title: Time course of lung function and exercise performance after heart transplantation.
abstract: To study the time course of exercise performance and the diffusion capacity after heart transplantation, we submitted two groups of patients to graded symptom-limited supine exercise. Patients in group 1 (n = 11) underwent operation 12.9 +/- 7.0 months before the study; those in group 2 (n = 10) underwent operation 53.9 +/- 14.8 months before the study. Respiratory and cardiovascular parameters were evaluated noninvasively at rest, at individual peak exercise, and 10 minutes later with a commercially available Sensormedics MMC 4400 metabolic measurement chart. Short-term survivors exhibited a lower maximum work capacity compared with that of long-term survivors (63.6 +/- 25.9 versus 100 +/- 50 W, p < 0.05), with a concomitant lower terminal heart rate (123 +/- 19 versus 137 +/- 17 beats/min, p < 0.05) that accounts for the lower cardiac output in this group, but statistical significance was not achieved (13.0 +/- 4.6 versus 17.5 +/- 6.3 L/min, not significant). Interestingly, significant differences were also observed for diffusion capacity before exercise (11.9 +/- 4.8 versus 19.3 +/- 7.3 ml/min/mm Hg, p < 0.05). The improvement of the diffusion capacity may be associated with a time-dependent change in the diffusion characteristics of the alveolocapillary membrane.
authors.affiliation: Clinic of Cardiovascular Surgery, University of Kiel, Germany.
authors.forename: A W
authors.initials: AW
authors.lastname: Jahnke
authors.forename: R
authors.initials: R
authors.lastname: Leyh
authors.forename: M
authors.initials: M
authors.lastname: Guha
authors.forename: H H
authors.initials: HH
authors.lastname: Sievers
authors.forename: A
authors.initials: A
authors.lastname: Bernhard
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D016572:Cyclosporine / Q000627:therapeutic use; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D008168:Lung / Q000502:physiology*; D008297:Male; D008450:Maximal Midexpiratory Flow Rate / Q000502:physiology; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology*; D011241:Prednisone / Q000627:therapeutic use; D011653:Pulmonary Diffusing Capacity / Q000502:physiology; D015996:Survival Rate; D013997:Time Factors; D014797:Vital Capacity / Q000502:physiology
chemical_list: D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone