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Lung function in patients with a congenital heart defect
Lung function in patients with a congenital heart defect
Due to the high survival rate, functional outcomes in patients with a congenital heart defect (CHD) have gained more and more attention in recent years. The physical and mental constitution of young, and old patients is of great interest. Especially in coping with everyday life, patients need to have sufficient functional capacity. Exercise performance is one of the strongest predictors of morbidity and mortality in CHD patients and is often impaired. In addition, lung function, an additional functional outcome, which is one of the decisive factors for good exercise capacity, frequently occurs reduced in patients with various CHD. This is significantly related to the underly-ing heart defect, but also to the patients’ lifestyles and generally the current times and therefore also the surgical decade and treatment concepts used for the patient. There are only few studies that have investigated the lung function of CHD patients by means of a "large lung function test" (body plethysmography). Both, the time required and the cost-benefit ratio, play a role here. This study aimed to investigate most lung parameters in a large cohort of CHD pa-tients. The results were divided by children and adults and separated regarding respec-tive heart defect categories. The data show that many patients with congenital heart defects have worse results of lung volumes and function. There is no significant difference in frequency between chil-dren and adults. Most patients who have reduced volumes have small lungs (restriction). Here the data show a correlation with surgery; only a few patients have obstruction in lung function. Nevertheless, more than one third of all patients have abnormal results in spirometry and body plethysmography. Even though the latter revealed that a significant propor-tion (22 out of 52 initially defined as preserved ratio impaired spirometry) had abnor-mal lung function, but the reason could not be specified due to lack of tests. These pa-tients show a non-specific pattern. Additionally, patients with a surgical intervention are more likely to have noteworthy re-sults. Since lung function is (also) related to performance - and because of this and to improve the quality of life of patients with CHD, it is necessary and recommended that a regular lung function test is performed. Changes in the results should lead to further testing and training - thus guaranteeing lifelong monitoring and support for the patient.
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Hock, Julia
2023
English
Universitätsbibliothek der Ludwig-Maximilians-Universität München
Hock, Julia (2023): Lung function in patients with a congenital heart defect. Dissertation, LMU München: Faculty of Medicine
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Abstract

Due to the high survival rate, functional outcomes in patients with a congenital heart defect (CHD) have gained more and more attention in recent years. The physical and mental constitution of young, and old patients is of great interest. Especially in coping with everyday life, patients need to have sufficient functional capacity. Exercise performance is one of the strongest predictors of morbidity and mortality in CHD patients and is often impaired. In addition, lung function, an additional functional outcome, which is one of the decisive factors for good exercise capacity, frequently occurs reduced in patients with various CHD. This is significantly related to the underly-ing heart defect, but also to the patients’ lifestyles and generally the current times and therefore also the surgical decade and treatment concepts used for the patient. There are only few studies that have investigated the lung function of CHD patients by means of a "large lung function test" (body plethysmography). Both, the time required and the cost-benefit ratio, play a role here. This study aimed to investigate most lung parameters in a large cohort of CHD pa-tients. The results were divided by children and adults and separated regarding respec-tive heart defect categories. The data show that many patients with congenital heart defects have worse results of lung volumes and function. There is no significant difference in frequency between chil-dren and adults. Most patients who have reduced volumes have small lungs (restriction). Here the data show a correlation with surgery; only a few patients have obstruction in lung function. Nevertheless, more than one third of all patients have abnormal results in spirometry and body plethysmography. Even though the latter revealed that a significant propor-tion (22 out of 52 initially defined as preserved ratio impaired spirometry) had abnor-mal lung function, but the reason could not be specified due to lack of tests. These pa-tients show a non-specific pattern. Additionally, patients with a surgical intervention are more likely to have noteworthy re-sults. Since lung function is (also) related to performance - and because of this and to improve the quality of life of patients with CHD, it is necessary and recommended that a regular lung function test is performed. Changes in the results should lead to further testing and training - thus guaranteeing lifelong monitoring and support for the patient.