Lung function and aerobic capacity in adult patients following modified Fontan procedure

OBJECTIVE To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation. DESIGN Retrospective cohort study. Values of maximum oxygen uptake (Vo 2max), maximum heart rate (HRmax), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were compared with...

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Published inHeart (British Cardiac Society) Vol. 85; no. 3; pp. 295 - 299
Main Authors Fredriksen, P M, Therrien, J, Veldtman, G, Warsi, M A, Liu, P, Siu, S, Williams, W, Granton, J, Webb, G
Format Journal Article
LanguageEnglish
Published London BMJ Publishing Group Ltd and British Cardiovascular Society 01.03.2001
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Abstract OBJECTIVE To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation. DESIGN Retrospective cohort study. Values of maximum oxygen uptake (Vo 2max), maximum heart rate (HRmax), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were compared with predictive values for different age groups. Patients were further subdivided into those with a pulmonary artery connection (RA–PA) or right atrium to right ventricle conduit (RA–RV). RESULTS At late follow up (median 10 years, range 1 to 26 years), patients with Fontan circulation had greatly diminished Vo 2max, HRmax, FVC, and FEV1 compared with predicted values. Early age at surgery had a positive impact on aerobic capacity. The FEV1:FVC ratio indicated restrictive lung function. No differences were found with respect to any variable between patients with RA–PA connections and those with RA–RV connections. CONCLUSIONS Patients with a Fontan circulation have greatly diminished values of aerobic capacity and a restrictive pattern of lung function. Patients with an early surgical procedure obtained higher values of Vo 2max. The theoretical benefits of including the right ventricle in a Fontan circulation were not apparent.
AbstractList To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation. Retrospective cohort study. Values of maximum oxygen uptake (VO(2)max), maximum heart rate (HRmax), forced vital capacity (FVC), and forced expiratory volume in one second (FEV(1)) were compared with predictive values for different age groups. Patients were further subdivided into those with a pulmonary artery connection (RA-PA) or right atrium to right ventricle conduit (RA-RV). At late follow up (median 10 years, range 1 to 26 years), patients with Fontan circulation had greatly diminished VO(2)max, HRmax, FVC, and FEV(1) compared with predicted values. Early age at surgery had a positive impact on aerobic capacity. The FEV(1):FVC ratio indicated restrictive lung function. No differences were found with respect to any variable between patients with RA-PA connections and those with RA-RV connections. Patients with a Fontan circulation have greatly diminished values of aerobic capacity and a restrictive pattern of lung function. Patients with an early surgical procedure obtained higher values of VO(2)max. The theoretical benefits of including the right ventricle in a Fontan circulation were not apparent.
OBJECTIVETo examine cardiopulmonary performance in 52 adult patients with a Fontan circulation.DESIGNRetrospective cohort study. Values of maximum oxygen uptake (VO(2)max), maximum heart rate (HRmax), forced vital capacity (FVC), and forced expiratory volume in one second (FEV(1)) were compared with predictive values for different age groups. Patients were further subdivided into those with a pulmonary artery connection (RA-PA) or right atrium to right ventricle conduit (RA-RV).RESULTSAt late follow up (median 10 years, range 1 to 26 years), patients with Fontan circulation had greatly diminished VO(2)max, HRmax, FVC, and FEV(1) compared with predicted values. Early age at surgery had a positive impact on aerobic capacity. The FEV(1):FVC ratio indicated restrictive lung function. No differences were found with respect to any variable between patients with RA-PA connections and those with RA-RV connections.CONCLUSIONSPatients with a Fontan circulation have greatly diminished values of aerobic capacity and a restrictive pattern of lung function. Patients with an early surgical procedure obtained higher values of VO(2)max. The theoretical benefits of including the right ventricle in a Fontan circulation were not apparent.
OBJECTIVE To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation. DESIGN Retrospective cohort study. Values of maximum oxygen uptake (Vo 2max), maximum heart rate (HRmax), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were compared with predictive values for different age groups. Patients were further subdivided into those with a pulmonary artery connection (RA–PA) or right atrium to right ventricle conduit (RA–RV). RESULTS At late follow up (median 10 years, range 1 to 26 years), patients with Fontan circulation had greatly diminished Vo 2max, HRmax, FVC, and FEV1 compared with predicted values. Early age at surgery had a positive impact on aerobic capacity. The FEV1:FVC ratio indicated restrictive lung function. No differences were found with respect to any variable between patients with RA–PA connections and those with RA–RV connections. CONCLUSIONS Patients with a Fontan circulation have greatly diminished values of aerobic capacity and a restrictive pattern of lung function. Patients with an early surgical procedure obtained higher values of Vo 2max. The theoretical benefits of including the right ventricle in a Fontan circulation were not apparent.
OBJECTIVE To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation. DESIGN Retrospective cohort study. Values of maximum oxygen uptake (V o 2 max), maximum heart rate (HRmax), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1 ) were compared with predictive values for different age groups. Patients were further subdivided into those with a pulmonary artery connection (RA-PA) or right atrium to right ventricle conduit (RA-RV). RESULTS At late follow up (median 10 years, range 1 to 26 years), patients with Fontan circulation had greatly diminished V o 2 max, HRmax, FVC, and FEV1 compared with predicted values. Early age at surgery had a positive impact on aerobic capacity. The FEV1 :FVC ratio indicated restrictive lung function. No differences were found with respect to any variable between patients with RA-PA connections and those with RA-RV connections. CONCLUSIONS Patients with a Fontan circulation have greatly diminished values of aerobic capacity and a restrictive pattern of lung function. Patients with an early surgical procedure obtained higher values of V o 2 max. The theoretical benefits of including the right ventricle in a Fontan circulation were not apparent.
OBJECTIVE —To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation.
 DESIGN —Retrospective cohort study. Values of maximum oxygen uptake (VO 2 max), maximum heart rate (HRmax), forced vital capacity (FVC), and forced expiratory volume in one second (FEV 1 ) were compared with predictive values for different age groups. Patients were further subdivided into those with a pulmonary artery connection (RA-PA) or right atrium to right ventricle conduit (RA-RV).
 RESULTS —At late follow up (median 10 years, range 1 to 26 years), patients with Fontan circulation had greatly diminished VO 2 max, HRmax, FVC, and FEV 1 compared with predicted values. Early age at surgery had a positive impact on aerobic capacity. The FEV 1 :FVC ratio indicated restrictive lung function. No differences were found with respect to any variable between patients with RA-PA connections and those with RA-RV connections.
 CONCLUSIONS —Patients with a Fontan circulation have greatly diminished values of aerobic capacity and a restrictive pattern of lung function. Patients with an early surgical procedure obtained higher values of VO 2 max. The theoretical benefits of including the right ventricle in a Fontan circulation were not apparent.


