title: Exercise capacity reflects ventricular function in patients having the Fontan circulation.
abstract: BACKGROUND
  In this study we sought to determine, first, whether maximal exercise capacity reflects ventricular function, and second, whether the age of the patient, and the age of completion of the Fontan circulation, influence ventricular function and exercise performance.
  
  
  RESULTS
  Cardiac magnetic resonance imaging and cardiopulmonary exercise testing were performed in 29 patients at a median time of 6.9 years after completion of the Fontan circulation. We divided the patients into 2 groups, the first 19 having their operation below the age of 18 years, and the second group, of 10 patients, having completion of the Fontan circulation when they were older than 18 years. Parameters for ventricular function and exercise were compared for both groups with controls. Compared to controls, the younger patients had normal end-diastolic ventricular volumes, but significantly impaired ventricular function, lower maximal work load and consumption of oxygen. The older patients had greater end-diastolic ventricular volumes, and significantly poorer ventricular function than both the younger patients and the controls. Maximal work load and consumption of oxygen were significantly lower in the older patients than in the younger ones and the controls.
  
  
  CONCLUSIONS
  Patients with the Fontan circulation have an impaired systolic ventricular function, which correlates with maximal exercise capacity and uptake of oxygen. Those having completion of the Fontan circulation when younger than 18 years had significantly better ventricular function and exercise performance than those who had completion of the Fontan circulation at an older age. An early creation of the Fontan circulation may preserve cardiac function and exercise capacity.
authors.affiliation: Departments of Congenital Heart Defects/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Germany. klimes@dhzb.de
authors.forename: Katrin
authors.initials: K
authors.lastname: Klimes
authors.forename: Stanislav
authors.initials: S
authors.lastname: Ovroutski
authors.forename: Hashim
authors.initials: H
authors.lastname: Abdul-Khaliq
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.forename: Vladimir
authors.initials: V
authors.lastname: Alexi-Meskishvili
authors.forename: Titus
authors.initials: T
authors.lastname: Kuehne
authors.forename: Matthias
authors.initials: M
authors.lastname: Gutberlet
authors.forename: Felix
authors.initials: F
authors.lastname: Berger
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D011379:Prognosis; D018754:Ventricular Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D016276:Ventricular Function / Q000502:physiology*