Endurance training may improve exercise capacity, lung function and quality of life in Fontan patients.
exercise capacity
exercise training
fontan circulation
physical activity
quality of life
Journal
Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
revised:
31
08
2021
received:
30
01
2021
accepted:
22
09
2021
pubmed:
24
9
2021
medline:
28
1
2022
entrez:
23
9
2021
Statut:
ppublish
Résumé
Children born with univentricular hearts undergo staged surgical procedures to a Fontan circulation. Long-term experience with Fontan palliation has shown dramatically improved survival but also of a life-long burden of an abnormal circulation with significant morbidity. Many Fontan patients have reduced exercise capacity, oxygen uptake, lung function and quality of life. Endurance training may improve submaximal, but not maximal, exercise capacity, lung function and quality of life. Physical activity and endurance training is also positively correlated with sleep quality. Reviewing the literature and from our single-centre experience, we believe there is enough evidence to support structured individualised endurance training in most young Fontan patients.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
17-23Subventions
Organisme : The Swedish Order of Freemasons
Organisme : The Mayflower charity foundation for children
Organisme : The Samariten foundation for paediatric research
Organisme : The Swedish Heart-Lung Foundation
Organisme : Sällskapet Barnavård
Informations de copyright
© 2021 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
Références
Idorn L, Olsen M, Jensen AS, et al. Univentricular hearts in Denmark 1977 to 2009: incidence and survival. Int J Cardiol. 2013;167:1311-1316.
Kverneland LS, Kramer P, Ovroutski S. Five decades of the Fontan operation: a systematic review of international reports on outcomes after univentricular palliation. Congenit Heart Dis. 2018;13:181-193.
Pundi KN, Johnson JN, Dearani JA, et al. 40-year follow-up after the Fontan operation: long-term outcomes of 1,052 patients. J Am Coll Cardiol. 2015;66:1700-1710.
Bjork VO, Olin CL, Bjarke BB, Thoren CA. Right atrial-right ventricular anastomosis for correction of tricuspid atresia. J Thorac Cardiovasc Surg. 1979;77:452-458.
de Leval MR, Kilner P, Gewillig M, Bull C. Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations. experimental studies and early clinical experience. J Thorac Cardiovasc Surg. 1988;96:682-695.
Fontan F, Baudet E. Surgical repair of tricuspid atresia. Thorax. 1971;26:240-248.
Kanakis MA, Petropoulos AC, Mitropoulos FA. Fontan operation. Hellenic J Cardiol. 2009;50:133-141.
Alsaied T, Bokma JP, Engel ME, et al. Factors associated with long-term mortality after Fontan procedures: a systematic review. Heart. 2017;103:104-110.
Poh CL, d'Udekem Y. Life after surviving Fontan surgery: a meta-analysis of the incidence and predictors of late death. Heart Lung Circ. 2018;27:552-559.
Poh CL, Zannino D, Weintraub RG, et al. Three decades later: the fate of the population of patients who underwent the atriopulmonary Fontan procedure. Int J Cardiol. 2017;231:99-104.
Udholm S, Aldweib N, Hjortdal VE, Veldtman GR. Prognostic power of cardiopulmonary exercise testing in Fontan patients: a systematic review. Open Heart. 2018;5:e000812.
Hedlund ER, Ljungberg H, Soderstrom L, Lundell B, Sjoberg G. Impaired lung function in children and adolescents with Fontan circulation may improve after endurance training. Cardiol Young. 2018;28:1115-1122.
Hedlund ER, Lundell B, Soderstrom L, Sjoberg G. Can endurance training improve physical capacity and quality of life in young Fontan patients? Cardiol Young. 2018;28:438-446.
Hedlund ER, Lundell B, Villard L, Sjoberg G. Reduced physical exercise and health-related quality of life after Fontan palliation. Acta Paediatr. 2016;105:1322-1328.
Hedlund ER, Soderstrom L, Lundell B. Appropriate heart rate during exercise in Fontan patients. Cardiol Young. 2020;30:674-680.
Hedlund ER, Villard L, Lundell B, Sjoberg G. Physical exercise may improve sleep quality in children and adolescents with Fontan circulation. Cardiol Young. 2019;29:922-929.
