| Excessive anaerobic metabolism during exercise after repair of aortic coarctation. | |
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MedLine Citation:
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PMID: 9290605 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine whether survivors of surgery for coarctation of the aorta (CoA) have an excessive reliance on anaerobic metabolism during exercise. BACKGROUND: Patients with peripheral vascular disease cannot increase blood flow to their muscles normally during exercise. Consequently they acquire an early, excessive reliance on anaerobic metabolism and have depression of the ventilatory anaerobic threshold (VAT) and of the slope of the oxygen consumption-work rate relationship (delta VO2/delta WR). We speculated that the capacity to augment blood flow to the lower extremities during exercise may be impaired after CoA surgery and would result in similar metabolic disturbances. STUDY DESIGN: Progressive exercise tests were performed on 15 patients (ages 19 +/- 7 years; range, 10 to 32) after successful repair of CoA (residual resting gradient, 7.7 +/- 7.1 mm Hg; range, 0 to 18), 15 age- and sex-matched healthy control subjects, and 10 patients (ages 13 +/- 3 years; range, 10 to 20) who had undergone ligation of a patent ductus arteriosus. RESULTS: The CoA patients' VAT averaged 14.8 +/- 3.8 ml O2/kg per minute versus 19.3 +/- 3.1 ml O2/kg per minute for the control subjects (p < 0.01), and their delta VO2/delta WR averaged 8.2 +/- 1.8 ml/watt compared with 10.1 +/- 1.4 ml/watt for control subjects (p < 0.01). Furthermore, 10 of 15 CoA patients had a VAT of less than 40% of predicted maximal oxygen consumption, and 9 of 16 had a delta VO2/delta WR of less than 8.7 ml O2/watt (generally accepted abnormal values). Patients with patent ductus arteriosus resembled the healthy control subjects with regard to anaerobic metabolism during exercise. CONCLUSIONS: Patients who have had CoA repairs commonly manifest an excessive reliance on anaerobic metabolism during exercise. This phenomenon may result from persistent blood flow abnormalities across the aortic arch during exercise, which may be present even after apparently successful surgery. |
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Authors:
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J Rhodes; R L Geggel; G R Marx; L Bevilacqua; Y B Dambach; Z M Hijazi |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of pediatrics Volume: 131 ISSN: 0022-3476 ISO Abbreviation: J. Pediatr. Publication Date: 1997 Aug |
Date Detail:
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Created Date: 1997-10-02 Completed Date: 1997-10-02 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 210-4 Citation Subset: AIM; IM |
Affiliation:
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Division of Pediatric Cardiology, Floating Hospital for Children, Tufts-New England Medical Center, Boston, Massachusetts, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anaerobic Threshold / physiology* Anaerobiosis Aortic Coarctation / metabolism, physiopathology, surgery* Case-Control Studies Child Ductus Arteriosus, Patent / metabolism, physiopathology, surgery Energy Metabolism / physiology Exercise Test Humans Leg / blood supply Ligation Muscle, Skeletal / blood supply Oxygen Consumption / physiology Peripheral Vascular Diseases / metabolism, physiopathology Physical Exertion / physiology* Regional Blood Flow / physiology Survivors Work / physiology |
| Comments/Corrections | |
Comment In:
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J Pediatr. 1997 Aug;131(2):178-9
[PMID:
9290599
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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