title: [Role of right-to-left atrial shunt in exercise tolerance of patients with Ebstein anomaly].
abstract: The aim of this study was to assess cardiorespiratory tolerance to exercise in children with non-operated, paucisymptomatic and untreated froms of Ebstein's anomaly. The authors undertook a prospective study in 11 children, mean age 9.6 years, who had lung function tests, cardiorespiratory exercise stress tests (bicycle ergometry N = 8, treadmill N = 3) and contrast echocardiography. All parameters of spirometry were normal. Contrast echocardiography showed a right-to-left interatrial shunt in 7 children (group 1) whereas the remaining 4 children had no shunt (group 2). The resting oxygen saturation was 97.4 +/- 2%, with no difference between the two groups. On the other hand, oxygen saturation at peak VO2 (VO2 max) was 90 +/- 9.5%, significantly lower in group 1 than in group 2 (85.7 +/- 2.2% vs 98.2 +/- 1.2%; p = 0.03). In group 1, the VO2 max was correlated to oxygen saturation (r = 0.98; p < 0.001, N = 6). The oxygen desaturation was correlated with presence of a right-to-left interatrial shunt (p = 0.01). The reduced exercise tolerance of non-operated, paucisymptomatic children with Ebstein's anomaly is due to a right-to-left interatrial shunt. In patients with poor exercise tolerance, contrast echocardiography is advised for the detection of these atrial shunts.
authors.affiliation: Service de cardiologie pédiatrique, hôpital Robert-Debré 48, Paris.
authors.forename: J M
authors.initials: JM
authors.lastname: Lupoglazoff
authors.forename: S
authors.initials: S
authors.lastname: Magnier
authors.forename: M
authors.initials: M
authors.lastname: Kabaker
authors.forename: B
authors.initials: B
authors.lastname: Riescher
authors.forename: K
authors.initials: K
authors.lastname: Benali
authors.forename: E
authors.initials: E
authors.lastname: Prioux
authors.forename: C
authors.initials: C
authors.lastname: Gaultier
authors.forename: A
authors.initials: A
authors.lastname: Casasoprana
mesh_terms: D000293:Adolescent; D002648:Child; D004437:Ebstein Anomaly / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male
vernacular_title: Rôle du shunt droit-gauche atrial dans la diminution de la tolérance à l'effort de la maladie d'Ebstein asymptomatique.