Reduced Exercise Tolerance and Pulmonary Capillary Recruitment with Remote Secondhand Smoke Exposure 英文参考文献.docVIP

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Reduced Exercise Tolerance and Pulmonary Capillary Recruitment with Remote Secondhand Smoke Exposure 英文参考文献.doc

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Reduced Exercise Tolerance and Pulmonary Capillary Recruitment with Remote Secondhand Smoke Exposure 英文参考文献

ReducedExerciseToleranceandPulmonaryCapillary RecruitmentwithRemoteSecondhandSmokeExposure MehrdadArjomandi1,3,4*,ThaddeusHaight5,NasratSadeghi6,RitaRedberg1,4,WarrenM.Gold1,2,3 1University of California San Francisco Flight Attendants Medical Research Institute Center of Excellence, San Francisco, California, United States of America, 2CardiovascularResearchInstitute, University ofCalifornia San Francisco, SanFrancisco,California,United States ofAmerica, 3Department ofMedicine, University of CaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica,4SanFranciscoVeteransAffairsMedicalCenter,SanFrancisco,California,UnitedStatesof America, 5School of Public Health, University of California Berkeley, Berkeley, California, United States of America, 6Radboud University Medical Center, Nijmegen, Netherlands Abstract Rationale: Flight attendants who worked on commercial aircraft before the smoking ban in flights (pre-ban FAs) were exposedtohighlevelsofsecondhandsmoke(SHS).Wepreviouslyshowednever-smokingpre-banFAstohavereduced diffusingcapacity(Dco)atrest. Methods: To determine whether pre-ban FAs increase their Dco and pulmonary blood flow (Qc_ ) during exercise, we administered a symptom-limited supine-posture progressively increasing cycle exercise test to determine the maximum work(watts)andoxygenuptake(Vo2)achievedbyFAs.After30minrest,wethenmeasuredDcoandQc_ at20,40,60,and _ 80percentofmaximumobservedwork. Results:TheFAswithabnormalrestingDcoachievedalowerlevelofmaximumpredictedworkandVo_ 2comparedtothose withnormalrestingDco(mean6SEM;88.762.9vs.102.563.1%predictedVo_ 2;p=0.001).Exerciselimitationwasassociated withtheFAs’FEV1(r=0.33;p=0.003).TheDcoincreasedlesswithexerciseinthosewithabnormalrestingDco(mean6SEM: 1.3660.16vs.1.9060.16ml/min/mmHgper20%increaseinpredictedwatts;p=0.020),andamongstallFAs,theincrease withexerciseseemedtobeincrementallylowerinthosewithlowerrestingDco.Exercise-inducedincreaseinQc_ wasnot differentin