{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:46:00Z","timestamp":1790019960985,"version":"4.0.1"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:00:00Z","timestamp":1627430400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100030888","name":"Fondation Priv\u00e9e des H\u00f4pitaux Universitaires de Gen\u00e8ve","doi-asserted-by":"crossref","award":["QS05-26"],"award-info":[{"award-number":["QS05-26"]}],"id":[{"id":"10.13039\/100030888","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Lungen Liga Geneva"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2021,7,10]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pectus excavatum (PE) and pectus carinatum (PC) have generally been considered an aesthetic issue, although there is growing evidence of associated cardiopulmonary function (CPF) impairment, especially in PE patients. The study goal was to determine any correlation between pectus malformations and cardiopulmonary symptoms and function based on systematic assessment of CPF and thoracic measurements, such as Haller Index (HI) and sternal torsion angle (STA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from 76 adolescent patients with PE (n=30) or PC (n=46) were retrospectively collected referred between January 2015 and April 2018. CPF measurements and thoracic imaging were performed in all patients. HI and STA correction indexes were measured in all patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Medical records from 76 patients (PE n=30; PC n=46) were analysed. Patients were predominantly male (&gt;93.3%), and aged between 13 and 14\u00bd old. PE was associated with airway obstruction, with a forced expiratory volume in 1 s value under the lower limit of normal in 13% of cases (p&lt;0.001). Restrictive syndrome was observed in 23% of cases (p&lt;0.001), with a Z score for total lung capacity under the lower limit of normal. In PC, pulmonary function was not affected. All patients showed slightly decreased values of left and right ejection fraction and cardiac index at rest, although values were within normal range. There were no significant correlations between pulmonary and cardiac functions or between low CPF and thoracic measurements.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>Our results confirm the modest impact of pectus malformations on CPF at rest, without correlation with anamnestic dyspnoea on exertion, nor with chest pain or anatomical measurements. Validation of new correction indexes could be helping characterise these malformations and choose optimal therapeutic management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2021-001020","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T12:28:27Z","timestamp":1627561707000},"page":"e001020","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Cardiopulmonary function in adolescent patients with pectus excavatum or carinatum"],"prefix":"10.1136","volume":"8","author":[{"given":"Salim","family":"Ramadan","sequence":"first","affiliation":[{"name":"Paediatric Pulmonology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Wilde","sequence":"additional","affiliation":[{"name":"Division of Paediatric Surgery, Department of Paediatrics, Gynaecology and Obstretrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Tabard-Foug\u00e8re","sequence":"additional","affiliation":[{"name":"Division of Paediatric Surgery, Department of Paediatrics, Gynaecology and Obstretrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Toso","sequence":"additional","affiliation":[{"name":"Paediatric Radiology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Beghetti","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Vall\u00e9e","sequence":"additional","affiliation":[{"name":"Division of Radiology, Department of Radiology and Medical Informatics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regula","family":"Corbelli","sequence":"additional","affiliation":[{"name":"Paediatric Pulmonology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance","family":"Barazzone-Argiroffo","sequence":"additional","affiliation":[{"name":"Paediatric Pulmonology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"},{"name":"Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Lascombes","sequence":"additional","affiliation":[{"name":"Division of Paediatric Surgery, Department of Paediatrics, Gynaecology and Obstretrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4771-875X","authenticated-orcid":false,"given":"Isabelle","family":"Ruchonnet-M\u00e9trailler","sequence":"additional","affiliation":[{"name":"Paediatric Pulmonology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"},{"name":"Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"key":"2025083112385462000_8.1.e001020.1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivs045"},{"key":"2025083112385462000_8.1.e001020.2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2009.03.001"},{"key":"2025083112385462000_8.1.e001020.3","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-010-0155-5"},{"key":"2025083112385462000_8.1.e001020.4","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198909010-00009"},{"key":"2025083112385462000_8.1.e001020.5","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s00586-016-4753-4","article-title":"Evaluation of thoracic factors after scoliosis surgery in patients with both scoliosis and pectus excavatum","volume":"27","author":"Tauchi","year":"2018","journal-title":"Eur Spine J"},{"key":"2025083112385462000_8.1.e001020.