RT Journal Article
SR Electronic
T1 High Mid-Flow to Vital Capacity Ratio and the Response to Exercise in Children With Congenital Heart Disease
JF Respiratory Care
FD American Association for Respiratory Care
SP 1629
OP 1635
DO 10.4187/respcare.04811
VO 61
IS 12
A1 Daphna Vilozni
A1 Maria Rosario Alcaneses-Ofek
A1 Ronen Reuveny
A1 Omer Rosenblum
A1 Omri Inbar
A1 Uriel Katz
A1 Tomer Ziv-Baran
A1 Gal Dubnov-Raz
YR 2016
UL http://rc.rcjournal.com/content/61/12/1629.abstract
AB BACKGROUND: Pulmonary mechanics may play a role in exercise intolerance in patients with congenital heart disease (CHD). A reduced FVC volume could increase the ratio between mid-flow (FEF25-75%) and FVC, which is termed high dysanapsis. The relationship between high dysanapsis and the response to maximum-intensity exercise in children with CHD had not yet been studied. The aim of this work was to examine whether high dysanapsis is related to the cardiopulmonary response to maximum-intensity exercise in pediatric subjects with CHD.METHODS: We retrospectively collected data from 42 children and adolescents with CHD who had either high dysanapsis (ratio >1.2; n = 21) or normal dysanapsis (control) (n = 21) as measured by spirometry. Data extracted from cardiopulmonary exercise test reports included peak values of heart rate, work load, V̇O2, V̇CO2, and ventilation parameters and submaximum values, including ventilatory threshold and ventilatory equivalents.RESULTS: There were no significant differences in demographic and clinical parameters between the groups. Participants with high dysanapsis differed from controls in lower median peak oxygen consumption (65.8% vs 83.0% of predicted, P = .02), peak oxygen pulse (78.6% vs 87.8% of predicted, P = .02), ventilatory threshold (73.8% vs 85.3% of predicted, P = .03), and maximum breathing frequency (106% vs 121% of predicted, P = .035). In the high dysanapsis group only, median peak ventilation and tidal volume were significantly lower than 80% of predicted values.CONCLUSIONS: In children and adolescents with corrected CHD, high dysanapsis was associated with a lower ventilatory capacity and reduced aerobic fitness, which may indicate respiratory muscle impairments.