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- W1982689305 abstract "Aerobic capacity is commonly impaired in patients with liver cirrhosis, as demonstrated by their low oxygen consumption at peak exercise (peak VO2). This impairment is correlated with the severity of the liver disease. We investigated the effect of orthotopic liver transplantation (OLT) alone on exercise capacity in this prospective study of patients with liver cirrhosis. Twenty liver transplant candidates, aged 27 to 61 years, underwent resting pulmonary function tests, echocardiography, and incremental cardiopulmonary exercise testing (CPET) before OLT and 16.3 ± 1.6 months after OLT. Following OLT, peak VO2 increased by a mean of only 7.7% (from 63.4 to 71.1% of predicted value), and decreased in one-quarter of the patients. Cardiac function was normal before OLT and no changes in respiratory indicators followed OLT. Change in peak VO2 after OLT (Δ peak VO2) was related to changes in hemoglobin level (r2 = 0.45, p = 0.04), the stopping of beta-blocker therapy, and muscle impairment, as suggested by the correlation between Δ peak VO2 and peak lactate concentration before OLT (r2 = 0.64, p < 0.01). Our study provides evidence of a very modest and inconsistent increase in aerobic capacity in liver transplant candidates after liver transplantation alone. This persistent impairment of exercise tolerance was principally of peripheral origin but anemia and beta-blocker treatment should be considered as major aggravating factors. Rehabilitation programs before and after transplantation may increase its benefits to these deconditioned liver transplant recipients in their daily lives. L’aptitude aérobie est classiquement altérée au cours de la cirrhose du foie, comme cela a été montré par l’abaissement de la consommation maximale d’oxygène lors d’un effort maximal (VO2 pic). Cette altération est corrélée à la sévérité de la maladie hépatique. Le but de ce travail prospectif était d’analyser les effets de la transplantation hépatique (TH) sur la capacité à l’exercice. Vingt patients en attente de TH, âgés de 27 à 61 ans, ont réalisé une exploration fonctionnelle respiratoire de repos et d’exercice (EFX) et une échographie cardiaque avant TH, et exploration fonctionnelle respiratoire de repos et à l’exercice 16,3 ± 1,6 mois après la TH. Après TH, le pic de VO2 augmentait en moyenne de seulement 7,7 % (de 63,4 à 71,1 % des valeurs prédites) et diminuait chez un quart des patients. La fonction cardiaque évaluée en échographie était normale avant TH. Il n’existait pas de modification significative des paramètres de repos après TH. Les modifications du pic de VO2 avant et après TH (Δ pic VO2) étaient associées à l’amélioration du taux d’hémoglobine (r2 = 0,45, p = 0,04), à l’arrêt des bêtabloquants et aux altérations musculaires comme suggéré par la corrélation entre le Δ pic VO2 et le pic de concentration en lactate avant TH (r2 = 0,64, p < 0,01). L’amélioration de l’aptitude aérobie après TH était discrète. La persistance de cette altération était essentiellement d’origine périphérique. L’anémie et le traitement bêtabloquant étaient des facteurs aggravants. La mise en place de programme de réhabilitation doit être envisagée avant et après TH pour améliorer le bénéfice clinique de la TH sur la vie quotidienne.What was known?•Aerobic capacity is commonly impaired in patients with liver cirrhosis.•The mechanisms responsible for this aerobic impairment are unclear but are related to liver disease.•The effect of liver transplantation alone on aerobic capacity is not known.What this study adds•Impaired aerobic capacity in patients with liver cirrhosis is primarily of peripheral origin but anemia and beta-blocker treatment should be considered as major aggravating factors.•Liver transplantation alone is associated with a very modest and inconsistent improvement of aerobic capacity.•The modesty of the effect of surgery alone shows the need for surpervised rehabilitation programs to improve the functional capacities on exercise of liver transplant recipients. Aerobic capacity is commonly impaired in patients with liver cirrhosis. The mechanisms responsible for this aerobic impairment are unclear but are related to liver disease. The effect of liver transplantation alone on aerobic capacity is not known. Impaired aerobic capacity in patients with liver cirrhosis is primarily of peripheral origin but anemia and beta-blocker treatment should be considered as major aggravating factors. Liver transplantation alone is associated with a very modest and inconsistent improvement of aerobic capacity. The modesty of the effect of surgery alone shows the need for surpervised rehabilitation programs to improve the functional capacities on exercise of liver transplant recipients." @default.
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- W1982689305 date "2010-07-01" @default.
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- W1982689305 title "Aerobic capacity in patients with chronic liver disease: Very modest effect of liver transplantation" @default.
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- W1982689305 doi "https://doi.org/10.1016/j.lpm.2009.09.027" @default.
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