEV(1)、肺移植受者的BMI、HRak、VEak、FEV(1)和移植后天数显著相关。除了这些变量外，物理因素以及与药物治疗、感染和排斥有关的因素也可能是移植受者PWC降低的原因。
Cardiorespiratory responses to progressive exercise were examined in 38 children who had undergone heart (n = 16), heart-lung (n = 13), or double-lung (n = 9) transplantation, and in 41 healthy controls. The four groups were similar in age, but the control subjects and heart transplant recipients were significantly larger than the heart-lung and lung recipients as assessed by body mass index (BMI). Time since transplant was significantly longer in the heart (601 days) compared with heart-lung (146 days) and lung (125 days) transplant groups. Physical work capacity and peak oxygen uptake were significantly reduced (43 to 64% of predicted) in the three transplant groups compared with the control group. Peak heart rate (percent predicted) was significantly higher in the control subjects (94%) compared with the heart (66%), heart-lung (70%), and lung (77%) transplant recipients. Peak minute ventilation was significantly higher in the control (72.9 L/min) and heart transplant (51.0 L/min) groups than the heart-lung (37.4 L/min) and lung (41.3 L/min) transplant groups. The control group had a higher peak tidal volume than the three transplant groups, and a higher peak respiratory rate than the lung transplant recipients. Correlational analysis revealed that physical work capacity (PWC) was significantly related to heart rate at peak exercise (HRpeak) and minute ventilation at peak exercise (VEpeak) in the heart transplant recipients, BMI, VEpeak, and FEV(1) in the heart-lung transplant recipients, and BMI, HRpeak, VEpeak, FEV(1), and number of days posttransplant in the lung transplant recipients. In addition to these variables, physical deconditioning and factors related to pharmacotherapy, infection, and rejection may also contribute to the decreased PWC observed in the transplant recipients.