Physiological Responses to Exercise in Pediatric Heart Transplant Recipients

被引:4
作者
Bovard, Joshua M. [1 ]
De Souza, Astrid M. [2 ]
Harris, Kevin C. [2 ,3 ]
Human, Derek G. [2 ,3 ]
Hosking, Martin C. K. [2 ,3 ]
Potts, James E. [2 ,3 ]
Armstrong, Kathryn [2 ]
Sandor, George G. S. [2 ,3 ]
Cote, Anita T. [3 ,4 ]
机构
[1] Univ British Columbia, Sch Kinesiol, Vancouver, BC, Canada
[2] BC Childrens Hosp, Childrens Heart Ctr, Vancouver, BC, Canada
[3] Univ British Columbia, Dept Pediat Cardiol, Vancouver, BC, Canada
[4] Trinity Western Univ, Sch Human Kinet, Langley, BC, Canada
基金
加拿大自然科学与工程研究理事会;
关键词
HEART TRANSPLANTATION; STRESS ECHOCARDIOGRAPHY; AEROBIC CAPACITY; LEFT VENTRICULAR FUNCTION; LEFT-VENTRICULAR MASS; CARDIAC-OUTPUT; STRESS ECHOCARDIOGRAPHY; PROGRESSIVE EXERCISE; ANATOMIC VALIDATION; AMERICAN-SOCIETY; UPRIGHT EXERCISE; NORMAL-CHILDREN; PERFORMANCE; GROWTH;
D O I
10.1249/MSS.0000000000001889
中图分类号
G8 [体育];
学科分类号
04 ; 0403 ;
摘要
Introduction Pediatric heart transplant (HTx) recipients have reduced exercise capacity typically two-thirds of predicted values, the mechanisms of which are not fully understood. We sought to assess the cardiorespiratory responses to progressive exercise in HTx relative to controls matched for age, sex, body size, and work rate. Methods Fourteen HTx recipients and matched controls underwent exercise stress echocardiography on a semisupine cycle ergometer. Hemodynamics, left ventricular (LV) dimensions, and volumes were obtained and indexed to body surface area. Oxygen consumption (VO2) was measured, and arteriovenous oxygen difference was estimated using the Fick Principle. Results At rest, LV mass index (P = 0.03) and volumes (P < 0.001) were significantly smaller in HTx, whereas wall thickness (P < 0.01) and LV mass-to-volume ratio (P = 0.01) were greater. Differences in LV dimensions and stroke volume persisted throughout exercise, but the pattern of response was similar between groups as HR increased. As exercise progressed, heart rate and cardiac index increased to a lesser extent in HTx. Despite this, VO2 was similar (P = 0.82) at equivalent work rates as HTx had a greater change in arteriovenous oxygen difference (P < 0.01). Conclusions When matched for work rate, HTx had similar metabolic responses to controls despite having smaller LV chambers and an attenuated increase in hemodynamic responses. These findings suggest that HTx may increase peripheral O-2 extraction as a compensatory mechanism in response to reduced cardiovascular function.
引用
收藏
页码:850 / 857
页数:8
相关论文
共 42 条
[1]   Left ventricular distensibility does not explain impaired exercise capacity in pediatric heart transplant recipients [J].
Altamirano-Diaz, Luis A. ;
Nelson, Michael D. ;
West, Lori J. ;
Khoo, Nee S. ;
Rebeyka, Ivan M. ;
Haykowsky, Mark J. .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2013, 32 (01) :63-69
[2]   Factors associated with low physical activity levels following pediatric cardiac transplantation [J].
Banks, Laura ;
Dipchand, Anne I. ;
Manlhiot, Cedric ;
Millar, Kyle ;
McCrindle, Brian W. .
PEDIATRIC TRANSPLANTATION, 2012, 16 (07) :716-721
[3]   A NEW METHOD FOR DETECTING ANAEROBIC THRESHOLD BY GAS-EXCHANGE [J].
BEAVER, WL ;
WASSERMAN, K ;
WHIPP, BJ .
JOURNAL OF APPLIED PHYSIOLOGY, 1986, 60 (06) :2020-2027
[4]   Accuracy and repeatability of pediatric cardiac output measurement using Doppler: 20-year review of the literature [J].
Chew, MS ;
Poelaert, J .
INTENSIVE CARE MEDICINE, 2003, 29 (11) :1889-1894
[5]   DETERMINATION OF STROKE VOLUME AND CARDIAC-OUTPUT DURING EXERCISE - COMPARISON OF TWO-DIMENSIONAL AND DOPPLER ECHOCARDIOGRAPHY, FICK OXIMETRY, AND THERMODILUTION [J].
CHRISTIE, J ;
SHELDAHL, LM ;
TRISTANI, FE ;
SAGAR, KB ;
PTACIN, MJ ;
WANN, S .
CIRCULATION, 1987, 76 (03) :539-547
[6]   HEMODYNAMIC-RESPONSES TO UPRIGHT EXERCISE OF ADOLESCENT CARDIAC TRANSPLANT RECIPIENTS [J].
CHRISTOS, SC ;
KATCH, V ;
CROWLEY, DC ;
EAKIN, BL ;
LINDAUER, AL ;
BEEKMAN, RH .
JOURNAL OF PEDIATRICS, 1992, 121 (02) :312-316
[7]   Left ventricular myocardial response to exercise in children after heart transplant [J].
Cifra, Barbara ;
Dragulescu, Andreea ;
Brun, Henrik ;
Slorach, Cameron ;
Friedberg, Mark K. ;
Manlhiot, Cedric ;
McCrindle, Brian W. ;
Dipchand, Anne ;
Mertens, Luc .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2014, 33 (12) :1241-1247
[8]   Semi-supine Exercise Stress Echocardiography in Children and Adolescents: Feasibility and Safety [J].
Ciliberti, P. ;
McLeod, I. ;
Cairello, F. ;
Kaski, J. P. ;
Fenton, M. ;
Giardini, A. ;
Marek, J. .
PEDIATRIC CARDIOLOGY, 2015, 36 (03) :633-639
[9]   AEROBIC PARAMETERS OF EXERCISE AS A FUNCTION OF BODY SIZE DURING GROWTH IN CHILDREN [J].
COOPER, DM ;
WEILERRAVELL, D ;
WHIPP, BJ ;
WASSERMAN, K .
JOURNAL OF APPLIED PHYSIOLOGY, 1984, 56 (03) :628-634
[10]   Coronary artery intimal thickening and ventricular dynamics in pediatric heart transplant recipients [J].
Cote, Anita T. ;
Hosking, Martin ;
Voss, Christine ;
Human, Derek G. ;
Sandor, George G. S. ;
Harris, Kevin C. .
CONGENITAL HEART DISEASE, 2018, 13 (05) :663-670