Hemodynamic causes of exercise intolerance in Fontan patients

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Hemodynamic causes of exercise intolerance in Fontan patients. / Hebert, Anders; Jensen, Annette S; Mikkelsen, Ulla Ramer; Idorn, Lars; Sørensen, Keld E; Thilen, Ulf; Hanseus, Katarina; Søndergaard, Lars.

I: International Journal of Cardiology, Bind 175, Nr. 3, 20.08.2014, s. 478–483.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Hebert, A, Jensen, AS, Mikkelsen, UR, Idorn, L, Sørensen, KE, Thilen, U, Hanseus, K & Søndergaard, L 2014, 'Hemodynamic causes of exercise intolerance in Fontan patients', International Journal of Cardiology, bind 175, nr. 3, s. 478–483. https://doi.org/10.1016/j.ijcard.2014.06.015

APA

Hebert, A., Jensen, A. S., Mikkelsen, U. R., Idorn, L., Sørensen, K. E., Thilen, U., Hanseus, K., & Søndergaard, L. (2014). Hemodynamic causes of exercise intolerance in Fontan patients. International Journal of Cardiology, 175(3), 478–483. https://doi.org/10.1016/j.ijcard.2014.06.015

Vancouver

Hebert A, Jensen AS, Mikkelsen UR, Idorn L, Sørensen KE, Thilen U o.a. Hemodynamic causes of exercise intolerance in Fontan patients. International Journal of Cardiology. 2014 aug. 20;175(3):478–483. https://doi.org/10.1016/j.ijcard.2014.06.015

Author

Hebert, Anders ; Jensen, Annette S ; Mikkelsen, Ulla Ramer ; Idorn, Lars ; Sørensen, Keld E ; Thilen, Ulf ; Hanseus, Katarina ; Søndergaard, Lars. / Hemodynamic causes of exercise intolerance in Fontan patients. I: International Journal of Cardiology. 2014 ; Bind 175, Nr. 3. s. 478–483.

Bibtex

@article{f760f26cf2d44c32ba9cfaf6486ce086,

title = "Hemodynamic causes of exercise intolerance in Fontan patients",

abstract = "BACKGROUND: Exercise intolerance is frequent among Fontan patients and an important determinant for quality of life. This study investigated the hemodynamic causes of impaired exercise capacity in Fontan patients with particular focus on the influence of stroke volume index (SVI) and heart rate (HR).METHODS AND RESULTS: In 38 Fontan patients, peak oxygen consumption (VO2), SVI and HR were recorded during incremental load exercise test and compared with 19 age and gender matched controls. SVI (ml/m(2)) was lower in patients than controls during warm-up (28[26-31] vs. 35[30-39], p=0.0093), at submaximal (40[37-43] vs. 55[51-59], p<0.0001) and at maximal exercise (38[35-40] vs. 54[51-58], p<0.0001). Similarly, HR (% of expected maximum) was lower in patients at warm-up (45[43-48]% vs. 64[57-64]%, p<0.0001), submaximal (71[68-75]% vs 85[82-88]%, p<0.0001) and maximal exercise (84[80-88]% vs. 97[95-99]%, p<0.0001). Furthermore, SVI dropped 14% (from 44[41-48] to 38[35-40] ml/m(2)) in Fontan patients from the peak plateau to maximal exercise vs. 5% (from 57[53-61] to 54[51-58] ml/m(2)) in controls, p<0.0001. The low SVI and HR explained 67% and 20% of the difference in peak VO2 between Fontan patients and controls respectively.CONCLUSION: SVI decreased significantly in Fontan patients near the end of maximal effort exercise. The low SVI at maximal exercise was the most important hemodynamic factor limiting exercise capacity in Fontan patients, whereas chronotropic impairment had a smaller impact. The low SVI and HR at maximal exercise accounted for the difference in peak VO₂ between Fontan patients and controls in this study.CLINICAL TRIAL REGISTRATION: http://www.cvk.sum.dk/CVK/Home/English.aspx (protocol nr: H-3-2010-045).",

keywords = "Adolescent, Adult, Case-Control Studies, Child, Exercise Test, Exercise Tolerance, Female, Fontan Procedure, Heart Rate, Hemodynamics, Humans, Male, Oxygen Consumption, Stroke Volume, Young Adult",

author = "Anders Hebert and Jensen, {Annette S} and Mikkelsen, {Ulla Ramer} and Lars Idorn and S{\o}rensen, {Keld E} and Ulf Thilen and Katarina Hanseus and Lars S{\o}ndergaard",

