The elucidation of the mechanisms of cardiovascular hypertrophy and hyperplasia and the establishment of angiogenesis by therapeutic electrical stimulation

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We evaluated exercise performance, psychological state, activities of daily living (ADL) and health-related quality of life (HRQL) levels, assessed using the sickness impact profile (SIP) and the linear analogue scale (QOL Scale) in 61 Japanese in-patients with emphysema. About half of them had severe anxiety and depression tendencies. Disabilities of ADL were apparent in stage II of COPD lung function severity as defined by the American Thoracic Society (ATS). Patients who were stage III required help maintaining their ADL. In the SIP, the higher the ATS stages, the more exercise performance and ADL impaired. However, psychological state and HRQL are not significantly correlated with ATS stages. These results indicate that lung function is not a simple determinant of psychological state and HRQL in Japanese patients with emphysema.We evaluated the long-term impact of lung volume reduction surgery (LVRS) for emphysema on HRQL assessed by the sickness impact profile (SIP) before and after LVRS in patients with severe emphysema who underwent pulmonary rehabilitation and LVRS (group A), along with measurements of lung function, exercise performance, and ADL. The patients with severe emphysema who underwent pulmonary rehabilitation but did not undergo LVRS served as a control group (group B).Lung function, exercise performance and ADL were improved significantly at 3 months post-LVRS and even maintained at 12 months follow-up. In group A, both SIP-overall score and SIP-physical score were improved significantly at 3 months post-LVRS and maintained at 6 and 12 months follow-ups. SIP-psychosocial score was improved significantly at 12 months. In group B, SIP scores were significantly impaired compared with group A at 6 and 12 months after pulmonary rehabilitation.These results suggest that LVRS improves not only lung function, exercise performance, and ADL, but also HRQL and these improvements are maintained for at least 12 months after the operation.