PMID- 33840477
OWN - NLM
STAT- MEDLINE
DCOM- 20211222
LR  - 20220531
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 208
DP  - 2021 Dec
TI  - Reversal of cardiopulmonary exercise intolerance in patients with post-thrombotic 
      obstruction of the inferior vena cava.
PG  - 219-225
LID - S0049-3848(21)00129-8 [pii]
LID - 10.1016/j.thromres.2021.03.025 [doi]
AB  - BACKGROUND: It is unclear whether cardiopulmonary exercise intolerance in 
      patients with chronic obstruction of the inferior vena cava (IVC) is reversible 
      following endovascular IVC reconstruction. METHODS: In 17 patients (mean age 
      45 +/- 15 years, 71% men) with post-thrombotic syndrome due to IVC obstruction and 
      preserved left ventricular ejection fraction (mean 58 +/- 3%), we performed 
      cardiopulmonary exercise testing before and 3 months after IVC reconstruction 
      (mean 4.1 +/- 1.5 implanted stents). The median time from latest episode of deep 
      vein thrombosis to intervention was 150 (interquartile range 102-820) days. 
      RESULTS: At baseline, 12 (71%) patients reported New York Heart Association 
      (NYHA) class II or III symptoms, 76% did not achieve >85% of predicted oxygen 
      uptake at peak exercise (mean 61.8 +/- 13.7%). After IVC reconstruction, the 
      following changes were observed at anaerobic threshold: work rate increased by 
      14.6 W, 95%CI (-0.7; 30.0), oxygen uptake increased by 1.8 ml/kg, 95%CI (0.3; 
      3.3). Oxygen pulse increased by 1.95 ml per beat, 95%CI (1.12; 2.78), 
      corresponding to a mean relative increase of 22.5%, 95%CI (12.4; 32.7) 
      (p < 0.001). The following changes were observed at peak exercise: work rate 
      increased by 48.1 W, 95%CI (27.8; 68.4), oxygen uptake increased by 6.4 ml/kg, 
      95%CI (3.8; 9.1). Oxygen pulse increased by 2.68 ml per beat, 95%CI (1.60; 3.76), 
      corresponding to a mean relative increase of 29.4%, 95%CI (17.7; 41.2) 
      (p < 0.001). At follow-up, 5 (29%) patients remained in NYHA class II. 
      CONCLUSIONS: In patients with chronic IVC obstruction, cardiopulmonary exercise 
      intolerance as a result of impaired cardiac filling is at least partially 
      reversible following endovascular IVC reconstruction. STUDY REGISTRATION: URL: 
      https://clinicaltrials.gov. Unique identifier: NCT02433054.
CI  - Copyright (c) 2021 Elsevier Ltd. All rights reserved.
FAU - Sebastian, Tim
AU  - Sebastian T
AD  - Clinic for Angiology, University Hospital Zurich, Switzerland.
FAU - Barco, Stefano
AU  - Barco S
AD  - Clinic for Angiology, University Hospital Zurich, Switzerland; Center for 
      Thrombosis and Hemostasis (CTH), University Mainz, Germany. Electronic address: 
      stefano.barco@usz.ch.
FAU - Kreuzpointner, Robert
AU  - Kreuzpointner R
AD  - Clinic for Angiology, University Hospital Zurich, Switzerland.
FAU - Konstantinides, Stavros
AU  - Konstantinides S
AD  - Center for Thrombosis and Hemostasis (CTH), University Mainz, Germany.
FAU - Kucher, Nils
AU  - Kucher N
AD  - Clinic for Angiology, University Hospital Zurich, Switzerland. Electronic 
      address: nils.kucher@usz.ch.
LA  - eng
SI  - ClinicalTrials.gov/NCT02433054
PT  - Journal Article
PT  - Observational Study
DEP - 20210409
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
SB  - IM
MH  - Adult
MH  - Exercise
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Postthrombotic Syndrome
MH  - Stroke Volume
MH  - *Vena Cava, Inferior/surgery
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Cardiopulmonary exercise testing
OT  - IVC reconstruction
OT  - Inferior vena cava
OT  - Post-thrombotic syndrome
OT  - Stent
EDAT- 2021/04/13 06:00
MHDA- 2021/12/24 06:00
CRDT- 2021/04/12 05:34
PHST- 2021/01/21 00:00 [received]
PHST- 2021/03/05 00:00 [revised]
PHST- 2021/03/22 00:00 [accepted]
PHST- 2021/04/13 06:00 [pubmed]
PHST- 2021/12/24 06:00 [medline]
PHST- 2021/04/12 05:34 [entrez]
AID - S0049-3848(21)00129-8 [pii]
AID - 10.1016/j.thromres.2021.03.025 [doi]
PST - ppublish
SO  - Thromb Res. 2021 Dec;208:219-225. doi: 10.1016/j.thromres.2021.03.025. Epub 2021 
      Apr 9.