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Cited by 74Chronic Obstructive Pulmonary Disease (COPD) ResearchRespiratory Support and MechanismsCardiovascular and exercise physiology

Stability of Improvements in Exercise Performance and Quality of Life Following Bilateral Lung Volume Reduction Surgery in Severe COPD

Cordova, Francis, O'Brien, Gerald, Furukawa, Satoshi, Kuzma, Ann Marie, Travaline, John, Criner, Gerard J.·1997·Chest
DOI 10.1378/chest.112.4.907
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Abstract

Study objective To evaluate the long-term stability of improvements in exercise capacity and quality of life (QOL) after lung volume reduction surgery (LVRS). Design Case-series analysis. Setting University hospital. Patients Twenty-six patients with severe airflow obstruction (mean FEV1 of 0.67+/-0.18 L) and moderate to severe hyperinflation (mean total lung capacity of 7.30+/-1.90 L). Intervention and measurements All patients underwent bilateral LVRS via median sternotomy. Serial measurement of lung function, symptom-limited cardiopulmonary exercise tests, 6-min walk distances (6MWD), and sickness impact profile (SIP) scores were done before, and at 3, 6, 12, and 18 months after surgery. Results FEV1 (0.93+/-0.29 vs 0.68+/-0.19 L, p<0.001) increased while residual volume (3.47+/-1.2 vs 4.77+/-1.5 L, p<0.001) decreased significantly at 3 months post-LVRS compared to baseline, and these changes were maintained at 12 to 18 months follow-up. Similarly, the increase in 6MWD at 3 months post-LVRS (340+/-84 vs 251+/-114 m, p<0.001) was sustained at all follow-up times. On cardiopulmonary exercise testing, total exercise time (9.0+/-1.8 vs 6.1+/-1.9 min, p<0.001), oxygen uptake at peak exercise (VO2 peak) (14.9+/-4 vs 11.9+/-3 mL/kg/min, p<0.001), maximum oxygen pulse (7.43+/-2.37 vs 5.85+/-1.96 mL/beat, p<0.005), and maximum minute ventilation (VEmax) (30.3+/-10 vs 23.5+/-7.1 L/min, p<0.001) increased significantly at 3 months post-LVRS. On serial study following LVRS, total exercise time remained significantly greater at 6 (8.5+/-1.38 min) and 12 months (8.71+/-2.0 min) post-LVRS compared to baseline (5.81+/-1.9 min, p<0.05). VO2 peak tended to be higher at all follow-up periods (3 months, 16.1+/-4.3; 6 months, 14.5+/-2.6; 12 months, 14.1+/-3.5 mL/kg) compared to baseline (12.6+/-3.9 mL/kg, p=0.08). Similarly, maximum O2 pulse tended to be higher in all follow-up studies (3 months, 8.45+/-2.7; 6 months, 7.6+/-1.7; 12 months, 7.42+/-2.1 mL/beat) compared to baseline (6.39+/-2.5 mL/beat, p=0.06). Higher VEmax continued to be observed at 6 (30+/-10 L/min) and 12 months (28+/-10 L/min) post-LVRS, compared to baseline (23+/-7 L/min, p=0.02). VEmax post-LVRS was significantly higher at 3 and 6 months compared to baseline on post-hoc analysis (p<0.05). Overall SIP scores were lower at 3 months (7 vs 18, p<0.0002) post-LVRS and were sustained in long-term follow-up. Conclusion We conclude that bilateral LVRS via median sternotomy in selected patients with severe, diffuse emphysema improves exercise performance and QOL at 3 months following LVRS and these improvements are maintained for at least 12 to 18 months in follow-up.

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Crossref · 10.1378/chest.112.4.907

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  • Lung volume reduction surgery increases maximal ventilatory capacity as evidenced by increases in both maximal voluntary ventilation and maximal minute ventilation at peak exercise.

    “Lung volume reduction surgery increases maximal ventilatory capacity as evidenced by increases in both maximal voluntary ventilation and maximal minute ventilation at peak exercise.176–178,180–182”

    From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [181]

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Authors
Cordova, F., O'Brien, G., Furukawa, S., Kuzma, A. M., Travaline, J., & Criner, G. J.
Affiliations
Temple University (US)
Corresponding author
Criner, Gerard J.
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
1997-10
Volume
112
Issue
4
Pages
907-915
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.112.4.907
OpenAlex
W2022889830
Cited by
74
References
29
Citations by year
2017: 2 · 2015: 1 · 2014: 2 · 2012: 1
FWCI
8.64
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
lung volume reduction surgery, chronic obstructive pulmonary disease, exercise capacity, quality of life, hyperinflation, 6-minute walk distance, cardiopulmonary exercise testing, FEV1, residual volume, oxygen consumption, median sternotomy, lung function recovery, Sickness Impact Profile, postoperative follow-up, patient-reported outcomes, health-related quality of life
MeSH terms
Airway Obstruction, Exercise Test, Physical Exertion, Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Longitudinal Studies, Lung, Lung Compliance, Male, Maximal Voluntary Ventilation, Middle Aged, Oxygen, Oxygen Consumption, Pneumonectomy, Pulmonary Emphysema, Pulmonary Gas Exchange, Quality of Life, Residual Volume, Spirometry, Sternum, Thoracotomy, Total Lung Capacity, Walking, Exercise Tolerance, Sickness Impact Profile

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