Decreased Exercise Performance with Age in Children with Hypoplastic Left Heart Syndrome - 07/03/14
, Richard E. Chinnock, MD b, Kathy J. Jenkins, MD, MPH c, William T. Mahle, MD d, Neda Mulla, MD b, Angela M. Sharkey, MD e, Michael F. Flanagan, MD a
Reprint requests: Pamela C. Jenkins, MD, PhD, Department of Pediatrics, Dartmouth Medical School, Hanover, NH 03756.Résumé |
Objective |
Children born with hypoplastic left heart syndrome (HLHS) may experience cardiac dysfunction after staged surgery or transplantation, which may worsen with age. We examined the hypothesis that exercise testing can address cardiovascular capacity and suggest interventions to improve quality of life.
Study design |
Children with HLHS ≥8 years old performed treadmill or bicycle ergometric testing at 4 centers. Results were compared with norms for age and sex.
Results |
Of the 42 participants, the mean age was 12.9 years (range, 8.5-17.0 years), 64% were boys, 20 had staged surgery, and 34 completed metabolic assessment. The percent of predicted maximal oxygen uptake (mVO2) was higher in younger children. Children aged 8 to 12 years achieved 70% of predicted mVO2; children aged 13 to 17 years achieved 60% of predicted mVO2 (P = .02). The percent of predicted peak heart rate trended higher in younger patients (83% versus 75%, P = .07). Electrocardiographic changes were more common in older children. In treadmill testing, patients who had a transplant had better exercise performance than patients who underwent staged surgery in percent of predicted exercise time (82% versus 54%, P < .0001) and peak rate-pressure product (241 × 103 versus 195 × 103, P = .02). The percent of predicted mVO2 did not differ between patients who had a transplant (66%) and patients who underwent staged surgery (61%, P = .25).
Conclusion |
Children with HLHS showed considerable age-related decline in exercise performance, regardless of surgical strategy.
Le texte complet de cet article est disponible en PDF.Abbreviations : CHQ-CF87, CHQ-PF50, ECG, HLHS, mVO2, RER
Plan
| Supported by Clinical Scientist Development Awards from the Doris Duke Charitable Foundation, New York, NY, and the Agency for Healthcare Research and Quality, Department of Health and Human Services. The sponsors had no role in the study. |
Vol 152 - N° 4
P. 507-512 - avril 2008 Retour au numéro
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