McCrindle BW, Williams RV, Mital S, et al. 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 Child. 2007;92:509-514.
Longmuir PE, Russell JL, Corey M, Faulkner G, McCrindle BW. Factors associated with the physical activity level of children who have the Fontan procedure. Am Heart J. 2011;161:411-417.
Dulfer K, Bossers SS, Utens EM, et al. Does functional health status predict health-related quality of life in children after Fontan operation? Cardiol Young. 2016;26:459-468.
Holbein CE, Fogleman ND, Hommel K, et al. A multinational observational investigation of illness perceptions and quality of life among patients with a Fontan circulation. Congenit Heart Dis. 2018;13:392-400.
Knowles RL, Day T, Wade A, et al. Patient-reported quality of life outcomes for children with serious congenital heart defects. Arch Dis Child. 2014;99:413-419.
Marshall KH, D'Udekem Y, Sholler GF, et al. Health-related quality of life in children, adolescents, and adults with a Fontan circulation: a meta-analysis. J Am Heart Assoc. 2020;9:e014172.
Uzark K, Zak V, Shrader P, et al. Assessment of quality of life in young patients with single venwtricle after the fontan operation. J Pediatr. 2016;170:166-172.
Varni JW, Burwinkle TM, Seid M. The PedsQL as a pediatric patient-reported outcome: reliability and validity of the PedsQL measurement model in 25,000 children. Expert Rev Pharmacoecon Outcomes Res. 2005;5:705-719.
McCrindle BW, Williams RV, Mitchell PD, et al. Relationship of patient and medical characteristics to health status in children and adolescents after the Fontan procedure. Circulation. 2006;113:1123-1129.
Hock J, Reiner B, Neidenbach RC, et al. Functional outcome in contemporary children with total cavopulmonary connection - Health-related physical fitness, exercise capacity and health-related quality of life. Int J Cardiol. 2018;255:50-54.
Goldberg DJ, Avitabile CM, McBride MG, Paridon SM. Exercise capacity in the Fontan circulation. Cardiol Young. 2013;23:824-830.
Jenkins PC, Chinnock RE, Jenkins KJ, et al. Decreased exercise performance with age in children with hypoplastic left heart syndrome. J Pediatr. 2008;152:507-512.
Muller J, Christov F, Schreiber C, Hess J, Hager A. Exercise capacity, quality of life, and daily activity in the long-term follow-up of patients with univentricular heart and total cavopulmonary connection. Eur Heart J. 2009;30:2915-2920.
Scheffers LE, Berg LEV, Ismailova G, Dulfer K, Takkenberg JJ, Helbing WA. Physical exercise training in patients with a Fontan circulation: a systematic review. Eur J Prev Cardiol. 2021;28(11):1269-1278. 10.1177/2047487320942869
Brassard P, Poirier P, Martin J, et al. Impact of exercise training on muscle function and ergoreflex in Fontan patients: a pilot study. Int J Cardiol. 2006;107:85-94.
Longmuir PE, Tyrrell PN, Corey M, Faulkner G, Russell JL, McCrindle BW. Home-based rehabilitation enhances daily physical activity and motor skill in children who have undergone the Fontan procedure. Pediatr Cardiol. 2013;34:1130-1151.
Banks L, McCrindle BW, Russell JL, Longmuir PE. Enhanced physiology for submaximal exercise in children after the fontan procedure. Med Sci Sports Exerc. 2013;45:615-621.
Wittekind S, Mays W, Gerdes Y, et al. A novel mechanism for improved exercise performance in pediatric Fontan patients after cardiac rehabilitation. Pediatr Cardiol. 2018;39:1023-1030.
Duppen N, Etnel JR, Spaans L, et al. Does exercise training improve cardiopulmonary fitness and daily physical activity in children and young adults with corrected tetralogy of Fallot or Fontan circulation? a randomized controlled trial. Am Heart J. 2015;170:606-614.
Sutherland N, Jones B, d'Udekem Y. Should we recommend exercise after the Fontan procedure? Heart Lung Circ. 2015;24:753-768.
