Cardiorespiratory response during exercise in patients with cyanotic congenital heart disease with and without a Fontan operation and in patients with congestive heart failure

Citation
H. Ohuchi et al., Cardiorespiratory response during exercise in patients with cyanotic congenital heart disease with and without a Fontan operation and in patients with congestive heart failure, INT J CARD, 66(3), 1998, pp. 241-251
Citations number
29
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
INTERNATIONAL JOURNAL OF CARDIOLOGY
ISSN journal
0167-5273 → ACNP
Volume
66
Issue
3
Year of publication
1998
Pages
241 - 251
Database
ISI
SICI code
0167-5273(19981030)66:3<241:CRDEIP>2.0.ZU;2-G
Abstract
To clarify the different cardiorespiratory response to exercise in patients with congenital heart disease and patients with chronic congestive heart f ailure, we investigated the effect of a progressive exercise test in 30 pat ients aged 10 to 24 years, including 9 patients with cyanotic congenital he art disease (group A), 13 patients who had undergone a Fontan operation (gr oup B), and 8 patients with reduced left ventricular function (group C), an d 18 healthy controls (group D). There was no difference in peak oxygen upt ake among patient groups and all group A, B, and C values were lower than t hose in group D (P<0.001). Although peak heart rate was lower in patient gr oups than in group D, heart rate at a given exercise intensity was highest in group C. The oxygen pulse (oxygen uptake divided by heart rate=stroke vo lume x arterial venous oxygen difference), as an indicator of stroke volume , was lower in patients groups, especially in group C, than in group D. The re was no difference in tidal volume between groups A and D, but the respir atory rates at any given exercise intensity were higher in group A than in the other patient groups, thus minute ventilation and the ventilatory equiv alent were highest in group A. The increased respiratory rate and low tidal volume in group C resulted in rapid and shallow respiration. There was no difference in exertional symptoms at peak exercise among the groups. In add ition to impaired responses of stroke volume during exercise in patients wi th reduced exercise capacity, there was little limitation of increase in ve ntilation in group B and excessive ventilation in group A. The present resu lts suggest that relationship between ventilatory and cardiac responses dur ing exercise in patients with cyanotic congenital heart disease with and wi thout a Fontan operation is different from the relationship in patients wit h chronic congestive heart failure; however, these pathological differences did not influence exertional symptoms. (C) 1998 Published by Elsevier Scie nce Ireland Ltd. All rights reserved.