[Influence of myocardial mass of the univentricular heart on exercise capacity in patients with functional single ventricle and Fontan surgery].
BACKGROUND
The Fontan operation causes an acute decrease of volume overload of the univentricular heart followed by changes in ventricular geometry. The postoperative increase of myocardial mass-volume-index (MVI) may alter ventricular diastolic function. In this study, we analysed whether the increase in MVI and changes of the ventricular geometry have an effect on the decrease of the exercise capacity in patients with Fontan surgery.


METHODS
We examined the cardiopulmonary function of 24 patients with functional single ventricle and Fontan operation 3.63 +/- 1.97 years after surgery (m = 14, w = 10, age: 14.57 +/- 9.74 years) using a bicycle cardiopulmonary exercise testing. The parameters of exercise capacity and cardiopulmonary function were correlated with Magnetic Resonance Imaging (MRI) parameters such as the MVI, enddiastolic ventricular muscle mass (EDMM) und endsystolic volume (ESV).


RESULTS
The exercise capacity was 2.06 +/- 0.54 W/kg (60.63 +/- 15.75% of the norm) and VO(2)max was 27.41 +/- 8.87 ml/min/kg (60.91 +/- 19.7% of the norm). There was a positive correlation of exercise capacity and VO(2)max with ESV (r(2) = 0.2572, p = 0.033) and EDMM (r(2) = 0.2544, p = 0.024), but none with the MVI.


CONCLUSIONS
Myocardial hypertrophy may influence the myocardial performance of the univentricular heart and thereby the physical performance in children and adults with Fontan circulation.
Niepage
S
S
Klinik für angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Schulze-Neick
I
I
Rechter
S
S
Abdul-Khaliq
H
H
Gutberlet
M
M
Alexi-Meskishvili
V
V
Hetzer
R
R
Lange
P E
PE
D000293:Adolescent; D000328:Adult; D002302:Cardiac Output / Q000502:physiology; D002306:Cardiac Volume / Q000502:physiology*; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology*; D002648:Child; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000473:pathology; D010100:Oxygen / Q000097:blood; D010807:Physical Endurance / Q000502:physiology; D011183:Postoperative Complications / Q000503:physiopathology*
D010100:Oxygen