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Effect of lung volume reduction surgery for severe emphysema on right ventricular function
Tommaso C Mineo1, Eugenio Pompeo, Paola Rogliani
1Division of Thoracic Surgery, University Tor Vergata, Rome, Italy. mineo@med.uniroma2.it
American Journal of Respiratory and Critical Care Medicine
|February 19, 2002
Summary
Lung volume reduction surgery (LVRS) significantly improves respiratory function and right ventricular performance in severe emphysema patients. This includes enhanced cardiac index and ejection fraction, especially during exercise, 6 months post-surgery.
Area of Science:
- Cardiology
- Pulmonology
- Thoracic Surgery
Background:
- Severe emphysema significantly impairs functional capacity and can affect right ventricular function.
- Lung volume reduction surgery (LVRS) is a treatment for severe emphysema, but its impact on right ventricular function requires detailed investigation.
Purpose of the Study:
- To investigate the effects of bilateral LVRS on right ventricular function at rest and during exercise in patients with severe emphysema.
Main Methods:
- Fast-thermistor thermodilution was used to measure cardiac index, stroke volume, and ejection fraction in 12 patients.
- Measurements were taken at rest and during submaximal upright exercise, before and 6 months after LVRS.
Main Results:
- LVRS significantly improved respiratory function (FEV1, RV/TLC ratio) and right ventricular function at rest (cardiac index, stroke volume).
- Significant improvements were also observed in right ventricular function during exercise (cardiac index, stroke volume index, ejection fraction).
- A correlation was found between changes in exercise ejection fraction response and RV/TLC ratio changes post-surgery.
Conclusions:
- Bilateral LVRS leads to significant improvements in right ventricular performance, particularly during exercise, in patients with severe emphysema.
- These findings suggest LVRS positively impacts cardiopulmonary hemodynamics beyond just lung function improvement.