Key result
Simulated high altitude elicits comparable pulmonary and hemodynamic responses in Fontan patients and healthy controls.
Why the study?
Current guidelines express safety concerns regarding altitude exposure for patients with a Fontan circulation, requiring investigation into hemodynamic and pulmonary responses to acute high altitude.
Does acute high-altitude exposure affect hemodynamic and pulmonary responses during exercise in patients with a Fontan circulation compared to healthy controls?
Observational (n=42)
Does acute high-altitude exposure affect hemodynamic and pulmonary responses during exercise in patients with a Fontan circulation compared to healthy controls?
Absolute Event Rate: -0.3% vs -12.8%
Acute high-altitude exposure (±2500 m) produces comparable pulmonary and hemodynamic responses in Fontan patients and healthy controls, suggesting it may be safer than current guidelines imply.
Acute high-altitude exposure may be safe in Fontan patients; challenges guideline concerns but remains hypothesis-generating pending prospective trials.
BACKGROUND: Traveling to high altitude has become more popular. High-altitude exposure causes hypobaric hypoxia. Exposure to acute high altitude, during air travel or mountain stays, seems to be safe for most patients with congenital heart disorders (CHD). Still, current guidelines for CHD patients express concerns regarding safety of altitude exposure for patients with a Fontan circulation. Therefore, investigating hemodynamic and pulmonary responses of acute high-altitude exposure (±2500 m) at rest and during maximal exercise in patients with Fontan circulation can provide clarity in this dispute and may contribute to improvement of clinical counseling. METHODS: Twenty-one Fontan patients with 21 age-matched healthy controls, aged 8-40 years, were enrolled in an observational study. Participants performed two cardiopulmonary exercise tests on a cycle ergometer with breath-by-breath respiratory gas analyses combined with noninvasive impedance cardiac output measurements: one at sea level (±6 m) and one at simulated high altitude (±2500 m), respectively. RESULTS: -diff (-0.3% vs -12.8%) between Fontan patients and healthy controls. CONCLUSION: Although, acute high-altitude exposure has a detrimental effect on exercise capacity, the impact on pulmonary and hemodynamic responses of high-altitude exposure is comparable between Fontan patients and healthy controls.
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Takken et al. (2019) conducted an observational in Fontan circulation (n=42). Simulated high altitude (±2500 m) vs. Sea level (±6 m) was evaluated on Exercise response difference. Acute simulated high-altitude exposure had a comparable impact on pulmonary and hemodynamic responses between Fontan patients and healthy controls (-0.3% vs -12.8%).
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