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March 1, 1998Journal of the American College of CardiologyOpen Access

Abnormal Dynamic Cardiorespiratory Responses to Exercise in Pediatric Patients After Fontan Procedure

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Why the study?

Do pediatric patients after the Fontan procedure have abnormal dynamic cardiorespiratory responses to submaximal exercise and recovery compared to healthy controls?

Population

16 pediatric patients who had undergone Fontan corrections for single-ventricle lesions, and 10 age-matched…

Comparison

Submaximal progressive exercise and 1-min… vs Age-matched healthy control subjects undergoing…

Design

Case-control

Authors

WTWilliam Brad TroutmanKaiser PermanenteTBThomas J. BarstowKansas State UniversityAGAlvaro GalindoUniversity of Nevada, Las Vegas

Discussion

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Overview

May guide exercise assessment in Fontan follow-up; leaves open whether targeting recovery improves outcomes.

Key Points

  • To evaluate dynamic cardiorespiratory responses during progressive submaximal exercise and recovery kinetics following brief exercise bursts in children with single-ventricle lesions repaired via the Fontan procedure.
  • Cross-sectional controlled study comparing 16 Fontan patients (mean age 12.2 ± 2.4 years; 9 boys) with 10 age-matched controls (mean age 12.2 ± 2.4 years; 6 boys).
  • Participants performed breath-by-breath gas exchange assessments on a cycle ergometer across two protocols: progressive exercise to evaluate dynamic cardiorespiratory relationships and a 1-minute constant work rate test to evaluate recovery times.
  • Peak VO2 and anaerobic threshold were significantly lower in Fontan patients compared to controls by 57% and 52%, respectively (p < 0.001).
  • Dynamic response slopes ΔVO2/ΔHR and ΔVO2/ΔWR were significantly reduced (p < 0.001), while ΔVE/ΔVCO2 was elevated (p < 0.005) in Fontan patients relative to controls.
  • Post-exercise recovery times in Fontan patients were prolonged by 154% for heart rate and 69% for VO2 (p < 0.01).

Structured PICO

Do pediatric patients after the Fontan procedure have abnormal dynamic cardiorespiratory responses to submaximal exercise and recovery compared to healthy controls?

P
Population
16 pediatric patients (mean age 12.2 +/- 2.4 years; 9 boys) who had undergone Fontan corrections for single-ventricle lesions, and 10 age-matched control subjects (mean age 12.2 +/- 2.4 years; 6 boys).
I
Intervention
Submaximal progressive exercise and 1-min constant work rate cycle ergometer tests.
C
Comparator
Age-matched healthy control subjects undergoing the same exercise protocols.
O
Outcome
Dynamic cardiorespiratory function (peak VO2, anaerobic threshold, dynamic relations of VO2, VCO2, VE, HR, WR) and recovery times for HR and VO2.surrogate

Pediatric patients after the Fontan procedure exhibit abnormal submaximal gas exchange responses to progressive exercise and prolonged recovery times after brief high-intensity exercise, providing mechanistic insight into their reduced physical activity.

Cite This Study

Troutman et al. (1998) studied this question.

synapsesocial.com/papers/6a7a647d4c448619ca0e22fchttps://doi.org/10.1016/s0735-1097(97)00545-7
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Dynamics of oxygen uptake during exercise in adults with cyanotic congenital heart disease.1986 · 132 citations
  2. 2Breath-by-breath measurement of true alveolar gas exchange1981 · 438 citations
  3. 3The Morbidity of Cardiac Nondisease in Schoolchildren1967 · 246 citations
  4. 4The level and tempo of children???s physical activities: an observational study1995 · 990 citations
  5. 5Oxygen cost and oxygen uptake dynamics and recovery with 1 min of exercise in children and adults1991 · 98 citations