Mulla N, Paridon S M, Pinsky W W
Division of Cardiology, Children's Hospital of Michigan, Detroit 48201, USA.
Pediatr Cardiol. 1995 May-Jun;16(3):120-6. doi: 10.1007/BF00801909.
In patients with tetralogy of Fallot and absent pulmonary valve, the dilated pulmonary arteries sometimes result in bronchial compression and pulmonary symptoms due to airway obstruction, recurrent pulmonary infection, and development of bronchiectasis. After complete intracardiac repair, residual pulmonary disease may be expected to result in impaired cardiopulmonary performance during exercise. To assess this hypothesis, nine patients with tetralogy of Fallot and absent pulmonary valve underwent exercise testing and were compared to 38 patients with tetralogy of Fallot repaired using a transannular patch. All patients were exercised to maximum volition using a 1 minute incremental treadmill protocol with monitoring of pulmonary functions and expired gases. Maximal heart rate, maximal oxygen consumption, oxygen consumption at anaerobic threshold, and maximal respiratory exchange ratio were similar for the two groups. There was no significant difference for ventilation and gas exchange parameters at rest or at maximal exercise, and values for both groups were below the predicted normal for healthy subjects. Breathing reserve, however, did tend to be somewhat lower in the group with tetralogy of Fallot with absent pulmonary valve. In summary, despite significant preoperative symptoms, cardiopulmonary performance during exercise in patients with tetralogy of Fallot and absent pulmonary valve is similar to patients with tetralogy of Fallot repaired with a transannular patch.
在法洛四联症合并肺动脉瓣缺如的患者中，扩张的肺动脉有时会因气道阻塞、反复肺部感染和支气管扩张的发展而导致支气管受压和肺部症状。在完成心内修复后，残余的肺部疾病可能会导致运动期间心肺功能受损。为了评估这一假设，对9例法洛四联症合并肺动脉瓣缺如的患者进行了运动测试，并与38例使用跨环补片修复的法洛四联症患者进行了比较。所有患者均采用1分钟递增式跑步机方案进行最大意愿运动，并监测肺功能和呼出气体。两组的最大心率、最大耗氧量、无氧阈值时的耗氧量和最大呼吸交换率相似。静息或最大运动时的通气和气体交换参数两组间无显著差异，且两组的值均低于健康受试者的预测正常值。然而，法洛四联症合并肺动脉瓣缺如组的呼吸储备确实往往略低。总之，尽管术前有明显症状，但法洛四联症合并肺动脉瓣缺如患者运动时的心肺功能与使用跨环补片修复的法洛四联症患者相似。
