Document Detail

Cardiorespiratory response during exercise in patients with cyanotic congenital heart disease with and without a Fontan operation and in patients with congestive heart failure.
MedLine Citation:
PMID:  9874076     Owner:  NLM     Status:  MEDLINE    
To clarify the different cardiorespiratory response to exercise in patients with congenital heart disease and patients with chronic congestive heart failure, we investigated the effect of a progressive exercise test in 30 patients aged 10 to 24 years, including 9 patients with cyanotic congenital heart disease (group A), 13 patients who had undergone a Fontan operation (group B), and 8 patients with reduced left ventricular function (group C), and 18 healthy controls (group D). There was no difference in peak oxygen uptake among patient groups and all group A, B, and C values were lower than those in group D (P<0.001). Although peak heart rate was lower in patient groups than in group D, heart rate at a given exercise intensity was highest in group C. The oxygen pulse (oxygen uptake divided by heart rate=stroke volume x arterial venous oxygen difference), as an indicator of stroke volume, was lower in patients groups, especially in group C, than in group D. There was no difference in tidal volume between groups A and D, but the respiratory rates at any given exercise intensity were higher in group A than in the other patient groups, thus minute ventilation and the ventilatory equivalent were highest in group A. The increased respiratory rate and low tidal volume in group C resulted in rapid and shallow respiration. There was no difference in exertional symptoms at peak exercise among the groups. In addition to impaired responses of stroke volume during exercise in patients with reduced exercise capacity, there was little limitation of increase in ventilation in group B and excessive ventilation in group A. The present results suggest that relationship between ventilatory and cardiac responses during exercise in patients with cyanotic congenital heart disease with and without a Fontan operation is different from the relationship in patients with chronic congestive heart failure; however, these pathological differences did not influence exertional symptoms.
H Ohuchi; Y Arakaki; Y Hiraumi; H Tasato; T Kamiya
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  66     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1999-03-16     Completed Date:  1999-03-16     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  241-51     Citation Subset:  IM    
Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan.
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MeSH Terms
Chronic Disease
Exercise Test
Fontan Procedure*
Heart Catheterization
Heart Defects, Congenital / diagnosis,  physiopathology*,  surgery
Heart Failure / diagnosis,  physiopathology*,  surgery
Hemodynamics / physiology
Respiratory Function Tests
Respiratory Physiological Phenomena*
Severity of Illness Index

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