 Keywords: congenital heart disease; exercise test; lung function; aerobic capacity
Author Fredriksen, P M
Warsi, M A
Granton, J
Veldtman, G
Liu, P
Williams, W
Webb, G
Therrien, J
Siu, S
AuthorAffiliation Toronto General Hospital (University Health Network), University of Toronto Congenital Cardiac Centre for Adults, 200 Elizabeth Street 12th-215 EN, Toronto, Ontario M5G 2C4, Canada
AuthorAffiliation_xml – name: Toronto General Hospital (University Health Network), University of Toronto Congenital Cardiac Centre for Adults, 200 Elizabeth Street 12th-215 EN, Toronto, Ontario M5G 2C4, Canada
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  surname: Therrien
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  surname: Veldtman
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  surname: Warsi
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Issue 3
Keywords Human
Maximum oxygen consumption
Prognosis
Congenital
Cardiovascular disease
Aerobe
Congenital disease
Fontan operation
Lung function
Treatment
Heart disease
Adult
Exercise tolerance test
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Snippet OBJECTIVE To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation. DESIGN Retrospective cohort study. Values of maximum oxygen...
To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation. Retrospective cohort study. Values of maximum oxygen uptake (VO(2)max),...
OBJECTIVETo examine cardiopulmonary performance in 52 adult patients with a Fontan circulation.DESIGNRetrospective cohort study. Values of maximum oxygen...
OBJECTIVE —To examine cardiopulmonary performance in 52 adult patients with a Fontan circulation.
 DESIGN —Retrospective cohort study. Values of maximum oxygen...
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pubmed
pascalfrancis
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bmj
SourceType Open Access Repository
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StartPage 295
SubjectTerms Adult
Adults
aerobic capacity
Age groups
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular disease
Cohort Studies
Congenital diseases
Congenital Heart Disease
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Exercise
Exercise Test
Exercise Tolerance
Female
Fontan Procedure
Forced Expiratory Volume
Heart
Heart Defects, Congenital - physiopathology
Heart Defects, Congenital - surgery
Heart Rate
Hospitals
Humans
Linear Models
lung function
Male
Medical sciences
Mortality
Oxygen Consumption
Oxygen saturation
Patients
Physical fitness
Retrospective Studies
Spirometry
Surgery
Ventilation
Vital Capacity
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Title Lung function and aerobic capacity in adult patients following modified Fontan procedure
URI http://dx.doi.org/10.1136/heart.85.3.295
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Volume 85
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