| Living at an altitude adversely affects exercise capacity in Fontan patients. | |
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MedLine Citation:
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PMID: 20849678 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Data assessing the effect of altitude on Fontan haemodynamics are limited to experimental models and case reports. Both suggest a detrimental impact. This study describes exercise performance in patients with Fontan circulation and matched controls at a low altitude versus at sea level. We sought to assess the impact of increasing altitude on functional capacity in patients with Fontan palliation. METHODS: A retrospective review of 22 patients at low altitude (1602 metres) and 119 patients at sea level with Fontan circulation, as well as age-, gender-, and altitude-matched controls, underwent maximal cardiopulmonary exercise testing. Linear regression models were created to determine the influence of altitude on differences in exercise variables between Fontan patients and their matched controls. RESULTS: Peak oxygen consumption was 28.4 millilitres per kilogram per minute (72% predicted) for the sea-level cohort and 24.2 millilitres per kilogram per minute (63% predicted) for the moderate altitude cohort. The matched case-control differences for patients at moderate altitude were greater for peak oxygen consumption (-29% against -13%, p = 0.04), anaerobic threshold (-36% against -5%, p = 0.001), and oxygen pulse (-35% against -18%, p = 0.007) when compared with patients living at sea level. When compared to institution-matched controls, the same parameters fell by 3%, 8.9%, and 4.2%, respectively, for each increase of 1000 feet in residential altitude (p = 0.03, p = 0.001, and p = 0.05, respectively). CONCLUSIONS: Patients with Fontan circulation at a higher altitude have impairment in aerobic capacity when compared with patients at sea level. Reduction in exercise capacity is associated with a reduction in stroke volume, likely related to increased pulmonary vascular resistance. |
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Authors:
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Jeffrey R Darst; Marko Vezmar; Brian W McCrindle; Cedric Manlhiot; Amy Taylor; Jennifer Russell; Anji T Yetman |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-09-20 |
Journal Detail:
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Title: Cardiology in the young Volume: 20 ISSN: 1467-1107 ISO Abbreviation: Cardiol Young Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-10-26 Completed Date: 2011-02-10 Revised Date: 2012-04-23 |
Medline Journal Info:
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Nlm Unique ID: 9200019 Medline TA: Cardiol Young Country: England |
Other Details:
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Languages: eng Pagination: 593-601 Citation Subset: IM |
Affiliation:
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The Heart Institute, The Children's Hospital, Aurora, Colorado, USA. darst.jeffrey@tchden.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Altitude* Anaerobic Threshold Blood Pressure Case-Control Studies Child Exercise Tolerance* Female Fontan Procedure* Heart Rate Humans Male Oxygen Consumption Respiration |
| Grant Support | |
ID/Acronym/Agency:
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U01 HL068288/HL/NHLBI NIH HHS; U01 HL068288-09/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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