Exercise Capacity Improves With Time in Pediatric Heart Transplant Recipients

International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy—2010

“…Reports of exercise stress testing in relation to diagnosis and/or outcomes of CAV in pediatric patients is limited to the observation of a deterioration in maximum oxygen consumption over time being associated with graft loss in a handful of patients. 88 Histopathology examination for microvasculopathy within endomyocardial biopsy specimens was reported in the pediatric population in 2 studies but without correlation with outcomes. 75,85 Pathologic descriptions and grading systems varied between the 2 studies.…”

Exercise capacity following pediatric heart transplantation: A systematic review

“…Twenty‐nine articles underwent full‐text review, with an additional 13 articles excluded due to participant age (n=7), lack of exercise testing (n=3), and articles not in English (n=3). A total of 16 studies were included in this systematic review: six prospective cross‐sectional, five retrospective longitudinal, four retrospective cross‐sectional, and one case series . Validity appraisal scores ranged from 6/9 to 8/9.…”

“…Individual study sample sizes ranged from 3 to 128 participants. Nine studies had control groups ranging in size from 7 to 160 participants; seven studies compared the study sample to normative data . Description of study samples is reported in Table .…”

“…Age at HT ranged from 3 days to 18 years, and age at formal exercise testing ranged from 5 to 21 years. Time since transplantation ranged from 28 days to 20 years, with 11 studies including only exercise testing data completed after 6 months post‐HT . Four studies included testing both before and after 6 months post‐HT .…”

Left ventricular myocardial response to exercise in children after heart transplant

“…longer follow-up. 10 We have demonstrated improved exercise capacity during follow-up in children after transplant, 11 possibly explaining some of the aforementioned discrepancies, as exercise capacity seem to be determined largely by time after transplant. Factors contributing to exercise limitation include deconditioning before transplant, degree of reinnervation after transplant, decreased HR response to exercise and possible myocardial dysfunction.…”