Arterial Stiffness and Its Relationship to Cardiorespiratory Fitness in Children and Young Adults with a Fontan Circulation

Noortman, Laurien; Haapala, Eero A.; Takken, Tim

doi:10.1007/s00246-019-02065-8

Cited by 11 publications

(11 citation statements)

References 41 publications

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“…The correlation with a higher arterial stiffness corresponds with the majority of studies in paediatric and adult Fontan patients [4,7,24]. A small study in 17 paediatric and adult Fontan patients, using the same non-invasive methodology, did not show an effect of arterial stiffness on exercise capacity, which may be explained by the small sample size [6].…”

Section: Discussionsupporting

confidence: 69%

“…An inability to increase ventricular preload during exercise prevents an appropriate increase in cardiac output, which is considered an important factor limiting exercise tolerance [3]. Other contributing factors included chronotropic incompetence, systolic and diastolic ventricular dysfunction and arterial stiffness [3][4][5][6][7][8]. As there is a direct relation between exercise performance and long-term outcome, a thorough understanding of the mechanisms influencing exercise capacity is important for efforts to improve outcome.…”

Section: Introductionmentioning

confidence: 99%

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Determinants of exercise limitation in contemporary paediatric Fontan patients with an extra cardiac conduit

Harteveld

Blom

Monteros

et al. 2021

International Journal of Cardiology

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Background: Although various determinants of exercise limitation in Fontan patients have been studied, most research has been performed in patients who underwent different surgical procedures with differing haemodynamic characteristics. The aim of the current study was to evaluate non-invasively measured cardiovascular parameters and their influence on exercise performance in paediatric Fontan patients with an extracardiac conduit and moderate-good systolic ventricular function. Methods: Fontan patients, between 8 and 18 years of age, with moderate to good systolic ventricular function and an extracardiac conduit were included. Exercise performance and cardiovascular assessment, comprising echocardiography, aortic stiffness measurement and ambulatory measurement of cardiac autonomous nervous activity were performed on the same day. Healthy subjects served as controls. Results: Thirty-six Fontan patients (age 14.0 years) and thirty-five healthy subjects (age 12.8 years) were included. Compared to controls, Fontan patients had reduced diastolic ventricular function and increased arterial stiffness. No differences were found in heart rate (HR) and cardiac parasympathetic nervous activity. In Fontan patients, maximal as well as submaximal exercise capacity was impaired, with the percentage of predicted capacity ranging between 54 and 72%. Chronotropic competence, however, was good with a peak HR of 174 (94% of predicted). Lower maximal and submaximal exercise capacity was correlated with a higher HR at rest, higher pulse wave velocity of the aorta and a lower ratio of early and late diastolic flow velocity. Conclusion: Contemporary paediatric Fontan patients have an impaired exercise capacity with preserved chronotropic competence. Exercise performance correlates with heart rate at rest, diastolic function and aortic stiffness.Abbreviations: ANS, Autonomic nervous system; E/A, Ratio between pulse wave Doppler peak early and late diastolic velocities; E/E', Ratio between pulse wave Doppler peak early and tissue Doppler peak early diastolic velocities; HR, heart rate; LF:HF ratio, ratio of low to high frequency power; OUES, Oxygen uptake efficiency slope; PEP, Pre-ejection period; PWVao, Aortic pulse wave velocity; VE/VCO 2 slope, Respiratory minute to CO 2 production slope; VO 2 peak, Peak oxygen uptake..

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Determinants of exercise limitation in contemporary paediatric Fontan patients with an extra cardiac conduit

Harteveld

Blom

Monteros

et al. 2021

International Journal of Cardiology

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“…A higher-intensity exercise prescription will reduce people's compliance. 8 Experiments have shown that the blood pressure response of cycling is more robust than running in 40% and 60% HRR sports. In the gradient exercise test of healthy young people, the systolic blood pressure response was more substantial than that of running.…”

Section: Discussion the Effect Of Running And Cycling On Arterial Stiffnessmentioning

confidence: 99%

The Therapeutic Effects of Sports on Arterial Stiffness

Huang

Zou

2021

Rev Bras Med Esporte

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Introduction: Cardiovascular disease has become a significant condition affecting human health. Increased arterial stiffness is a leading stage in the occurrence and development of many cardiovascular diseases. Objective: To observe the effect of different acute exercise programs on arterial stiffness of healthy young people under the same amount of exercise. Methods: We selected 16 healthy boys to conduct a blank control test, continuous exercise test, and intermittent exercise. They were divided into blank schemes. Car plan and running plan. Arterial stiffness was repeatedly measured immediately after exercise and 40 minutes after the end. Results: In the three exercise intervention experiments, the heart-ankle vascular index decreased significantly immediately after exercise. After 60 minutes of rest, the heart-ankle vascular index rebounded. Conclusion: Physical exercise can significantly reduce arterial stiffness. Changing the training intensity in sports with the same target heart rate does not affect arterial stiffness. Level of evidence II; Therapeutic studies - investigation of treatment results.

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“…Moreover, reduced muscle mass and increased visceral fat are associated with large artery stiffness in postmenopausal women with type 2 diabetes mellitus and in middle-aged adults [ 9 , 10 ]. Lower levels of arterial stiffness correlate with higher values of cardiorespiratory fitness and muscle strength not only in older adults but also in younger [ 11 , 12 ]. In general, increased arterial stiffness impairs the proper functioning of some body systems and disrupts the quality of life in women after menopause.…”

Section: Introductionmentioning

confidence: 99%

Effects of Combined Resistance and Aerobic Training on Arterial Stiffness in Postmenopausal Women: A Systematic Review

Manojlovic

Protić-Gava

Maksimović

et al. 2021

IJERPH

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The aim of this systematic review was to investigate the effects of combined resistance and aerobic exercise on arterial stiffness in postmenopausal women. Two databases, PubMed and Google Scholar were searched to identify relevant studies. The methodological quality was assessed with the Physiotherapy Evidence Database (PEDro) scale. Only seven studies met the eligibility criteria, and their outcomes were presented. Four studies demonstrated the effects of combined resistance and aerobic training, while three showed the effectiveness of exercise with both training components, aerobic and resistance. In all studies, arterial stiffness was measured by brachial–ankle pulse wave velocity (baPWV). Participants were middle-aged or older postmenopausal women of various health statuses (hypertensive, with comorbidities or healthy). The results unequivocally show that combined training reduces arterial stiffness. The most important finding of this review paper is that the applied type of exercise decreased baPWV in the range of 0.6–2.1 m/s. Moreover, combined resistance and aerobic exercise for 12 weeks, performed three times a week for about 60 min per training session, at a moderate intensity (40–60% HRR or HRmax), may be clinically meaningful to the cardiovascular system. In conclusion, we can say that combined resistance and aerobic training, or exercise with resistance and aerobic components, have important health implications for the prevention of cardiovascular disease and the maintenance or improvement of health in middle-aged and older postmenopausal women with different health conditions.

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Arterial Stiffness and Its Relationship to Cardiorespiratory Fitness in Children and Young Adults with a Fontan Circulation

Cited by 11 publications

References 41 publications

Determinants of exercise limitation in contemporary paediatric Fontan patients with an extra cardiac conduit

Determinants of exercise limitation in contemporary paediatric Fontan patients with an extra cardiac conduit

The Therapeutic Effects of Sports on Arterial Stiffness

Effects of Combined Resistance and Aerobic Training on Arterial Stiffness in Postmenopausal Women: A Systematic Review

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