Exercise performance after the arterial switch operation for D-transposition of the great arteries

被引:51
作者
Mahle, WT
McBride, MG
Paridon, SM
机构
[1] Childrens Hosp Philadelphia, Div Cardiol, Cardiovasc Exercise Physiol Lab, Philadelphia, PA 19104 USA
[2] Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA
关键词
D O I
10.1016/S0002-9149(00)01496-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Early- and intermediate-term results of the arterial switch operation for D-transposition of the great arteries (D-TGA) are encouraging. However, questions remain about the long-term outcome for these patients, especially with regard to exercise performance. Preliminary studies have demonstrated normal endurance time on treadmills. However, data regarding aerobic capacity and cardiopulmonary function are lacking. We report the cardiopulmonary performance of 22 school-age patients with D-TGA who underwent the arterial switch operation. Outcome variables included maximal oxygen consumption (VO2), maximal cardiac index, and peak heart rate. Patient and procedure-related variables were assessed for their association with outcome variables using linear and logistic regression. The mean values of maximal VO2 (113 +/- 19% predicted) and maximal cardiac index (96 +/- 18% predicted) were within normal limits for the pediatric population. Although the mean peak heart rate for the entire group (184 +/- 14 beats/ min) was within normal limits, there were 7 subjects (32%) with chronotropic impairment. Significant ST-segment depression was seen in 2 subjects (9%). In regression analysis, surgery subsequent to the arterial switch was associated with lower maximal cardiac index (p = 0.01). Other variables were not significantly associated with maximal VO2, maximal cardiac index, and peak heart rate. In particular, chronotropic impairment was not significantly associated with maximal VO2 or maximal cardiac index. These findings demonstrate that cardiopulmonary performance during exercise is excellent after the arterial switch operation. The finding of ST-segment depression in some subjects supports the role of formal exercise testing in those patients participating in vigorous athletic activities. (C) 2001 by Excerpta Medica, Inc. Inc.
引用
收藏
页码:753 / 758
页数:6
相关论文
共 19 条
[1]   Myocardial blood flow and coronary flow reserve late after anatomical correction of transposition of the great arteries [J].
Bengel, FM ;
Hauser, M ;
Duvernoy, CS ;
Kuehn, A ;
Ziegler, SI ;
Stollfuss, JC ;
Beckmann, M ;
Sauer, U ;
Muzik, O ;
Schwaiger, M ;
Hess, J .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 32 (07) :1955-1961
[2]   Long-term fate of the coronary arteries after the arterial switch operation in newborns with transposition of the great arteries [J].
Bonnet, D ;
Bonhoeffer, P ;
Piechaud, JF ;
Aggoun, Y ;
Sidi, D ;
Planche, C ;
Kachaner, J .
HEART, 1996, 76 (03) :274-279
[3]   EVIDENCE FOR FUNCTIONAL SYMPATHETIC REINNERVATION OF LEFT-VENTRICLE AND CORONARY-ARTERIES AFTER ORTHOTOPIC CARDIAC TRANSPLANTATION IN HUMANS [J].
BURKE, MN ;
MCGINN, AL ;
HOMANS, DC ;
CHRISTENSEN, BV ;
KUBO, SH ;
WILSON, RF .
CIRCULATION, 1995, 91 (01) :72-78
[4]   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
[5]   EXERCISE RESPONSES IN FUNCTIONAL SINGLE VENTRICLE BEFORE AND AFTER FONTAN OPERATION [J].
DRISCOLL, DJ .
PROGRESS IN PEDIATRIC CARDIOLOGY, 1993, 2 (03) :44-49
[6]   INFLUENCE OF ANATOMIC CORRECTION FOR TRANSPOSITION OF THE GREAT-ARTERIES ON MYOCARDIAL PERFUSION - RADIONUCLIDE IMAGING WITH TC-99M 2-METHOXY ISOBUTYL ISONITRILE [J].
HAYES, AM ;
BAKER, EJ ;
KAKADEKER, A ;
PARSONS, JM ;
MARTIN, RP ;
RADLEYSMITH, R ;
QURESHI, SA ;
YACOUB, M ;
MAISEY, MN ;
TYNAN, M .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1994, 24 (03) :769-777
[7]   Cardiological and general health status in preschool- and school-age children after neonatal arterial switch operation [J].
HovelsGurich, HH ;
Seghaye, MC ;
Dabritz, S ;
Messmer, BJ ;
vonBernuth, G .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 1997, 12 (04) :593-601
[8]   Abnormal neurohumoral responses to exercise in patients with heart disease: Inhibition of an increase in endothelin-1 production during exercise [J].
Ishikawa, S ;
Miyauchi, T ;
Ueno, M ;
Sagawa, K ;
Sakai, S ;
Ushinohama, H ;
Kado, H ;
Sunagawa, H ;
Goto, K ;
Sugishita, Y ;
Honda, S .
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 1998, 31 :S406-S411
[9]   Sympathetic denervation and reinnervation after arterial switch operation for complete transposition [J].
Kondo, C ;
Nakazawa, M ;
Momma, K ;
Kusakabe, K .
CIRCULATION, 1998, 97 (24) :2414-2419
[10]  
LARSEN RL, 1992, PEDIATRICS, V89, P722