Evaluation of pulmonary function and exercise performance by cardiopulmonary exercise testing before and after lung transplantation

Matthew N. Bartels, Hilary F. Armstrong, Renee E. Gerardo, Aimee M. Layton, Benjamin O. Emmert-Aronson, Joshua R. Sonett, Selim M. Arcasoy

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Detailed description of functional exercise outcomes before and after lung transplantation is lacking. The objective of this study was to describe and compare posttransplant improvement in lung function and peak exercise parameters in patients with advanced lung disease. Methods: The study included 153 patients who underwent lung transplantation over 7 years who had complete cardiopulmonary exercise testing (CPET) and pulmonary function tests (PFTs) before and after lung transplantation. CPET and PFT within 30 months pretransplant and posttransplant were compared. Results: Pulmonary function markedly improved posttransplant as FVC increased 67%, maximum voluntary ventilation increased 91%, and FEV 1 increased 136%. However, peak oxygen consumption increased only 19%, peak CO 2 production increased 50%, and peak work increased 78%. Although transplant recipients had a 1.5-to 2.0-fold increase in exercise capacity posttransplant, peak exercise capacity remained at 50% of the predicted normal, suggesting a maximal limitation. Subgroup stratification into quartiles based on pretransplant exercise capacity revealed the greatest exercise benefit to be in the lowest functional pretransplant groups. Conclusions: Lung transplant recipients have an increase in exercise capacity that does not match the improvement in lung function, indicating that poor strength, deconditioning, or other peripheral factors play a significant role in the limitation of exercise benefit posttransplantation. Further elucidation of the mechanisms of exercise limitation may allow for improved exercise outcomes posttransplant.

Original languageEnglish (US)
Pages (from-to)1604-1611
Number of pages8
JournalChest
Volume140
Issue number6
DOIs
StatePublished - Dec 2011
Externally publishedYes

Fingerprint

Lung Transplantation
Exercise
Lung
Respiratory Function Tests
Carbon Monoxide
Oxygen Consumption
Lung Diseases
Ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Bartels, M. N., Armstrong, H. F., Gerardo, R. E., Layton, A. M., Emmert-Aronson, B. O., Sonett, J. R., & Arcasoy, S. M. (2011). Evaluation of pulmonary function and exercise performance by cardiopulmonary exercise testing before and after lung transplantation. Chest, 140(6), 1604-1611. https://doi.org/10.1378/chest.10-2721

Evaluation of pulmonary function and exercise performance by cardiopulmonary exercise testing before and after lung transplantation. / Bartels, Matthew N.; Armstrong, Hilary F.; Gerardo, Renee E.; Layton, Aimee M.; Emmert-Aronson, Benjamin O.; Sonett, Joshua R.; Arcasoy, Selim M.

In: Chest, Vol. 140, No. 6, 12.2011, p. 1604-1611.

Research output: Contribution to journalArticle

Bartels, MN, Armstrong, HF, Gerardo, RE, Layton, AM, Emmert-Aronson, BO, Sonett, JR & Arcasoy, SM 2011, 'Evaluation of pulmonary function and exercise performance by cardiopulmonary exercise testing before and after lung transplantation', Chest, vol. 140, no. 6, pp. 1604-1611. https://doi.org/10.1378/chest.10-2721
Bartels, Matthew N. ; Armstrong, Hilary F. ; Gerardo, Renee E. ; Layton, Aimee M. ; Emmert-Aronson, Benjamin O. ; Sonett, Joshua R. ; Arcasoy, Selim M. / Evaluation of pulmonary function and exercise performance by cardiopulmonary exercise testing before and after lung transplantation. In: Chest. 2011 ; Vol. 140, No. 6. pp. 1604-1611.
@article{4f753d9a02364a52941003faf9dcee7c,
title = "Evaluation of pulmonary function and exercise performance by cardiopulmonary exercise testing before and after lung transplantation",
abstract = "Background: Detailed description of functional exercise outcomes before and after lung transplantation is lacking. The objective of this study was to describe and compare posttransplant improvement in lung function and peak exercise parameters in patients with advanced lung disease. Methods: The study included 153 patients who underwent lung transplantation over 7 years who had complete cardiopulmonary exercise testing (CPET) and pulmonary function tests (PFTs) before and after lung transplantation. CPET and PFT within 30 months pretransplant and posttransplant were compared. Results: Pulmonary function markedly improved posttransplant as FVC increased 67{\%}, maximum voluntary ventilation increased 91{\%}, and FEV 1 increased 136{\%}. However, peak oxygen consumption increased only 19{\%}, peak CO 2 production increased 50{\%}, and peak work increased 78{\%}. Although transplant recipients had a 1.5-to 2.0-fold increase in exercise capacity posttransplant, peak exercise capacity remained at 50{\%} of the predicted normal, suggesting a maximal limitation. Subgroup stratification into quartiles based on pretransplant exercise capacity revealed the greatest exercise benefit to be in the lowest functional pretransplant groups. Conclusions: Lung transplant recipients have an increase in exercise capacity that does not match the improvement in lung function, indicating that poor strength, deconditioning, or other peripheral factors play a significant role in the limitation of exercise benefit posttransplantation. Further elucidation of the mechanisms of exercise limitation may allow for improved exercise outcomes posttransplant.",
author = "Bartels, {Matthew N.} and Armstrong, {Hilary F.} and Gerardo, {Renee E.} and Layton, {Aimee M.} and Emmert-Aronson, {Benjamin O.} and Sonett, {Joshua R.} and Arcasoy, {Selim M.}",
year = "2011",
month = "12",
doi = "10.1378/chest.10-2721",
language = "English (US)",
volume = "140",
pages = "1604--1611",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "6",

