Cerebral hemodynamics in the presence of decreased systemic venous compliance in patients with Fontan physiology may limit anaerobic exercise capacity.

Pediatric Cardiology
Rohit P RaoPeter C Frommelt

Abstract

Patients who have had the Fontan procedure report poor exercise performance. Fontan subjects can tolerate a higher level of sub maximal activity than might be anticipated from VO2, suggesting a different mechanism of exercise limitation. Near-infrared spectroscopy (NIRS) provides a non-invasive, continuous method to monitor regional tissue oxygenation (rSO2) and thereby a window into regional oxygen supply-demand relationships. We hypothesized that Fontan patients would have altered rSO2 trends from normal population that might reflect the mechanisms of exercise limitation. All the patients without structural or acquired heart disease and Fontan patients were eligible for inclusion if they were ordered to undergo cardiopulmonary exercise testing (CPET). Four-site regional rSO2 were recorded continuously during exercise. The difference between the oxyhemoglobin saturation measured by pulse oximetry (SpO2) and NIRS (rSO2) was computed as the regional arterial-venous saturation difference (AVDO2). A total of 33 normal subjects and five Fontan subjects scheduled for CPET were recruited. None of the Fontan subjects had a fenestration of the conduit. In the cerebral circulation, the Fontan patients have a significantly higher initial...Continue Reading

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Citations

Feb 10, 2016·American Heart Journal·Hirofumi SaikiHideaki Senzaki
Jan 12, 2013·Annales Françaises D'anesthèsie Et De Rèanimation·P Mauriat, N Tafer
Apr 2, 2016·The American Journal of Cardiology·Devaraj NavaratnamGruschen Veldtman
Aug 11, 2017·Congenital Heart Disease·Gruschen R VeldtmanMarc Gewillig
Apr 25, 2018·Circulation·Bradley S MarinoUNKNOWN American Heart Association Congenital Cardiac Defects Committee of the Council on Cardiovascular Disease in the Young; Counc
Sep 15, 2020·International Heart Journal·Norihiko OkaKagami Miyaji

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