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A Novel Mechanism for Improved Exercise Performance in Pediatric Fontan Patients After Cardiac Rehabilitation

Wittekind, Samuel
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522419865157589

Abstract Details

2018, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Background: Patients with a Fontan circulation have impaired exercise capacity. Cardiac rehabilitation (CR) has shown promise in enhancing peak exercise parameters in this population, but an improvement in submaximal exercise has not been consistently demonstrated. We assessed the hypothesis that participation in CR will be associated with more efficient oxygen extraction and ventilation during submaximal exercise. Methods: In this prospective study, pediatric Fontans completed two 60 minute CR sessions per week for 12 weeks. Cardiopulmonary exercise testing and stress echocardiography were performed at baseline and last CR session, then compared with a paired sample t-test. Results: Ten pediatric Fontans completed the study. Five had tricuspid atresia and 5 had hypoplastic left heart syndrome. No serious adverse events occurred during CR sessions. Peak indexed oxygen consumption increased by a mean of 3.7 mL/kg/min (95% CI, 1.5 to 5.9; p=0.004), and peak oxygen pulse increased by a mean of 0.9 mL/beat (95% CI, 0.4 to 1.4; p=0.004). The peak respiratory exchange ratio did not change significantly. The significant difference in oxygen pulse became evident during submaximal exercise without a corresponding difference in echocardiographic stroke volume. Indexed oxygen consumption at ventilatory anaerobic threshold increased by a mean of 3.0 mL/kg/min (95% CI, -0.07 to 6.0; p=0.055). The slope for the volume of expired ventilation to volume of carbon dioxide production improved by a mean of 4.5 (95% CI, -8.4 to -0.6; p=0.03). Conclusions: We observed significant improvements in both submaximal and peak exercise performance in pediatric Fontans undergoing CR with no serious adverse events. These changes appeared to be mediated, at least in part, by more efficient oxygen extraction and ventilation.
Erin Haynes, Dr.P.H. (Committee Chair)
John Jefferies (Committee Member)
Eileen King, Ph.D. (Committee Member)
17 p.
Surgery
Fontan; Single ventricle; Cardiac Rehabiliation; Excersie therapy; Exercise testing

Recommended Citations

Citations

  • Wittekind, S. (2018). A Novel Mechanism for Improved Exercise Performance in Pediatric Fontan Patients After Cardiac Rehabilitation [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522419865157589

    APA Style (7th edition)

  • Wittekind, Samuel. A Novel Mechanism for Improved Exercise Performance in Pediatric Fontan Patients After Cardiac Rehabilitation. 2018. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522419865157589.

    MLA Style (8th edition)

  • Wittekind, Samuel. "A Novel Mechanism for Improved Exercise Performance in Pediatric Fontan Patients After Cardiac Rehabilitation." Master's thesis, University of Cincinnati, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522419865157589

    Chicago Manual of Style (17th edition)

ucin1522419865157589
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© 2018, some rights reserved.Creative Commons License A Novel Mechanism for Improved Exercise Performance in Pediatric Fontan Patients After Cardiac Rehabilitation by Samuel Wittekind is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. Based on a work at etd.ohiolink.edu.
This open access ETD is published by University of Cincinnati and OhioLINK.