Cardiac performance assessment during cardiopulmonary exercise test can improve the management of children with repaired congenital heart disease

Guirgis, Lisa; Khraiche, Diala; Ladouceur, Magalie; Iserin, Laurence; Bonnet, Damien; Legendre, Antoine

doi:10.1016/j.ijcard.2019.10.032

Cited by 8 publications

(2 citation statements)

References 39 publications

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“…KKH olan çocuklarda, kardiyak onarımdan sonra rezidüel lezyonlar devam edebilmekte ve kardiyak fonksiyonda ilerleyici bir değişikliğe yol açabilmektedir (8). Bu hastalar eşlik eden pulmoner ve diğer tıbbi komplikasyonlara sahip olabilmektedir.…”

Section: Konjenital Kalp Hastalığıunclassified

YENİDOĞAN ve ÇOCUK BİREYLERDE KARDİYOPULMONER REHABİLİTASYON GEREKTİREN HASTALIKLAR

ATALAY

DURMUŞ

Yurdalan

2021

Gazi Sağlık Bilimleri Dergisi

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Kardiyopulmoner Rehabilitasyon gerektiren pediatrik hastalıklar, hastaların hem fiziksel sağlıklarını hem de uyum sonuçlarını etkilemektedir. Yaşamın erken dönemlerinde ameliyat gerektiren doğuştan kardiyak ve pulmoner sorunları olan çocuklar, gelişimsel gecikmeler ve bilişsel bozukluklar riski altındadır. Yaşamın daha ileri dönemlerinde olan çocuklar da aynı şekilde konjenital kalp hastalığı, kardiyomiyopatiler, kalp transplantasyonu, astım, kistik fibrozis gibi kardiyak ve pulmoner sorunlar yaşayabilmektedir. Bu hastalıkların sonucunda hastaların fonksiyonel kapasiteleri azalmaktadır ve sekonder problemlerin meydana gelme ihtimali olmaktadır. Azalan fonksiyonel kapasitenin iyileştirilmesi ve oluşabilecek sekonder problemlerin etkilerinin en aza indirilmesi isteği bu çocuklarda kardiyopulmoner rehabilitasyon gerekliliğini doğurmaktadır. Pediatrik kardiyopulmoner rehabilitasyon uygulamadan önce fizyoterapistin kardiyak ve pulmoner hastalıkların tanımlamalarını, patofizyolojilerini, fonksiyonel kapasitenin düşük olmasının nedenlerini, görülebilecek semptomları iyi bilmesi gerekmektedir.

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Section: Konjenital Kalp Hastalığıunclassified

YENİDOĞAN ve ÇOCUK BİREYLERDE KARDİYOPULMONER REHABİLİTASYON GEREKTİREN HASTALIKLAR

ATALAY

DURMUŞ

Yurdalan

2021

Gazi Sağlık Bilimleri Dergisi

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“…The potential causes of the impaired cardiovascular response are multiple and include ventricular dysfunction 4 5 6 , aberrant intraventricular conduction 7 , impaired ventilation mechanics 8 , arterial desaturation and residual lesions 9 in particular of RV outlet obstruction 10 and pulmonary/tricuspid valve regurgitation 4 .…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Exercise Testing in children and adolescents with repaired Tetralogy of Fallot

Danton,

Hadjisoteriou,

Noonan

et al. 2024

Preprint

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Introduction: By comparison with adults, cardiopulmonary exercise testing in children with Tetralogy of Fallot is limited, and its clinical application less validated. This study aimed to provide a comprehensive CPET profile in a child-adolescent population with repaired TOF, to explore cardiovascular mechanisms underpinning exercise intolerance and determine associations between CPET indices and clinical outcome.Methods Seventy-four CPETs were completed in 58 child and adolescents with repaired TOF (age 13.8 ± 2.4 years). CPET parameters were corrected for age, sex and body size using Blanchard formulae. At follow-up (4.9 years, IQR 3.5–7.9) clinical status and re-intervention was evaluated and CPET indices predicting these outcomes determined.Results Cohort VO2peak was within low-normal limits (% pred: 74.1% ± 15.4 ) with 15 patients (26%) displaying moderately-severe reduction (VO2peak < 65% pred). Oxygen uptake efficiency slope highly correlated with VO2peak (r = 0.94, p < 0.001) and was insensitive to exercise intensity. No significant change in CPET occurred in patients who underwent interval testing at 24 ± 14.5 months, although there was a variable response in VO2peak between individuals. Chronotropic response and heart rate-VO2 slope (indicator of stroke volume) predicted oxygen consumption: VO2peak (p < 0.001, R2 = 65.78%) and workload (p < 0.001, R2 = 52.32%). Adverse clinical status was associated with reduced workload (OR 0.97, p = 0.011). VE/VCO2 slope was steeper in those that died (39.2 SD 16.7 vs. 31.45 SD 5.06, p = 0.025). Twenty-four patients (43.8%) underwent RVOT intervention post-CPET which was associated with increased HR-VO2 slope (OR 1.042, p = 0.004).Conclusions In children and adolescents with repaired TOF important reduction in cardiopulmonary functioning were apparent in 25% of patients. Exercise intolerance was related to reduced chronotropic response and deficient stroke volume increment.

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Cardiopulmonary Exercise Testing in Children and Adolescents with Repaired Tetralogy of Fallot: Mechanisms of Exercise Intolerance and Clinical Implications

MHD,

et al. 2024

Pediatr Cardiol

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Cardiac performance assessment during cardiopulmonary exercise test can improve the management of children with repaired congenital heart disease

Cited by 8 publications

References 39 publications

YENİDOĞAN ve ÇOCUK BİREYLERDE KARDİYOPULMONER REHABİLİTASYON GEREKTİREN HASTALIKLAR

YENİDOĞAN ve ÇOCUK BİREYLERDE KARDİYOPULMONER REHABİLİTASYON GEREKTİREN HASTALIKLAR

Cardiopulmonary Exercise Testing in children and adolescents with repaired Tetralogy of Fallot

Cardiopulmonary Exercise Testing in Children and Adolescents with Repaired Tetralogy of Fallot: Mechanisms of Exercise Intolerance and Clinical Implications

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