Journal
AMERICAN JOURNAL OF THE MEDICAL SCIENCES
Volume 359, Issue 3, Pages 140-146Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjms.2019.12.011
Keywords
Pulmonary embolism; Exercise capacity; Ventilatory efficiency; Recovery; Cardiopulmonary exercise test
Categories
Funding
- National Science and Tech-nology Information System of the People's Republic of China [2018YFC1313603]
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Background: Although anticoagulation therapy can reduce the risk for pulmonary embolism (PE) recurrence, symptoms such as exertional dyspnea or pain can persist for several months to years. Therefore, we aimed to assess the improvement of ventilatory efficiency and exercise capacity during cardiopulmonary exercise test in PE patients after short duration of anticoagulant therapy. Materials and Methods: Pulmonary function testing, arterial blood gas analysis and cardiopulmonary exercise test were performed in 30 PE patients after anticoagulant therapy of 4 weeks (early phase) and after 6 months (late phase). In addition, another 30 healthy volunteers underwent the same tests. Results: Percentage of forced vital capacity (FVC %pred) improvement was evident in the PE group (P < 0.01) after 6 months of treatment. Peak Load, peak Load %pred, peak oxygen uptake (<(V)over dot>O-2), peak <(V)over dot>O-2%pred increased significantly after treatment for 6 months (P < 0.01), while lowest minute ventilation in relation to carbon dioxide production (<(V)over dot>E/<(V)over dot>CO2) and lowest <(V)over dot>E/<(V)over dot>CO2 %pred decreased significantly (P = 0.001). In PE group, the increment of peak (V)over dot>O-2 %pred from 4 weeks to 6 months correlated with the decrease of lowest <(V)over dot>E/<(V)over dot>CO2 %pred (r = 0.639, P < 0.001) but not the increment of FVC %pred (r = 0.058, P = 0.769). Conclusions: Exercise capacity improved significantly and there was a gradual improvement in ventilatory efficiency after 6 months of anticoagulation therapy.
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