Journal Article

Analysis of the recovery phase after maximal exercise in children with repaired tetralogy of Fallot and the relationship with ventricular function

Panzer, Joseph, François, Katrien, Bové, Thierry, De Wilde, Hans, De Groote, Katya, Boone, Jan, Martens, Thomas, Muiño Mosquera, Laura, Van Belleghem, Hannah, Coomans, Ilse, Vandekerckhove, Kristof, De Kinder, Sara, De Wolf, Daniël

2020

Overview

Few studies demonstrate delayed recovery after exercise in children and adults with heart disease. We assess the recovery patterns of gas exchange parameters and heart rate (HR) in children with repaired Tetralogy of Fallot (rToF) compared to healthy peers and investigate the correlation with ventricular function and QRS duration. 45 children after rToF and 45 controls performed a maximal incremental cardiopulmonary exercise test. In the subsequent recovery period, patterns of VO2, VCO2 and HR were analysed. Half-life time (T1/2) of the exponential decay and drop per minute (Recmin) were compared between groups. In the rToF group, correlations were examined between the recovery parameters and QRS-duration and ventricular function, described by fractional shortening (FS) and tricuspid annular plane systolic excursion (TAPSE) measured at baseline prior to exercise. Recovery of VO2 and VCO2 was delayed in rToF patients, half-life time values were higher compared to controls (T1/2VO2 52.51 ±11.29 s vs. 44.31 ± 10.47 s; p = 0.001 and T1/2VCO2 68.28 ± 13.84 s vs. 59.41 ± 12.06 s; p = 0.002) and percentage drop from maximal value was slower at each minute of recovery (p<0.05). Correlations were found with FS (T1/2VO2: r = -0.517; p<0.001; Rec1minVO2: r = -0.636, p<0.001; Rec1minVCO2: r = -0.373, p = 0.012) and TAPSE (T1/2VO2: r = -0.505; p<0.001; Rec1minVO2: r = -0.566, p<0.001; T1/2VCO2: r = -0.466; p = 0.001; Rec1minVCO2: r = -0.507, p<0.001), not with QRS-duration. No difference was found in HR recovery between patients and controls. Children after rToF show a delayed gas exchange recovery after exercise. This delay correlates to ventricular function, demonstrating its importance in recovery after physical activity.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Age / Biology and Life Sciences / Blood pressure / Cardiac function / Cardiac patients / Cardiology / Cardiovascular disease / Cardiovascular diseases / Care and treatment / Child / Children / Congenital diseases / Coronary artery disease / Correlation / Demographic aspects / Engineering and Technology / Evaluation / Exercise - physiology / Exercise for children / Exercise Test / Exercise Therapy - methods / Exercise Tolerance - physiology / Female / Gas exchange / Half-life / Heart diseases / Heart rate / Heart Rate - physiology / Heart surgery / Hospitals / Humans / Male / Medicine and Health Sciences / Parameters / Patient outcomes / Patients / Pediatrics / Physical activity / Physical fitness for children / Physical Sciences / Physical training / Physiological aspects / Recovery / Recovery (Medical) / Recovery of Function - physiology / Retrospective Studies / Tetralogy of Fallot / Tetralogy of Fallot - physiopathology / Tetralogy of Fallot - rehabilitation / Tetralogy of Fallot - surgery / Vanadium oxides / Ventricle / Ventricular Dysfunction, Right - physiopathology / Ventricular function / Ventricular Function - physiology / Ventricular Function, Right - physiology / Workloads