Cardiopulmonary exercise test as a tool in surveillance after Fontan operation

Elizabeth W. Wang-Giuffre , Unnati H. Doshi

Vessel Plus ›› 2022, Vol. 6 ›› Issue (1) : 29

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Vessel Plus ›› 2022, Vol. 6 ›› Issue (1) :29 DOI: 10.20517/2574-1209.2021.98
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Cardiopulmonary exercise test as a tool in surveillance after Fontan operation

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Abstract

Fontan patients have significantly decreased exercise tolerance secondary to several factors, most notably, a lack of a subpulmonary pump to augment systemic venous return to the heart and to overcome the pulmonary vascular resistance. Cardiopulmonary exercise testing is an important inexpensive non-invasive tool to monitor for subclinical changes and functional data over time that may portend the need for earlier intervention.

Keywords

Fontan / cardiopulmonary exercise test / fontan outcomes / oxygen consumption / oxygen uptake efficiency slope / anaerobic threshold

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Elizabeth W. Wang-Giuffre, Unnati H. Doshi. Cardiopulmonary exercise test as a tool in surveillance after Fontan operation. Vessel Plus, 2022, 6(1): 29 DOI:10.20517/2574-1209.2021.98

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References

[1]

Fontan F.Surgical repair of tricuspid atresia.Thorax1971;26:240-8 PMCID:PMC1019078

[2]

Syamasundar Rao P.Fontan operation: a comprehensive review. In: S. Firstenberg M, Khan I, editors. Advances in complex valvular disease. IntechOpen; 2021.

[3]

Cordina RL,Karmali A.Resistance training improves cardiac output, exercise capacity and tolerance to positive airway pressure in Fontan physiology.Int J Cardiol2013;168:780-8

[4]

McCrindle BW,Mital S.Physical activity levels in children and adolescents are reduced after the Fontan procedure, independent of exercise capacity, and are associated with lower perceived general health.Arch Dis Child2007;92:509-14 PMCID:PMC2066169

[5]

Ong L,Irvine J.Parental overprotection and heart-focused anxiety in adults with congenital heart disease.Int J Behav Med2011;18:260-7

[6]

Argiento P,Mulè M.Exercise stress echocardiography for the study of the pulmonary circulation.Eur Respir J2010;35:1273-8 PMCID:PMC2879460

[7]

Stickland MK,Petersen SR.Does fitness level modulate the cardiovascular hemodynamic response to exercise?.J Appl Physiol (1985)2006;100:1895-901

[8]

Hsia TY,Redington AN,Deanfield JE.Effects of respiration and gravity on infradiaphragmatic venous flow in normal and Fontan patients.Circulation2000;102:III148-53

[9]

Gewillig MH,Bull C,Deanfield JE.Exercise responses in patients with congenital heart disease after fontan repair: Patterns and determinants of performance.J Am Coll Cardiol1990;15:1424-32

[10]

Lambert E,Cheung M.Sympathetic and vascular dysfunction in adult patients with Fontan circulation.Int J Cardiol2013;167:1333-8

[11]

Driscoll DJ,Heise CT.Functional single ventricle: cardiorespiratory response to exercise.J Am Coll Cardiol1984;4:337-42

[12]

Ohuchi H,Takasugi H,Yagihara T.Restrictive ventilatory impairment and arterial oxygenation characterize rest and exercise ventilation in patients after fontan operation.Pediatr Cardiol2004;25:513-21

[13]

Mancini DM,Kussmaul W,Edmunds LH Jr.Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure.Circulation1991;83:778-86

[14]

Driscoll DJ.Exercise testing after the Fontan operation.Pediatr Cardiol1999;20:57-9; discussion 60

[15]

Durongpisitkul K,Mahoney DW.Cardiorespiratory response to exercise after modified Fontan operation: determinants of performance.J Am Coll Cardiol1997;29:785-90

[16]

Harrison DA,Walters JE.Cardiopulmonary function in adult patients late after Fontan repair.J Am Coll Cardiol1995;26:1016-21

[17]

Cooper DM,Taylor-Lucas C,Galassetti P.Cardiopulmonary exercise testing in children and adolescents with high body mass index.Pediatr Exerc Sci2016;28:98-108 PMCID:PMC5920512

