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Objective: Studies suggest that cardiovascular risk of patients with congenital heart disease (CHD) is increased. This study aims on the predictive value of a single daily activity and exercise capacity assessments on the change of body-mass-index (BMI) and blood pressure in the future. Patients and Methods: We retrospectively analyzed all patients with CHD who underwent a daily activity assessment by triaxial accelerometry and accompanied cardiopulmonary exercise testing. From 276 patients 16 years or older (120 female, 28.6 ± 8.5 years) current BMI and blood pressure could be abstracted from their last outpatient visit. Results: After a mean follow-up of 5.5 ± 1.5 years, the BMI of the patients has increased from 23.0 ± 3.4 to 23.7 ± 3.5 kg/m2 (p<.001) corresponding to an annual increase of 0.14 ± 0.40 kg/m2 respectively. The systolic blood pressure decreased by -0.37 ± 3.14 mmHg (p=.049). The multivariable regression analysis corrected for confounders showed no association to annual BMI change according to baseline daily activity levels (p=.891) or peak oxygen uptake (p=.596). Only in patients with higher BMI at baseline (Beta= -.275; p<.001) and females (Beta= -.177; p=.009) increase in BMI was less. Also the blood pressure change was not associated with daily activity levels (p=.420) and peak oxygen uptake (p=.732) at baseline. Conclusions: Single daily activity or exercise capacity measures do not predict future BMI or blood pressure changes. Regular evaluation of functional status including exercise testing, activity assessment and tailored counseling are therefore recommended in patients with CHD.
Lung transplantation is an established treatment option for patients of end-stage lung diseases. Leading indications include chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and bronchiectasis, pulmonary arterial hypertension. Living donor lung transplantation (LDLT) was indicated for patients who experience a decline in physical condition and have limited life expectancy and had the better result than from brain dead. The first case of LDLT in Vietnam is 7 year olds boy with difuse congenital bronchiectasis, chronic respiratory failure and cor pulmonale. The right and left lower lobes from father and relative uncle are implanted in a recipient in place of whole right and left lung. The initial result of this recipient showed that lung function recuperated quickly and had no early complications. After 12 months surgery, the recipient had normal physical exercise capacity, subclinical tests in normal limits and no respiratory symptoms, opportunistic infection.