Congenital heart diseaseRelation of Systemic Venous Return, Pulmonary Vascular Resistance, and Diastolic Dysfunction to Exercise Capacity in Patients With Single Ventricle Receiving Fontan Palliation
Section snippets
Methods
The University of Michigan institutional review board approved the study. We prospectively recruited Fontan patients aged 8 to 30 years living within 200 miles of the hospital or scheduled for upcoming appointments at our institution. Control subjects of similar age and gender were recruited from the local population. To reduce the risk to the study patients and to avoid possible confounding explanations for exercise intolerance, the exclusion criteria listed in Table 1 were applied. All
Results
The demographic and medical characteristics for the entire study population are summarized in Table 2. No differences between the groups were significant.
The exercise performance measures for both cohorts are listed in Table 3.
Discussion
Reduced exercise capacity in the postoperative Fontan patient has been well documented.12, 13, 14, 15, 16, 17, 18, 19, 20, 21 The etiology of this exercise limitation is multifactorial, although recent data have suggested a reduction in SV reserve as the primary determinant of variation in exercise performance across a large Fontan population.19 Chronotropic incompetence and arterial desaturation, although widely seen in this population and previously thought to explain a significant portion of
Acknowledgment
We acknowledge Robert Gajarski, MD, for his content review and editorial contributions, Caren Goldberg, MD, MS, for her statistical assistance, and Matthew Stephens, MS, and Nicole Warnke, MS, for their tireless efforts in the administration of the exercise testing in our study and on a daily basis.
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