The effect of lung volume reduction surgery on chronotropic incompetence

Hilary F. Armstrong, Jose Gonzalez-Costello, Ulrich P. Jorde, Mark E. Ginsburg, Aimee M. Layton, Byron M. Thomashow, Matthew N. Bartels

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Chronotropic incompetence (CI) is a marker of poor prognosis in patients with COPD. Treatments that improve pulmonary function and exercise capacity may affect CI. Objectives are to evaluate CI before and after lung volume reduction surgery (LVRS) and determine if changes in CI are associated with changes in pulmonary function and exercise capacity. Methods: We performed a retrospective review of 75 patients who underwent LVRS and who had complete cardiopulmonary exercise testing and concurrent pulmonary function tests two months before and about 6 months after surgery. Additionally we evaluated 28 control patients that were randomized to medical treatment as part of the National Emphysema Treatment Trial at our center. We studied CI using the percent of predicted heart rate reserve = (heart rate peak - heart rate rest)/((208 - 0.7 × age) - heart rate rest) × 100, before and after surgery and compared it to the control group. Results: Mean percent of predicted heart rate reserve improved from 41% to 50% (p-value <0.001) after LVRS, while the control group did not change. The mean forced vital capacity and expiratory volume in 1 s, peak oxygen consumption, carbon dioxide production, ventilation, tidal volume and maximal workload all improved in the surgery group, while the controls did not improve. Conclusions: CI improves after LVRS in a population of patients with COPD. CI improvements are associated with the increases in pulmonary function and exercise capacity. This improvement is seen in a domain of known cardiopulmonary impairment prior to surgery that improves as a positive response to the therapy of LVRS.

Original languageEnglish (US)
Pages (from-to)1389-1395
Number of pages7
JournalRespiratory Medicine
Volume106
Issue number10
DOIs
StatePublished - Oct 2012
Externally publishedYes

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Pneumonectomy
Heart Rate
Exercise
Lung
Chronic Obstructive Pulmonary Disease
Control Groups
Respiratory Function Tests
Tidal Volume
Vital Capacity
Emphysema
Therapeutics
Workload
Carbon Dioxide
Oxygen Consumption
Ventilation

Keywords

  • Emphysema
  • Heart physiology
  • Lung volume reduction

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Armstrong, H. F., Gonzalez-Costello, J., Jorde, U. P., Ginsburg, M. E., Layton, A. M., Thomashow, B. M., & Bartels, M. N. (2012). The effect of lung volume reduction surgery on chronotropic incompetence. Respiratory Medicine, 106(10), 1389-1395. https://doi.org/10.1016/j.rmed.2012.06.011

The effect of lung volume reduction surgery on chronotropic incompetence. / Armstrong, Hilary F.; Gonzalez-Costello, Jose; Jorde, Ulrich P.; Ginsburg, Mark E.; Layton, Aimee M.; Thomashow, Byron M.; Bartels, Matthew N.

In: Respiratory Medicine, Vol. 106, No. 10, 10.2012, p. 1389-1395.

Research output: Contribution to journalArticle

Armstrong, HF, Gonzalez-Costello, J, Jorde, UP, Ginsburg, ME, Layton, AM, Thomashow, BM & Bartels, MN 2012, 'The effect of lung volume reduction surgery on chronotropic incompetence', Respiratory Medicine, vol. 106, no. 10, pp. 1389-1395. https://doi.org/10.1016/j.rmed.2012.06.011
Armstrong HF, Gonzalez-Costello J, Jorde UP, Ginsburg ME, Layton AM, Thomashow BM et al. The effect of lung volume reduction surgery on chronotropic incompetence. Respiratory Medicine. 2012 Oct;106(10):1389-1395. https://doi.org/10.1016/j.rmed.2012.06.011
Armstrong, Hilary F. ; Gonzalez-Costello, Jose ; Jorde, Ulrich P. ; Ginsburg, Mark E. ; Layton, Aimee M. ; Thomashow, Byron M. ; Bartels, Matthew N. / The effect of lung volume reduction surgery on chronotropic incompetence. In: Respiratory Medicine. 2012 ; Vol. 106, No. 10. pp. 1389-1395.
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