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CJAP ›› 2021, Vol. 37 ›› Issue (2): 189-194.doi: 10.12047/j.cjap.0079.2021.123

• ORIGINAL ARTICLES • Previous Articles     Next Articles

Cardiopulmonary exercise testing was used to evaluate objectively and quantitatively the holistic function in patients after neoadjuvant chemotherapy

LIU Fang1, SUN Xing-guo1△, HIGHTOWER Curtis2, GE Wan-gang1   

  1. 1. Fuwai Hospital National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease Clinical Medicine Research, Beijing 100037, China;
    2. MD Anderson Cancer Center,Houston, USA
  • Received:2020-08-12 Revised:2021-03-15 Online:2021-03-28 Published:2021-10-20

Abstract: Objective: Cardiopulmonary exercise testing(CPET)was used to evaluate objectively and quantitatively the holistic function in patients accepted preoperative chemotherapy. Methods: This study investigated reliable objective and quantitative assessment methods of symptom limited maximal incremental CPET before and after chemotherapy in patients with 6 esophageal cancer. We re-analyzed the changes in cardiopulmonary, metabolism, and other functions physiologic parameters of CPET. Results: After patients accepted preoperative chemotherapy,Peak oxygen consumption (Peak VO2)(P<0.05), anaerobic threshold (AT) and peak oxygen pulse (Peak O2 paulse), oxygen uptake efficiency plateau (OUEP)were decreased (P<0.01). The lowest of ventilatory equivalent for carbon dioxide and slope of ventilatory equivalent for carbon dioxide were increased (P<0.05). For individual of all patients, except one patient's Peak VO2 and OUEP slightly increased,all of the above indicators were reduced in the remaining patients. The lowest of ventilatory equivalent for carbon dioxide and slope of ventilatory equivalent for carbon dioxide increased in all the patients,except one patient's slope of ventilatory equivalent for carbon dioxide decreased slightly. The heart rate of 6 patients showed an upward trend in each state, but there was no statistical difference. Three of the 6 patients had blood pressure measurement, and the other 3 patients had a significant decrease in diastolic blood pressure (P<0.05) except at extreme state.The patients had lower oxygen uptake at AT(P<0. 01) and extreme state (P<0. 05) than that before chemotherapy. The oxygen uptake efficiency in a warm-up state(P<0. 01),and an AT state(P<0. 05)after chemotherapy were lower than those before chemotherapy. The ventilator equivalent for carbon dioxide after chemotherapy was in the each states presented an upward trend, but only ventilator equivalent for carbon dioxide after in the warm-up state (P<0.05) and AT(P<0.01) had statistical significance. oxygen pulse in all four states showed a decreasing trend, and only at AT (P<0.05) showed a significant decrease.After chemotherapy,the PETCO2 in a warm-up state after chemotherapy was lower than that before chemotherapy(P<0. 05); the PETO2 in a quiescent state,a warm - up state,and an extreme state after chemotherapy were higher than those before chemotherapy;but there was nosignificant difference. Conclusion: The holistic functional capacity of patients with esophageal significantly decreased after 136 days chemotherapy. The circulatory functionalandentilator functional parameters significantly decreased after chemotherapy.

Key words: cardiopulmonary exercise testing, esophageal cancer, preoperative chemotherapy, holistic functional status, objective quantitative assessment

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