Publications (2)2.4 Total impact
Article: Improved cardiopulmonary exercise function after modified Nuss operation for pectus excavatum.[show abstract] [hide abstract]
ABSTRACT: Patients with pectus excavatum have compromised cardiac function during exercise. We hypothesized that the Nuss technique would improve cardiopulmonary function during exercise. We investigated 75 teenagers (49 patients and 26 controls) at rest and during bicycle exercise prior to surgery and 1 year postoperative. Prior to surgery, patients had a lower cardiac index 6.6 ± 1.1 l/min/m(2) when compared with controls 8.1 ± 1.0 l/min/m(2) during submaximal exercise, P = 0.0001. There was no difference in heart rate or increase in heart rate between the two groups. One year after surgery, cardiac index had significantly increased in the pectus group, P = 0.0054 although cardiac index was still significantly lower 7.2 ± 1.0 l/min/m(2) when compared with the control subjects (8.5 ± 1.6 l/min/m(2), P = 0.0008). Both the patients and the controls increased their VO(2) max during the one-year study period although the controls increased most. Right ventricular diastolic dimension increased in both groups over the one-year study period and left ventricular dimensions increased in the patients. Before operation, the patients had lower forced expiratory capacity FEV(1) 86 ± 13% when compared with controls 94 ± 10%, P = 0.009. Patients increased FEV(1)/forced vital capacity over the one-year long study course although there were no differences between groups. Patients with pectus excavatum have lower cardiac index at submaximal exercise when compared with healthy age-matched controls. Their cardiac index and FEV(1) are increased one year after the modified Nuss operation.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 12/2011; 41(5):1063-7. · 2.40 Impact Factor
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ABSTRACT: Patients with pectus excavatum complain about fatigue, tachypnea, discomfort and dyspnea, but the existence of an equivalent underlying pathophysiology has been questioned. We investigated 75 teenagers (49 pectus excavatum patients and 26 age matched controls) at rest and during bicycle exercise at submaximal exercise levels. At rest cardiac function was determined using echocardiography. During rest and exercise, cardiac output, heart rate and aerobic exercise capacity were measured using photo-acoustic gas-rebreathing technique for non-invasive determination of the cardiopulmonary function. At rest, no cardiac differences were found between control subjects and patients with pectus excavatum. During submaximal exercise, cardiac index was lower 6.6(6.3-7.0) l/min/m(2) among the pectus patients as compared to the control subjects 8.0(7.3-8.8) l/min/m(2), P=0.0001. The lower cardiac output among the pectus patients was due to a lower stroke index 42(39-45) ml/beat/m(2) as compared to controls 54(44-64) ml/beat/m(2), P=0.0022, whereas heart rate was unchanged. Cardiac function is significantly impaired at submaximal exercise level compared to healthy age matched controls.Interactive cardiovascular and thoracic surgery 07/2011; 13(4):377-80.