O'Byrne ML, Desai S, Lane M, McBride M, Paridon S, Goldmuntz E. Relationship between habitual exercise and performance on cardiopulmonary exercise testing differs between children with single and biventricular circulations. Pediatr Cardiol. 2017;38:472-483.
Cordina R, O'Meagher S, Gould H, et al. Skeletal muscle abnormalities and exercise capacity in adults with a Fontan circulation. Heart. 2013;99:1530-1534.
Kroonstrom LA, Johansson L, Zetterstrom AK, Dellborg M, Eriksson P, Cider A. Muscle function in adults with congenital heart disease. Int J Cardiol. 2014;170:358-363.
Sandberg C, Thilen U, Wadell K, Johansson B. Adults with complex congenital heart disease have impaired skeletal muscle function and reduced confidence in performing exercise training. Eur J Prev Cardiol. 2015;22:1523-1530.
Cordina RL, O'Meagher S, Karmali A, et al. Resistance training improves cardiac output, exercise capacity and tolerance to positive airway pressure in Fontan physiology. Int J Cardiol. 2013;168:780-788.
Shafer KM, Garcia JA, Babb TG, Fixler DE, Ayers CR, Levine BD. The importance of the muscle and ventilatory blood pumps during exercise in patients without a subpulmonary ventricle (Fontan operation). J Am Coll Cardiol. 2012;60:2115-2121.
Laohachai K, Winlaw D, Selvadurai H, et al. Inspiratory muscle training is associated with improved inspiratory muscle strength, resting cardiac output, and the ventilatory efficiency of exercise in patients with a Fontan circulation. J Am Heart Assoc. 2017;6:e005750.
Ait Ali L, Pingitore A, Piaggi P, et al. Respiratory training late after Fontan intervention: impact on cardiorespiratory performance. Pediatr Cardiol. 2018;39:695-704.
Turquetto ALR, Dos Santos MR, Agostinho DR, et al. Aerobic exercise and inspiratory muscle training increase functional capacity in patients with univentricular physiology after Fontan operation: a randomized controlled trial. Int J Cardiol. 2021;330:50-58.
Wu FM, Opotowsky AR, Denhoff ER, et al. A pilot study of inspiratory muscle training to improve exercise capacity in patients with Fontan physiology. Semin Thorac Cardiovasc Surg. 2018;30:462-469.
Fritz C, Muller J, Oberhoffer R, Ewert P, Hager A. Inspiratory muscle training did not improve exercise capacity and lung function in adult patients with Fontan circulation: a randomized controlled trial. Int J Cardiol. 2020;319:69-70.
Claessen G, La Gerche A, Van De Bruaene A, et al. Heart rate reserve in fontan patients: Chronotropic incompetence or hemodynamic limitation? J Am Heart Assoc. 2019;8:e012008.
Jacobsen RM, Ginde S, Mussatto K, Neubauer J, Earing M, Danduran M. Can a home-based cardiac physical activity program improve the physical function quality of life in children with Fontan circulation? Congenit Heart Dis. 2016;11:175-182.
Opotowsky AR, Landzberg MJ, Earing MG, et al. Abnormal spirometry after the Fontan procedure is common and associated with impaired aerobic capacity. Am J Physiol Heart Circ Physiol. 2014;307:H110-H117.
Idorn L, Hanel B, Jensen AS, et al. New insights into the aspects of pulmonary diffusing capacity in Fontan patients. Cardiol Young. 2014;24:311-320.
Turquetto ALR, Caneo LF, Agostinho DR, et al. Impaired pulmonary function is an additional potential mechanism for the reduction of functional capacity in clinically stable Fontan patients. Pediatr Cardiol. 2017;38:981-990.
Matthews IL, Fredriksen PM, Bjornstad PG, Thaulow E, Gronn M. Reduced pulmonary function in children with the Fontan circulation affects their exercise capacity. Cardiol Young. 2006;16:261-267.
Ohuchi H, Ohashi H, Takasugi H, Yamada O, Yagihara T, Echigo S. Restrictive ventilatory impairment and arterial oxygenation characterize rest and exercise ventilation in patients after fontan operation. Pediatr Cardiol. 2004;25:513-521.