Document Detail


Exercise performance after the arterial switch operation for D-transposition of the great arteries.
MedLine Citation:
PMID:  11249896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early- and intermediate-term results of the arterial switch operation for D-transposition of the great arteries (D-TGA) are encouraging. However, questions remain about the long-term outcome for these patients, especially with regard to exercise performance. Preliminary studies have demonstrated normal endurance time on treadmills. However, data regarding aerobic capacity and cardiopulmonary function are lacking. We report the cardiopulmonary performance of 22 school-age patients with D-TGA who underwent the arterial switch operation. Outcome variables included maximal oxygen consumption (VO2), maximal cardiac index, and peak heart rate. Patient and procedure-related variables were assessed for their association with outcome variables using linear and logistic regression. The mean values of maximal VO2 (113 +/- 19% predicted) and maximal cardiac index (96 +/- 18% predicted) were within normal limits for the pediatric population. Although the mean peak heart rate for the entire group (184 +/- 14 beats/min) was within normal limits, there were 7 subjects (32%) with chronotropic impairment. Significant ST-segment depression was seen in 2 subjects (9%). In regression analysis, surgery subsequent to the arterial switch was associated with lower maximal cardiac index (p = 0.01). Other variables were not significantly associated with maximal VO2, maximal cardiac index, and peak heart rate. In particular, chronotropic impairment was not significantly associated with maximal VO2 or maximal cardiac index. These findings demonstrate that cardiopulmonary performance during exercise is excellent after the arterial switch operation. The finding of ST-segment depression in some subjects supports the role of formal exercise testing in those patients participating in vigorous athletic activities.
Authors:
W T Mahle; M G McBride; S M Paridon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  87     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-23     Completed Date:  2001-04-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  753-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aerobiosis
Cardiac Output
Child
Electrocardiography
Exercise Test
Exercise Tolerance*
Female
Forced Expiratory Volume
Heart Rate
Humans
Logistic Models
Male
Oxygen Consumption
Prognosis
Respiratory Mechanics
Transposition of Great Vessels / physiopathology,  surgery*
Vital Capacity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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