year = "2014",

month = aug,

day = "20",

doi = "10.1016/j.ijcard.2014.06.015",

language = "English",

volume = "175",

pages = "478–483",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

number = "3",

}

RIS

TY - JOUR

T1 - Hemodynamic causes of exercise intolerance in Fontan patients

AU - Hebert, Anders

AU - Jensen, Annette S

AU - Mikkelsen, Ulla Ramer

AU - Idorn, Lars

AU - Sørensen, Keld E

AU - Thilen, Ulf

AU - Hanseus, Katarina

AU - Søndergaard, Lars

PY - 2014/8/20

Y1 - 2014/8/20

N2 - BACKGROUND: Exercise intolerance is frequent among Fontan patients and an important determinant for quality of life. This study investigated the hemodynamic causes of impaired exercise capacity in Fontan patients with particular focus on the influence of stroke volume index (SVI) and heart rate (HR).METHODS AND RESULTS: In 38 Fontan patients, peak oxygen consumption (VO2), SVI and HR were recorded during incremental load exercise test and compared with 19 age and gender matched controls. SVI (ml/m(2)) was lower in patients than controls during warm-up (28[26-31] vs. 35[30-39], p=0.0093), at submaximal (40[37-43] vs. 55[51-59], p<0.0001) and at maximal exercise (38[35-40] vs. 54[51-58], p<0.0001). Similarly, HR (% of expected maximum) was lower in patients at warm-up (45[43-48]% vs. 64[57-64]%, p<0.0001), submaximal (71[68-75]% vs 85[82-88]%, p<0.0001) and maximal exercise (84[80-88]% vs. 97[95-99]%, p<0.0001). Furthermore, SVI dropped 14% (from 44[41-48] to 38[35-40] ml/m(2)) in Fontan patients from the peak plateau to maximal exercise vs. 5% (from 57[53-61] to 54[51-58] ml/m(2)) in controls, p<0.0001. The low SVI and HR explained 67% and 20% of the difference in peak VO2 between Fontan patients and controls respectively.CONCLUSION: SVI decreased significantly in Fontan patients near the end of maximal effort exercise. The low SVI at maximal exercise was the most important hemodynamic factor limiting exercise capacity in Fontan patients, whereas chronotropic impairment had a smaller impact. The low SVI and HR at maximal exercise accounted for the difference in peak VO₂ between Fontan patients and controls in this study.CLINICAL TRIAL REGISTRATION: http://www.cvk.sum.dk/CVK/Home/English.aspx (protocol nr: H-3-2010-045).

AB - BACKGROUND: Exercise intolerance is frequent among Fontan patients and an important determinant for quality of life. This study investigated the hemodynamic causes of impaired exercise capacity in Fontan patients with particular focus on the influence of stroke volume index (SVI) and heart rate (HR).METHODS AND RESULTS: In 38 Fontan patients, peak oxygen consumption (VO2), SVI and HR were recorded during incremental load exercise test and compared with 19 age and gender matched controls. SVI (ml/m(2)) was lower in patients than controls during warm-up (28[26-31] vs. 35[30-39], p=0.0093), at submaximal (40[37-43] vs. 55[51-59], p<0.0001) and at maximal exercise (38[35-40] vs. 54[51-58], p<0.0001). Similarly, HR (% of expected maximum) was lower in patients at warm-up (45[43-48]% vs. 64[57-64]%, p<0.0001), submaximal (71[68-75]% vs 85[82-88]%, p<0.0001) and maximal exercise (84[80-88]% vs. 97[95-99]%, p<0.0001). Furthermore, SVI dropped 14% (from 44[41-48] to 38[35-40] ml/m(2)) in Fontan patients from the peak plateau to maximal exercise vs. 5% (from 57[53-61] to 54[51-58] ml/m(2)) in controls, p<0.0001. The low SVI and HR explained 67% and 20% of the difference in peak VO2 between Fontan patients and controls respectively.CONCLUSION: SVI decreased significantly in Fontan patients near the end of maximal effort exercise. The low SVI at maximal exercise was the most important hemodynamic factor limiting exercise capacity in Fontan patients, whereas chronotropic impairment had a smaller impact. The low SVI and HR at maximal exercise accounted for the difference in peak VO₂ between Fontan patients and controls in this study.CLINICAL TRIAL REGISTRATION: http://www.cvk.sum.dk/CVK/Home/English.aspx (protocol nr: H-3-2010-045).

KW - Adolescent

KW - Adult

KW - Case-Control Studies

KW - Child

KW - Exercise Test

KW - Exercise Tolerance

KW - Female

KW - Fontan Procedure

KW - Heart Rate

KW - Hemodynamics

KW - Humans

KW - Male

KW - Oxygen Consumption

KW - Stroke Volume

KW - Young Adult

U2 - 10.1016/j.ijcard.2014.06.015

DO - 10.1016/j.ijcard.2014.06.015

M3 - Journal article

C2 - 25023794

VL - 175

SP - 478

EP - 483

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 3

ER -

ID: 138131547