[18]

Butts RJ,Jackson L.Estimating equations for cardiopulmonary exercise testing variables in Fontan patients: derivation and validation using a multicenter cross-sectional database.Pediatr Cardiol2015;36:393-401 PMCID:PMC4361225

[19]

Giardini A,Pace Napoleone C.Natural history of exercise capacity after the Fontan operation: a longitudinal study.Ann Thorac Surg2008;85:818-21

[20]

Udholm S,Hjortdal VE.Prognostic power of cardiopulmonary exercise testing in Fontan patients: a systematic review.Open Heart2018;5:e000812 PMCID:PMC6059270

[21]

Cunningham JW,Rhodes J,Landzberg MJ.Decline in peak oxygen consumption over time predicts death or transplantation in adults with a Fontan circulation.Am Heart J2017;189:184-92

[22]

Diller GP,Dimopoulos K.Predictors of morbidity and mortality in contemporary Fontan patients: results from a multicenter study including cardiopulmonary exercise testing in 321 patients.Eur Heart J2010;31:3073-83

[23]

Egbe AC,Khan AR.Cardiopulmonary exercise test in adults with prior Fontan operation: the prognostic value of serial testing.Int J Cardiol2017;235:6-10

[24]

Nathan AS,Moko L.Exercise oscillatory ventilation in patients with Fontan physiology.Circ Heart Fail2015;8:304-11

[25]

Goldberg DJ,McBride MG.Exercise capacity in the Fontan circulation.Cardiol Young2013;23:824-30

[26]

Fernandes SM,Graham DA.Exercise testing identifies patients at increased risk for morbidity and mortality following Fontan surgery.Congenit Heart Dis2011;6:294-303

[27]

Goldberg DJ,Goldstein BH.Pediatric Heart Network InvestigatorsResults of the FUEL trial.Circulation2020;141:641-51 PMCID:PMC7042084

[28]

Baba R,Morotome Y.Reproducibility of the oxygen uptake efficiency slope in normal healthy subjects.J Sports Med Phys Fitness1999;39:202-6

[29]

Hollenberg M.Oxygen uptake efficiency slope: an index of exercise performance and cardiopulmonary reserve requiring only submaximal exercise.J Am Coll Cardiol2000;36:194-201

[30]

Bongers BC,Blank AC,Takken T.The oxygen uptake efficiency slope in children with congenital heart disease: construct and group validity.Eur J Cardiovasc Prev Rehabil2011;18:384-92

[31]

Giardini A,Gargiulo G,Picchio FM.Accuracy of oxygen uptake efficiency slope in adults with congenital heart disease.Int J Cardiol2009;133:74-9

[32]

Chen CA,Chiu HH.Prognostic value of submaximal exercise data for cardiac morbidity in Fontan patients.Med Sci Sports Exerc2014;46:10-5

[33]

Arena R,Abella J.Prognostic value of timing and duration characteristics of exercise oscillatory ventilation in patients with heart failure.J Heart Lung Transplant2008;27:341-7

[34]

Leite JJ,de Freitas HF.Periodic breathing during incremental exercise predicts mortality in patients with chronic heart failure evaluated for cardiac transplantation.J Am Coll Cardiol2003;41:2175-81

[35]

Guazzi M,Vicenzi M.Exercise oscillatory ventilation may predict sudden cardiac death in heart failure patients.J Am Coll Cardiol2007;50:299-308

[36]

Muneuchi J,Yamamura K.Exertional oscillatory ventilation during cardiopulmonary exercise test in Fontan patients with total cavopulmonary connection.Pediatr Cardiol2009;30:452-7

[37]

Paridon SM,Colan SD.Pediatric Heart Network InvestigatorsA cross-sectional study of exercise performance during the first 2 decades of life after the Fontan operation.J Am Coll Cardiol2008;52:99-107

[38]

Shafer KM,Rhodes J.Exercise testing and spirometry as predictors of mortality in congenital heart disease: contrasting Fontan physiology with repaired tetralogy of Fallot.Congenit Heart Dis2018;13:903-10

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