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(03)00123-4"},{"key":"2025083112385462000_8.1.e001020.7","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20062"},{"key":"2025083112385462000_8.1.e001020.8","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-12-73"},{"key":"2025083112385462000_8.1.e001020.9","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.athoracsur.2017.09.037","article-title":"Impact of pectus excavatum on cardiopulmonary function","volume":"105","author":"Abu-Tair","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2025083112385462000_8.1.e001020.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-006-1861-y"},{"key":"2025083112385462000_8.1.e001020.11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.4103\/apc.APC_121_18","article-title":"Improvement of cardiopulmonary function after minimally invasive surgical repair of pectus excavatum (Nuss procedure) in children","volume":"12","author":"Das","year":"2019","journal-title":"Ann Pediatr Cardiol"},{"key":"2025083112385462000_8.1.e001020.12","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-015-0111-7"},{"key":"2025083112385462000_8.1.e001020.13","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"2025083112385462000_8.1.e001020.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.07.021"},{"key":"2025083112385462000_8.1.e001020.15","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2009.072785"},{"key":"2025083112385462000_8.1.e001020.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(87)80585-7"},{"key":"2025083112385462000_8.1.e001020.17","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-003-1116-1"},{"key":"2025083112385462000_8.1.e001020.18","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3389\/fped.2017.00257","article-title":"New methods for imaging evaluation of chest wall deformities","volume":"5","author":"Lain","year":"2017","journal-title":"Front Pediatr"},{"key":"2025083112385462000_8.1.e001020.19","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.8724"},{"key":"2025083112385462000_8.1.e001020.20","doi-asserted-by":"publisher","DOI":"10.1136\/thx.48.8.803"},{"key":"2025083112385462000_8.1.e001020.21","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201710-1981ST"},{"key":"2025083112385462000_8.1.e001020.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0232575","article-title":"Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape","volume":"15","author":"Biavati","year":"2020","journal-title":"PLoS One"},{"key":"2025083112385462000_8.1.e001020.23","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-010-0067-z"},{"key":"2025083112385462000_8.1.e001020.24","doi-asserted-by":"crossref","first-page":"466","DOI":"10.21037\/acs.2016.09.09","article-title":"Diminished pulmonary function in pectus excavatum: from denying the problem to finding the mechanism","volume":"5","author":"Kelly","year":"2016","journal-title":"Ann Cardiothorac Surg"},{"key":"2025083112385462000_8.1.e001020.25","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt345"},{"key":"2025083112385462000_8.1.e001020.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.03.027"},{"key":"2025083112385462000_8.1.e001020.27","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1007\/s00383-020-04738-5","article-title":"The chest wall gender divide: females have better cardiopulmonary function and exercise tolerance despite worse deformity in pectus excavatum","volume":"36","author":"Casar Berazaluce","year":"2020","journal-title":"Pediatr Surg Int"},{"key":"2025083112385462000_8.1.e001020.28","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/j.jpedsurg.2008.02.007","article-title":"Surgical correction of pectus carinatum: lessons learned from 260 patients","volume":"43","author":"Fonkalsrud","year":"2008","journal-title":"J Pediatr Surg"},{"key":"2025083112385462000_8.1.e001020.29","doi-asserted-by":"crossref","first-page":"456","DOI":"10.21037\/acs.2016.08.02","article-title":"A prospective study on quality of life in youths after pectus excavatum correction","volume":"5","author":"Lomholt","year":"2016","journal-title":"Ann Cardiothorac Surg"},{"key":"2025083112385462000_8.1.e001020.30","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1093\/ejcts\/ezaa335","article-title":"Impact of surgical treatment of pectus carinatum on cardiopulmonary function: a prospective study","volume":"59","author":"Del Frari","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025083112385462000_8.1.e001020.31","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivv286"},{"key":"2025083112385462000_8.1.e001020.32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0189128","article-title":"Occult RV systolic dysfunction detected by CMR derived RV circumferential strain in patients with pectus excavatum","volume":"12","author":"Truong","year":"2017","journal-title":"PLoS One"},{"key":"2025083112385462000_8.1.e001020.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.01.065"},{"key":"2025083112385462000_8.1.e001020.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.09.009"},{"key":"2025083112385462000_8.1.e001020.35","doi-asserted-by":"publisher","DOI":"10.1117\/1.3210782"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2021-001020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T19:39:04Z","timestamp":1756669144000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2021-001020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,7,29]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bmjresp-2021-001020"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2021-001020","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}