TY - JOUR

T1 - Surgical closure of a ventricular septal defect in early childhood leads to altered pulmonary function in adulthood

T2 - A long-term follow-up

AU - Rex, Christian E

AU - Eckerström, Filip

AU - Heiberg, Johan

AU - Maagaard, Marie

AU - Rubak, Sune

AU - Redington, Andrew

AU - Hjortdal, Vibeke E

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BACKGROUND: The long-term outlook after surgical closure of ventricular septal defect (VSD) has traditionally been considered benign. However, there is an increasing awareness of not only late cardiac dysfunction, but also pulmonary abnormalities. The primary aim of this study was to describe pulmonary function in adults with a surgically repaired VSD, and secondarily to determine the effects of salbutamol on the potential abnormalities.METHODS: All patients (operated for a VSD in early childhood) and controls (age- and gender-matched) underwent static and dynamic spirometry, impulse oscillometry, multiple breath washout, diffusion capacity for carbon monoxide, and cardiopulmonary exercise testing. In a double-blinded, cross-over study, participants were randomized to inhalation of either 900 μg of salbutamol or placebo. The primary outcome was forced expiratory volume in 1 s.RESULTS: In total, 30 participants with a surgically closed VSD and 30 healthy controls were included. The VSD participants had a lower forced expiratory volume in 1 s (99 ± 13% vs. 111 ± 13%), p < 0.001, impaired forced vital capacity, (106 ± 12% vs. 118 ± 13%), p < 0.001, and lower peak expiratory flow, (95 ± 18% vs. 118 ± 19%), p < 0.001, than the control group. Also, the VSD group had a lower alveolar volume than the control group, (92 ± 10% vs. 101 ± 11%), p < 0.001, but there were no differences in the remaining pulmonary function parameters. Salbutamol reduced airway resistances in both groups, but exercise performance was not improved by salbutamol, however.CONCLUSIONS: Adults who have undergone surgical closure of a VSD in early childhood have reduced pulmonary function compared with controls, which is unaffected by inhalation of salbutamol.

AB - BACKGROUND: The long-term outlook after surgical closure of ventricular septal defect (VSD) has traditionally been considered benign. However, there is an increasing awareness of not only late cardiac dysfunction, but also pulmonary abnormalities. The primary aim of this study was to describe pulmonary function in adults with a surgically repaired VSD, and secondarily to determine the effects of salbutamol on the potential abnormalities.METHODS: All patients (operated for a VSD in early childhood) and controls (age- and gender-matched) underwent static and dynamic spirometry, impulse oscillometry, multiple breath washout, diffusion capacity for carbon monoxide, and cardiopulmonary exercise testing. In a double-blinded, cross-over study, participants were randomized to inhalation of either 900 μg of salbutamol or placebo. The primary outcome was forced expiratory volume in 1 s.RESULTS: In total, 30 participants with a surgically closed VSD and 30 healthy controls were included. The VSD participants had a lower forced expiratory volume in 1 s (99 ± 13% vs. 111 ± 13%), p < 0.001, impaired forced vital capacity, (106 ± 12% vs. 118 ± 13%), p < 0.001, and lower peak expiratory flow, (95 ± 18% vs. 118 ± 19%), p < 0.001, than the control group. Also, the VSD group had a lower alveolar volume than the control group, (92 ± 10% vs. 101 ± 11%), p < 0.001, but there were no differences in the remaining pulmonary function parameters. Salbutamol reduced airway resistances in both groups, but exercise performance was not improved by salbutamol, however.CONCLUSIONS: Adults who have undergone surgical closure of a VSD in early childhood have reduced pulmonary function compared with controls, which is unaffected by inhalation of salbutamol.

KW - Administration, Inhalation

KW - Adult

KW - Airway Resistance/physiology

KW - Albuterol/administration & dosage

KW - Bronchodilator Agents/administration & dosage

KW - Cardiac Surgical Procedures/adverse effects

KW - Cross-Over Studies

KW - Disease Progression

KW - Double-Blind Method

KW - Exercise Test

KW - Exercise Tolerance/physiology

KW - Female

KW - Follow-Up Studies

KW - Forced Expiratory Volume

KW - Heart Septal Defects, Ventricular/physiopathology

KW - Humans

KW - Male

KW - Postoperative Complications/drug therapy

KW - Pulmonary Ventilation/physiology

KW - Respiratory Function Tests

KW - Young Adult

U2 - 10.1016/j.ijcard.2018.06.109

DO - 10.1016/j.ijcard.2018.06.109

M3 - Journal article

C2 - 30001944

VL - 274

SP - 100

EP - 105

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -