Exercise Pathophysiology and Testing in Individuals With a Fontan Circulation.
Journal
CJC pediatric and congenital heart disease
ISSN: 2772-8129
Titre abrégé: CJC Pediatr Congenit Heart Dis
Pays: United States
ID NLM: 9918697364606676
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
03
11
2022
accepted:
07
01
2023
medline:
16
11
2023
pubmed:
16
11
2023
entrez:
16
11
2023
Statut:
epublish
Résumé
The Fontan circulation, a surgical palliation for single-ventricle congenital heart disease, profoundly impacts the cardiopulmonary response to exercise. Reliant on passive pulmonary blood flow, the Fontan circulation has limited capacity to augment cardiac output as necessary to supply working muscles during exercise. Cardiopulmonary exercise testing (CPET) objectively assesses cardiorespiratory fitness and provides insight into the etiology of exercise intolerance. Furthermore, CPET variables, such as peak oxygen consumption and submaximal variables, have prognostic value and may be used as meaningful endpoints in research studies. CPET is also useful in clinical research applications to assess the effect of pharmacologic or other interventions. Medical therapies to improve exercise tolerance in individuals with a Fontan circulation, such as pulmonary vasodilators, may modestly improve peak oxygen consumption. Exercise training focused on aerobic fitness and lower extremity strength may have a more consistent and larger impact on these measures of aerobic fitness. CPET is a valuable diagnostic and prognostic tool for those with a Fontan circulation. Newer ancillary assessments, such as noninvasive peripheral venous pressure monitoring and cardiac output measurements, hold promise to provide a more nuanced insight into the underlying pathophysiology. La circulation de Fontan, une solution chirurgicale palliative aux cardiopathies congénitales univentriculaires, a de profondes répercussions sur la réponse cardiorespiratoire à l’exercice physique. Puisqu’elle repose sur un flux sanguin pulmonaire passif, la circulation de Fontan présente une capacité limitée à accroître le débit cardiaque au besoin pour assurer l’approvisionnement des muscles durant l’effort physique. L’épreuve d’effort cardiorespiratoire (EECR) permet de mesurer la capacité cardiorespiratoire de manière objective et de mieux comprendre les causes de l’intolérance à l’effort. En outre, les variables mesurées lors de l’EECR, comme la consommation maximale d’oxygène (VO
Autres résumés
Type: Publisher
(fre)
La circulation de Fontan, une solution chirurgicale palliative aux cardiopathies congénitales univentriculaires, a de profondes répercussions sur la réponse cardiorespiratoire à l’exercice physique. Puisqu’elle repose sur un flux sanguin pulmonaire passif, la circulation de Fontan présente une capacité limitée à accroître le débit cardiaque au besoin pour assurer l’approvisionnement des muscles durant l’effort physique. L’épreuve d’effort cardiorespiratoire (EECR) permet de mesurer la capacité cardiorespiratoire de manière objective et de mieux comprendre les causes de l’intolérance à l’effort. En outre, les variables mesurées lors de l’EECR, comme la consommation maximale d’oxygène (VO
Identifiants
pubmed: 37969357
doi: 10.1016/j.cjcpc.2023.01.001
pii: S2772-8129(23)00002-7
pmc: PMC10642126
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
112-123Informations de copyright
© 2023 The Authors.
Références
Circulation. 2003 Sep 9;108(10):1227-31
pubmed: 12939218
Congenit Heart Dis. 2008 Jul-Aug;3(4):254-61
pubmed: 18715459
Heart. 2000 Apr;83(4):420-4
pubmed: 10722541
Am Heart J. 2016 Apr;174:80-8
pubmed: 26995373
Heart. 2016 Jul 15;102(14):1081-6
pubmed: 27220691
Pulm Circ. 2019 Jan-Mar;9(1):2045894018790450
pubmed: 29972332
Pediatr Res. 1988 Jul;24(1):1-5
pubmed: 3412842
J Thorac Cardiovasc Surg. 2014 Oct;148(4):1481-9
pubmed: 24507891
Cochrane Database Syst Rev. 2020 Oct 28;10:CD013400
pubmed: 33112424
Pediatr Cardiol. 2019 Dec;40(8):1584-1590
pubmed: 31473799
Circulation. 2019 Aug 6;140(6):e234-e284
pubmed: 31256636
Int J Pediatr. 2010;2010:
pubmed: 20871839
J Am Coll Cardiol. 2001 Jun 1;37(7):1967-74
pubmed: 11401140
Am J Cardiol. 2017 Aug 1;120(3):461-466
pubmed: 28624095
Heart. 2020 Feb;106(3):233-239
pubmed: 31492699
J Am Heart Assoc. 2020 Apr 21;9(8):e015639
pubmed: 32290749
Am J Cardiol. 2004 Jan 1;93(1):117-9
pubmed: 14697484
Semin Thorac Cardiovasc Surg. 2018 Winter;30(4):462-469
pubmed: 30063966
Am J Cardiol. 2019 Jul 1;124(1):144-150
pubmed: 31030969
J Am Coll Cardiol. 1998 Mar 1;31(3):668-73
pubmed: 9502651
J Am Heart Assoc. 2017 Aug 21;6(8):
pubmed: 28862962
J Thorac Cardiovasc Surg. 1999 Apr;117(4):697-704
pubmed: 10096964
Heart Fail Clin. 2014 Jan;10(1):105-16
pubmed: 24275298
Can J Cardiol. 2020 Sep;36(9):1499-1507
pubmed: 32284163
Circulation. 2020 Feb 25;141(8):641-651
pubmed: 31736357
Ann Thorac Surg. 2009 Aug;88(2):565-72; discussion 572-3
pubmed: 19632413
Pediatr Exerc Sci. 2012 Feb;24(1):2-21
pubmed: 22433260
Pediatr Cardiol. 2021 Dec;42(8):1740-1748
pubmed: 34136951
Am J Physiol Heart Circ Physiol. 2014 Jul 1;307(1):H110-7
pubmed: 24791784
Heart Fail Rev. 2021 Jan;26(1):91-100
pubmed: 31845048
Congenit Heart Dis. 2015 Mar-Apr;10(2):105-16
pubmed: 25196547
Circ Heart Fail. 2015 Mar;8(2):304-11
pubmed: 25550441
Eur Respir J. 2009 Oct;34(4):888-94
pubmed: 19324955
Ann Thorac Surg. 2008 Mar;85(3):818-21
pubmed: 18291148
Congenit Heart Dis. 2011 Jul-Aug;6(4):294-303
pubmed: 21418537
Int J Cardiol. 2017 May 15;235:6-10
pubmed: 28284501
J Am Coll Cardiol. 1997 Mar 15;29(4):785-90
pubmed: 9091525
J Clin Invest. 1994 Feb;93(2):677-83
pubmed: 7509345
Circulation. 1980 Sep;62(3):528-34
pubmed: 7398013
Congenit Heart Dis. 2018 Nov;13(6):903-910
pubmed: 30216689
J Appl Physiol (1985). 1997 Sep;83(3):948-57
pubmed: 9292484
Eur Heart J. 2008 Jul;29(13):1681-7
pubmed: 18534975
Heart. 2001 Mar;85(3):295-9
pubmed: 11179270
Cardiol Young. 2009 Aug;19(4):331-9
pubmed: 19519964
Pediatr Cardiol. 2022 Jun;43(5):969-976
pubmed: 35106621
Circulation. 2000 Mar 14;101(10):1080-2
pubmed: 10715250
Circulation. 1995 Jan 15;91(2):372-8
pubmed: 7805240
Postgrad Med J. 2007 Nov;83(985):675-82
pubmed: 17989266
Am J Cardiol. 2010 Apr 15;105(8):1169-75
pubmed: 20381672
J Am Coll Cardiol. 1990 May;15(6):1424-32
pubmed: 2329245
Circulation. 2011 Mar 22;123(11):1185-93
pubmed: 21382896
Eur Heart J. 2012 Jun;33(11):1386-96
pubmed: 22199119
Circulation. 1982 Jun;65(6):1043-8
pubmed: 7074766
J Am Coll Cardiol. 2017 Jun 6;69(22):2735-2744
pubmed: 28571639
ESC Heart Fail. 2022 Feb;9(1):337-344
pubmed: 34894102
Heart Lung Circ. 2021 Sep;30(9):1356-1363
pubmed: 33745814
J Heart Lung Transplant. 2022 Jun;41(6):704-707
pubmed: 35400586
Int J Cardiol. 2013 Sep 30;168(2):780-8
pubmed: 23154055
J Appl Physiol (1985). 2002 Mar;92(3):1183-90
pubmed: 11842057
Circulation. 2013 Aug 20;128(8):873-934
pubmed: 23877260
Heart. 2013 Oct;99(20):1530-4
pubmed: 23846614
Catheter Cardiovasc Interv. 2020 Mar 1;95(4):803-809
pubmed: 31145542
Pediatr Cardiol. 2021 Jan;42(1):158-168
pubmed: 32975603
J Cardiovasc Magn Reson. 2018 Dec 17;20(1):85
pubmed: 30558626
Pediatr Cardiol. 2017 Aug;38(6):1097-1105
pubmed: 28623384
Eur J Heart Fail. 2013 Jun;15(6):690-8
pubmed: 23361871
J Am Heart Assoc. 2020 Dec 15;9(24):e016850
pubmed: 33317366
J Am Coll Cardiol. 2012 Nov 13;60(20):2115-21
pubmed: 23083785
Congenit Heart Dis. 2015 Jan-Feb;10(1):E11-6
pubmed: 24890846
Thorac Cardiovasc Surg. 2010 Dec;58(8):468-72
pubmed: 21110269
Eur Heart J. 2010 Dec;31(24):3073-83
pubmed: 20929979
Int J Cardiol. 2013 Oct 3;168(3):1779-87
pubmed: 23746621
Ann Thorac Surg. 2009 Feb;87(2):555-60; discussion 560-1
pubmed: 19161779
J Am Coll Cardiol. 1984 Oct;4(4):756-64
pubmed: 6481015
Heart. 2016 Jul 15;102(14):1109-14
pubmed: 26917538
Int J Cardiol. 2021 Mar 1;326:77-80
pubmed: 33189798
Circulation. 2007 Sep 11;116(11 Suppl):I165-71
pubmed: 17846299
J Am Coll Cardiol. 1993 Jul;22(1):216-20
pubmed: 8251012
J Am Coll Cardiol. 1986 May;7(5):1087-94
pubmed: 3958365
Int J Cardiol. 2013 Oct 3;168(3):2435-40
pubmed: 23545150
Heart. 2020 Oct 30;:
pubmed: 33127650
Am J Cardiol. 1996 Apr 15;77(10):887-9
pubmed: 8623749
Heart. 2018 Apr;104(8):680-684
pubmed: 28988207
Jpn Heart J. 1998 Sep;39(5):659-69
pubmed: 9925997
Am J Physiol Heart Circ Physiol. 2019 Feb 1;316(2):H335-H344
pubmed: 30388023
Heart. 2017 Jul;103(14):1111-1116
pubmed: 28237969
Arch Dis Child. 2007 Jun;92(6):509-14
pubmed: 17307794
J Cardiovasc Med (Hagerstown). 2007 Oct;8(10):775-81
pubmed: 17885514
J Am Heart Assoc. 2020 Dec 15;9(24):e018345
pubmed: 33289459
J Heart Lung Transplant. 2014 Nov;33(11):1194-6
pubmed: 25169956
Cardiol Young. 2014 Apr;24(2):311-20
pubmed: 23552344
Cardiol Young. 2006 Jun;16(3):261-7
pubmed: 16725065
Eur J Prev Cardiol. 2021 Sep 20;28(11):1269-1278
pubmed: 34551076
Am Heart J. 2017 Jul;189:184-192
pubmed: 28625375
Med Sci Sports Exerc. 2014 Jan;46(1):10-5
pubmed: 23846156
Circulation. 2014 Dec 2;130(23):2021-30
pubmed: 25446057
Open Heart. 2018 Jul 3;5(1):e000812
pubmed: 30057765
Pediatr Cardiol. 2008 May;29(3):585-8
pubmed: 18071783
J Am Heart Assoc. 2019 May 7;8(9):e012008
pubmed: 31041880