Cardiorespiratory Response to Exercise in Children after Modified Fontan Operation

Zając, Andrzej; Tomkiewicz, Lidia; Podolec, Piotr; Tracz, Wiesława; Malec, Edward

doi:10.1080/140174302753675348

Cited by 25 publications

(26 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean age at Fontan procedure was 5.1 ±3.3 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) years. The mean postoperative time was 19.4 ±5.1 (13-30) years.…”

Section: Resultsmentioning

confidence: 99%

“…In spite of the fact that Fontan operation significantly counteracted the mortality of patients with hemodynamically single ventricle, they develop many complications including the impairment of exercise capacity [2,3,5,10].…”

Section: Discussionmentioning

confidence: 99%

“…Those observations are in line with our study -we observed a trend towards a decrease of maximum HR and increase of HRR in Fontan patients according to postoperative time. A chronotropic incompetence can be related to an abnormal reflex control of heart rate or adrenergic dysfunction [2,16]. The HR plays an important role in controlling a CO in Fontan circulation during exercise [20].…”

Section: Discussionmentioning

confidence: 99%

“…The aim of Fontan procedure is to restore a balance between pulmonary and systemic circulation and improve or nearly normalize arterial saturation in patients with functionally univentricular heart. Nevertheless, due to the lack of subpulmonary pump, circulatory system becomes haemodynamically less efficient, what can lead to impairment of exercise capacity [2][3][4][5]. Reduction in exercise capacity can be caused by many factors, including an increase in pulmonary artery systolic pressure with a reduction of preload of single ventricle, impairment of autoregulation of systemic vascular resistance, and the absence of a prepulmonary pump [6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Exercise capacity in adult patients after Fontan procedure. (RCD code: IV-5B.1)

Smaś-Suska

Weryński

Dłużniewska

et al. 2016

Journal of Rare Cardiovascular Diseases

Self Cite

View full text Add to dashboard Cite

Background: The aim of Fontan procedure is to restore a balance between pulmonary and systemic circulation and improve or nearly normalize arterial saturation in patients with functionally univentricular heart. Nevertheless, due to the lack of subpulmonary pump, the circulatory system becomes haemodynamically less efficient, what can lead to the impairment of exercise capacity. Aim: The aim of the study was to investigate exercise capacity by means of cardiopulmonary exercise test and pulmonary function tests, of 37 adult Fontan patients with regard to the time passed from the index procedure. The patients were divided into 3 groups: group I -up to 15 years post procedure; group II -16-20 years, group III -more than 20 years after Fontan procedure). Results: 37 Fontan patients (mean age was 24.4 ±5.7 years, 40% of women) were enrolled in the study. The mean postoperative time was 19.4 ±5.1 (13-30) years. Mean, peak oxygen consumption (VO 2peak) was 22.7 ±7.1 ml/kg/min (64.2 ±18.5% of predicted value). According to postoperative time a significant increase of ventilatory equivalent of carbon dioxide (VE/VCO 2 ) (p = 0.033) and significant decrease of forced expiratory volume in 1 s/ vital capacity (FEV 1 %VC) between group 2 and 3 (p = 0.026) were observed. Additionally, the age of the patients correlated negatively with and heart rate (HR) (r = -0.360, p <0.05) and peak oxygen consumption (VO 2peak) (r = -0,337, p < 0.05). Moreover, age at Fontan operation and time after Fontan procedure was related to ventilator equivalent of oxygen (VE/VO 2 ) (r = -0,343, p <0.05, and r = 0.393, p <0.05). Single ventricle ejection fraction (SVEF) and atrioventricular regurgitation degree did not corresponded with cardiopulmonary exercise test (CPET) values. Conclusions: Results highlight the complex problem of diminished exercise capacity of Fontan patients depending on the time passed from the procedure. Exercise tolerance deteriorates in time: VE/VCO 2 increases, FEV1/VC markedly lowers in a group of Fontan patients at 20 years follow-up. JRCD 2016; 2 (8): [254][255][256][257][258]

show abstract

“…The mean age at Fontan procedure was 5.1 ±3.3 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) years. The mean postoperative time was 19.4 ±5.1 (13-30) years.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Exercise capacity in adult patients after Fontan procedure. (RCD code: IV-5B.1)

Smaś-Suska

Weryński

Dłużniewska

et al. 2016

Journal of Rare Cardiovascular Diseases

Self Cite

View full text Add to dashboard Cite

show abstract

“…Additionally, chronotropic incompetence occurs during exercise in patients with Fontan circulation [20], with an HR consistently lower than in normal subjects. This situation is due to abnormal reflex control of HR and adrenergic dysfunction [20,22]. Heart rate plays an important role in determining the cardiac output in Fontan circulation during exercise [19,20], when autonomic dysfunction of the sinus node leads to a relatively low HR [23].…”

Section: Discussionmentioning

confidence: 99%