title: Impact of exercise training on muscle function and ergoreflex in Fontan patients: a pilot study.
abstract: BACKGROUND
  Several studies have demonstrated persistent reduced exercise capacity in Fontan patients even after surgical intervention. The purpose of this study was to evaluate if the skeletal muscle function of these patients is abnormal, if it correlates with exercise tolerance and if it can be improved by exercise training.
  
  
  METHODS
  We evaluated the functional capacity of seven patients who underwent Fontan procedure (age:16+/-5 years, mean+/-SD) and seven healthy children (19+/-7 years) paired for age, sex, height and weight. Evaluation included pulmonary evaluation, neuromuscular function and exercise tolerance. Secondly, an 8-week exercise training program was performed by five of these patients.
  
  
  RESULTS
  The ergoreflex contribution to absolute diastolic blood pressure was higher (12.5+/-4.8 vs. 5.6+/-4.2 mmHg; p=0.04) in Fontan patients vs. healthy subjects whereas a trend was encountered regarding the ergoreflex contribution to absolute systolic blood pressure (9.0+/-7.0 vs. 0.4+/-9.0 mmHg; p=0.09). Furthermore, time to fatigue of the non-dominant forearm muscles was shorter in Fontan patients vs. healthy subjects (431+/-290 vs. 847+/-347 s; p=0.03). Following exercise training, there was a significant reduction of the ergoreflex contribution to absolute values of systolic blood pressure (9.8+/-0.9 vs. 0.3+/-2.7 mmHg; p<0.05). There was an association between muscle strength and VO2 peak in Fontan patients (upper limb: r=0.895; p<0.01; lower limb: r=0.838; p<0.05, respectively).
  
  
  CONCLUSIONS
  Skeletal muscle function in Fontan patients is abnormal which may have an impact in the reduced exercise tolerance encountered in these patients. Exercise training may have beneficial impacts on the skeletal muscle function in this population.
authors.affiliation: Institut Universitaire de Cardiologie et de Pneumologie, Hôpital Laval, Université Laval, Québec, Canada.
authors.forename: Patrice
authors.initials: P
authors.lastname: Brassard
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier
authors.forename: Julie
authors.initials: J
authors.lastname: Martin
authors.forename: Martin
authors.initials: M
authors.lastname: Noël
authors.forename: Eric
authors.initials: E
authors.lastname: Nadreau
authors.forename: Christine
authors.initials: C
authors.lastname: Houde
authors.forename: Alain
authors.initials: A
authors.lastname: Cloutier
authors.forename: Jean
authors.initials: J
authors.lastname: Perron
authors.forename: Jean
authors.initials: J
authors.lastname: Jobin
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D016552:Ergometry; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D018729:Fontan Procedure / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010101:Oxygen Consumption; D010865:Pilot Projects