title: Serial measurements of exercise performance in pediatric heart transplant patients using stress echocardiography.
abstract: Heart transplantation is an increasingly acceptable therapeutic option for children with end-stage and complex congenital heart disease. With advances in surgery, immunosuppression, and follow-up care, functional outcomes need to be evaluated. We report the results of serial exercise testing performed using stress echocardiography in a cohort of pediatric HTP. HTP (n = 7) exercised on a semi-recumbent ergometer to volitional fatigue. Echocardiography-Doppler measurements, HR, and blood pressure were taken at rest and during staged exercise. Results were compared with healthy CON (n = 12). HTP did significantly less work during exercise (940 vs. 1218 J/kg, p < 0.03). Their SVI (33 vs. 49 mL/m(2), p < 0.003), CI (5.16 vs. 9.25 L/min/m(2), p < 0.0005), and HR (162 vs. 185 bpm, p < 0.02) were lower at peak exercise. HTP had a lower SF at peak exercise (48% vs. 52%, p < 0.03) and an abnormal relationship between the MVCFc and σPS. During follow-up, hemodynamics and left ventricular function remained relatively constant in HTP. HTP are able to exercise safely; however, their exercise tolerance is reduced, and hemodynamics and contractility are diminished. Over time, their hemodynamics and left ventricular function have remained relatively constant.
authors.affiliation: Department of Pediatrics, BC Children's Hospital, The University of British Columbia, Vancouver, BC, Canada.
authors.forename: Joanne P
authors.initials: JP
authors.lastname: Yeung
authors.forename: Derek G
authors.initials: DG
authors.lastname: Human
authors.forename: George G S
authors.initials: GG
authors.lastname: Sandor
authors.forename: Astrid M
authors.initials: AM
authors.lastname: De Souza
authors.forename: James E
authors.initials: JE
authors.lastname: Potts
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002648:Child; D004452:Echocardiography / Q000379:methods; D025401:Echocardiography, Stress / Q000379:methods*; D015444:Exercise; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006331:Heart Diseases / Q000601:surgery / Q000628:therapy; D016027:Heart Transplantation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D010372:Pediatrics / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods; D016277:Ventricular Function, Left
chemical_list: D007166:Immunosuppressive Agents