Cardiac performance assessment during cardiopulmonary exercise test can improve the management of children with repaired congenital heart disease.
Int J Cardiol
; 300: 121-126, 2020 02 01.
Article
em En
| MEDLINE
| ID: mdl-31753582
ABSTRACT
BACKGROUND:
Children with repaired congenital heart disease (CHD) have impaired maximal aerobic capacity (VO2max). Determining the causes of their VO2max alteration remains challenging. Cardiac output measure using thoracic impedancemetry during cardiopulmonary exercise tests (CPET) can help to understand the determinants of VO2max in children with open-heart repaired CHD.METHOD:
We analyzed CPET in 77 children with repaired CHD. Among them, 55 patients had residual lesions. Patients with repaired CHD were compared with 44 age-matched healthy individuals. Maximal oxygen content brought to capillaries (QO2max) and oxygen muscle diffusion capacity (DO2) were assessed using cardiac output measure, Fick principle and simplified Fick law.RESULTS:
In the 55 patients with residual lesion, VO2max, QO2max and DO2 were lower than those of controls (76.1 vs 86% of theoretical value, pâ¯<â¯0.01; 2.15 vs 2.81â¯L/mn, pâ¯<â¯0.001; 24.7 vs 28.8â¯ml/min/mmHg, pâ¯<â¯0.05). Decrease in QO2max was due to both impaired stroke volume and chronotropic insufficiency (48 vs 53â¯ml/m2 and pâ¯<â¯0.05; 171 vs 185/min pâ¯<â¯0.001). Patients without residual lesion (22/77) had normal VO2max with lower maximal heart rate compensated by higher SV (pâ¯<â¯0.05).CONCLUSION:
Aerobic capacity was normal in children without residual lesions after CHD repair. Patients with residual lesion have impaired VO2max due to both lower central and peripheral determinants. Measuring cardiac performance during CPET allowed a better selection of patients with altered cardiac reserve that can benefit from residual lesion treatment and find the good timing for intervention. Detection of peripheral deconditioning can lead to a rehabilitation program.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Consumo de Oxigênio
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Exercício Físico
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Tolerância ao Exercício
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Gerenciamento Clínico
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Teste de Esforço
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Cardiopatias Congênitas
Tipo de estudo:
Observational_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article