Document Detail


Enhanced Physiology for Submaximal Exercise in Children after the Fontan Procedure.
MedLine Citation:
PMID:  23190591     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: After the Fontan procedure, children exhibit reduced peak exercise capacity; yet, their sub-maximal exercise response remains unclear. This study sought to determine the relationship between sub-maximal and peak exercise capacity, and physical activity in Fontan patients. METHODS: This cross-sectional study recruited 50 Fontan patients (59% males) with a median age of 9 years (range: 6-12). The median age at Fontan procedure was 2.9 years (range: 1.6-9.1). Study assessments included medical history, exercise testing, and accelerometry. RESULTS: Significantly lower sub-maximal oxygen consumption (VO2) and heart rate (HR) in response to a standardized workload than published values for healthy children, (mean±SD) of -1.72±5.24 (p<0.001) and -1.45±1.98 (p<0.001), respectively, suggest enhanced sub-maximal work efficiency in this group of patients after Fontan. Higher sub-maximal VO2 z-score was associated with higher sub-maximal HR z-Score (p=0.02) and lower body mass index z-score (p=0.01). Higher peakVO2 was associated with higher sub-maximal VO2 z-score (p<0.01), male sex (p=0.03), higher RER (p=0.02), lower sub-maximal HR z-score (p<0.01), and higher chronotropic responsiveness (p<0.0001). Exercise test duration z-score was associated with lower sub-maximal HR z-score (p=0.02) and higher chronotropic responsiveness (p=0.02). CONCLUSIONS: Fontan patients exhibit a lower sub-maximal VO2 and HR responsiveness at a given workload than healthy controls during standardized exercise testing; Thus, they may be better adapted to perform sub-maximal exercise. While peak exercise capacity is limited, Fontan patients are able to perform sub-maximal physical activities at the same level as their healthy peers.
Authors:
Laura Banks; Brian W McCrindle; Jennifer L Russell; Patricia E Longmuir
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-27
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  -     ISSN:  1530-0315     ISO Abbreviation:  Med Sci Sports Exerc     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
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