Bussières L M, Pflugfelder P W, Ahmad D, Taylor A W, Kostuk W J
Faculty of Kinesiology, University Hospital, University of Western Ontario, London, Canada.
Eur Respir J. 1995 Jun;8(6):959-62.
The aim of our study was to characterize the time course and magnitude of the changes in lung function in the first year after cardiac transplantation. Resting pulmonary function tests (spirometry, lung volumes and transfer factor) were performed in 14 patients prior to and at 1, 3 and 12 months after surgery. Resting central haemodynamics were also measured serially in the first year post-transplantation. Before transplantation, patients had impaired resting lung function with marked decrease in transfer factor (TL,CO). Although resting central haemodynamics improved markedly within the first week after cardiac transplantation, lung function (forced expiratory volume in one second (FEV1)) was significantly improved only at three months post-transplantation. TL,CO, however, decreased further early after cardiac transplantation. By 12 months, FEV1 and forced vital capacity had increased significantly by 31 and 33%, respectively, while total lung capacity increased by 22%. On the other hand, TL,CO did not increase significantly and remained well below normal at 12 months after cardiac transplantation, at a value equal to 68% of predicted. We conclude that the resting abnormalities in lung function of most patients with heart failure are reversible after cardiac transplantation, except for TL,CO which remains below normal values. Recovery of lung function, however, lags behind the improvement in cardiac function.
我们研究的目的是描述心脏移植后第一年肺功能变化的时间进程和幅度。对14例患者在手术前以及术后1个月、3个月和12个月进行了静息肺功能测试（肺量计、肺容积和换气系数）。在移植后的第一年还连续测量了静息中心血流动力学。移植前，患者静息肺功能受损，换气系数（TL,CO）显著降低。尽管心脏移植后第一周内静息中心血流动力学明显改善，但肺功能（一秒用力呼气容积（FEV1））仅在移植后三个月时显著改善。然而，心脏移植后早期TL,CO进一步降低。到12个月时，FEV1和用力肺活量分别显著增加了31%和33%，而肺总量增加了22%。另一方面，TL,CO没有显著增加，在心脏移植后12个月时仍远低于正常水平，仅为预测值的68%。我们得出结论，除TL,CO仍低于正常值外，大多数心力衰竭患者移植后的静息肺功能异常是可逆的。然而，肺功能的恢复滞后于心脏功能的改善。