}

TY - JOUR

T1 - Evaluation of pulmonary function and exercise performance by cardiopulmonary exercise testing before and after lung transplantation

AU - Bartels, Matthew N.

AU - Armstrong, Hilary F.

AU - Gerardo, Renee E.

AU - Layton, Aimee M.

AU - Emmert-Aronson, Benjamin O.

AU - Sonett, Joshua R.

AU - Arcasoy, Selim M.

PY - 2011/12

Y1 - 2011/12

N2 - Background: Detailed description of functional exercise outcomes before and after lung transplantation is lacking. The objective of this study was to describe and compare posttransplant improvement in lung function and peak exercise parameters in patients with advanced lung disease. Methods: The study included 153 patients who underwent lung transplantation over 7 years who had complete cardiopulmonary exercise testing (CPET) and pulmonary function tests (PFTs) before and after lung transplantation. CPET and PFT within 30 months pretransplant and posttransplant were compared. Results: Pulmonary function markedly improved posttransplant as FVC increased 67%, maximum voluntary ventilation increased 91%, and FEV 1 increased 136%. However, peak oxygen consumption increased only 19%, peak CO 2 production increased 50%, and peak work increased 78%. Although transplant recipients had a 1.5-to 2.0-fold increase in exercise capacity posttransplant, peak exercise capacity remained at 50% of the predicted normal, suggesting a maximal limitation. Subgroup stratification into quartiles based on pretransplant exercise capacity revealed the greatest exercise benefit to be in the lowest functional pretransplant groups. Conclusions: Lung transplant recipients have an increase in exercise capacity that does not match the improvement in lung function, indicating that poor strength, deconditioning, or other peripheral factors play a significant role in the limitation of exercise benefit posttransplantation. Further elucidation of the mechanisms of exercise limitation may allow for improved exercise outcomes posttransplant.

AB - Background: Detailed description of functional exercise outcomes before and after lung transplantation is lacking. The objective of this study was to describe and compare posttransplant improvement in lung function and peak exercise parameters in patients with advanced lung disease. Methods: The study included 153 patients who underwent lung transplantation over 7 years who had complete cardiopulmonary exercise testing (CPET) and pulmonary function tests (PFTs) before and after lung transplantation. CPET and PFT within 30 months pretransplant and posttransplant were compared. Results: Pulmonary function markedly improved posttransplant as FVC increased 67%, maximum voluntary ventilation increased 91%, and FEV 1 increased 136%. However, peak oxygen consumption increased only 19%, peak CO 2 production increased 50%, and peak work increased 78%. Although transplant recipients had a 1.5-to 2.0-fold increase in exercise capacity posttransplant, peak exercise capacity remained at 50% of the predicted normal, suggesting a maximal limitation. Subgroup stratification into quartiles based on pretransplant exercise capacity revealed the greatest exercise benefit to be in the lowest functional pretransplant groups. Conclusions: Lung transplant recipients have an increase in exercise capacity that does not match the improvement in lung function, indicating that poor strength, deconditioning, or other peripheral factors play a significant role in the limitation of exercise benefit posttransplantation. Further elucidation of the mechanisms of exercise limitation may allow for improved exercise outcomes posttransplant.

UR - http://www.scopus.com/inward/record.url?scp=80053354272&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053354272&partnerID=8YFLogxK

U2 - 10.1378/chest.10-2721

DO - 10.1378/chest.10-2721

M3 - Article

VL - 140

SP - 1604

EP - 1611

JO - Chest

JF - Chest

SN - 0012-3692

IS - 6

ER -