Paridon S M, Sullivan N M, Schneider J, Pinsky W W
Cardiology Division, Children's Hospital of Michigan, Detroit 48201.
Am J Cardiol. 1993 Dec 15;72(18):1444-7. doi: 10.1016/0002-9149(93)90194-h.
Although long-term evaluations of patients after repair of total anomalous pulmonary venous connection have generally shown them to be clinically asymptomatic, assessment of their cardiovascular and pulmonary systems have been limited. Residual cardiopulmonary abnormalities undetected at rest may result in impaired function during exercise. To evaluate this hypothesis 9 patients underwent exercise testing after repair of total anomalous pulmonary venous connection. Pulmonary function testing was performed before exercise. Patients exercised using a 1-minute incremental bicycle or treadmill protocol monitoring heart rate, oxygen consumption, carbon dioxide production and minute ventilation. Compared with healthy children, the study patients had reduced maximal oxygen consumption and reduced oxygen consumption at ventilatory anaerobic threshold. Chronotropic response was impaired in 5 patients. Resting pulmonary functions showed evidence of mild restrictive lung disease. Breathing reserve was within normal limits. It is concluded that (1) aerobic capacity is mildly reduced after repair of total anomalous pulmonary venous connection, (2) chronotropic impairment is a common occurrence, and (3) pulmonary testing suggests mild restrictive lung disease that does not compromise exercise performance.
尽管对完全性肺静脉异位连接修复术后患者的长期评估总体显示他们临床上无症状，但对其心血管和肺部系统的评估一直有限。静息时未被检测到的残留心肺异常可能导致运动期间功能受损。为了评估这一假设，9例完全性肺静脉异位连接修复术后的患者接受了运动测试。运动前进行了肺功能测试。患者使用1分钟递增式自行车或跑步机方案进行运动，监测心率、耗氧量、二氧化碳产生量和每分通气量。与健康儿童相比，研究中的患者最大耗氧量降低，通气无氧阈时的耗氧量也降低。5例患者变时反应受损。静息肺功能显示有轻度限制性肺病的迹象。呼吸储备在正常范围内。得出的结论是：（1）完全性肺静脉异位连接修复术后有氧能力轻度降低；（2）变时功能受损很常见；（3）肺部测试提示有轻度限制性肺病，但不影响运动表现。
