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Objectives: We sought to describe the prevalence of restrictive lung function in structural congenital heart disease and to determine the effect of cardiothoracic surgical intervention. Methods: The data from a retrospective review of the spirometry findings from pediatric patients with structural congenital heart disease were compared with the data from 220 matched controls. Restrictive lung function was defined as a forced vital capacity of <80%, with a preserved ratio of the forced expiratory volume in the first second to forced vital capacity of >80%. Results: Of the children with congenital heart disease, 20% met the criteria for restrictive lung function compared with 13.2% of the controls (P = .03). The prevalence in those with congenital heart disease without a surgical history was similar to that of the controls (odds ratio, 0.62; 95% confidence interval, 0.34-1.13). Restrictive lung function was more likely if surgical intervention had occurred within the first year of life (odds ratio, 1.96; 95% confidence interval, 1.08-3.55; P < .0001). Those who had undergone both sternotomy and thoracotomy had a greater prevalence of restrictive lung function than those who had undergone sternotomy or thoracotomy alone (54.2% vs 25.6% and 23.5%, respectively; P < .0001). The prevalence of restrictive lung function increased significantly with each additional surgical intervention (odds ratio, 1.61; 95% confidence interval, 1.29-2.01; P < .0001). Conclusions: Restrictive lung function was more prevalent in those with congenital heart disease after cardiothoracic surgical intervention than in the controls or patients without surgical intervention. The prevalence was also greater with surgical intervention at an earlier age. The risk was equivalent when sternotomy alone was compared with thoracotomy alone but was significantly greater when both sternotomy and thoracotomy were performed. The risk increased with each additional surgery performed. [Copyright &y& Elsevier]

Background: The minimum duration of exercise needed to acutely lower blood pressure (BP) has not been established. The purpose of this study is to compare the effects of short and long duration on the BP response to a session of aerobic exercise. Methods: Subjects were 45 men (mean ± SEM, 43.4 ± 1.5 years) with elevated BP (144.6 ± 1.6/85.2 ± 1.1 mm Hg). Using a parallel design, men were randomly assigned to 40% (LITE, n = 23) or 60% (MOD, n = 22) of maximal oxygen consumption. Following assignment, they completed 3 experiments: a no-exercise control, and a 15-minute SHORT and 30-minute LONG cycle bout. Subjects left the laboratory wearing an ambulatory BP monitor. Repeated measure analysis of variance tested if BP differed among experimental conditions (no-exercise control, LONG, and SHORT) and over time within groups (LITE and MOD). Results: For 9 hours, systolic BP increased from baseline after all conditions (P < .001); however, systolic BP was reduced by 5.6 ± 2.0 and 4.3 ± 1.6 mm Hg after SHORT and LONG with LITE, and 4.1 ± 1.6 and 4.9 ± 1.9 mm Hg with MOD, respectively, compared with no-exercise control (P < .05). For 9 hours, diastolic BP (DBP) decreased from baseline after all conditions (P < .001). DBP was reduced by 2.1 ± 1.0 and 3.6 ± 1.4 mm Hg after SHORT and LONG with MOD for 3 hours (P < .05), and average DBP was lower by 2.4 ± 1.0 mm Hg after LONG with LITE for 9 hours versus no-exercise control (P < .05). Conclusions: The immediate BP-lowering effects of short-duration, lower intensity exercise are comparable to those of higher amounts of exercise. Additional investigation is needed to better quantify the dose of exercise needed to lower BP. [Copyright &y& Elsevier]