title: Effects of acute oxygen supplementation on functional capacity and heart rate recovery in Eisenmenger syndrome.
abstract: BACKGROUND
  Eisenmenger syndrome (ES) precipitates the extreme manifestation of pulmonary hypertension, which leads to severe functional limitation and poor quality of life. The propose of the current study was: 1) examined the acute effects of 40% oxygen supplementation during the 6-minute walk test (6MWT); and 2) evaluate the relation between exercise capacity and clinical cardiac parameters in patients with ES.
  
  
  METHODS
  Thirty subjects were prospectively included; all were submitted to a 6MWT with compressed air and with 40% of oxygen. Heart rate recovery at the first minute (HRR1) and perceived effort Borg scale for dyspnea and lower limb fatigue were recorded in both tests scenarios.
  
  
  RESULTS
  The 6MWT distance was modestly, negatively associated with pulmonary vascular resistance (PVR) [r=0.46, p=0.02]. Patients improved 6MWT distance (p<0.001) and exhibited a faster HRR1(p<0.001) with 40% supplemental oxygen compared to compressed air. With 40% supplemental oxygen, subjects revealed lower dyspnea and lower limb fatigue compared to 6MWT without oxygen supplementation (p<0.001). The amount of change in the 6MWT distance from air to oxygen was moderate, positively associated with tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (RVFAC) [r=0.50, p=0.03; r=0.64, p<0.001, respectively].
  
  
  CONCLUSIONS
  Acute 40% oxygen supplementation in patients with Eisenmenger syndrome led to an improvement in 6MWT distance, faster HRR1and lower dyspnea and lower limb fatigue perception. Moreover, functional capacity was positively associated with right ventricular parameters.
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Laion R A
authors.initials: LR
authors.lastname: Gonzaga
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil; Department of Human Motion Sciences, Physical Therapy School, Federal University of Sao Paulo-Santos, Rua Silva Jardim, Edifício Central 136, 11015-020 Santos, SP, Brazil.
authors.forename: Bruna C
authors.initials: BC
authors.lastname: Matos-Garcia
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil; Department of Human Motion Sciences, Physical Therapy School, Federal University of Sao Paulo-Santos, Rua Silva Jardim, Edifício Central 136, 11015-020 Santos, SP, Brazil.
authors.forename: Isadora S
authors.initials: IS
authors.lastname: Rocco
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Isis
authors.initials: I
authors.lastname: Begot
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Bolzan
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Solange B
authors.initials: SB
authors.lastname: Tatani
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Vinicius B
authors.initials: VB
authors.lastname: Santos
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Célia M C
authors.initials: CM
authors.lastname: Silva
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Antonio C C
authors.initials: AC
authors.lastname: Carvalho
authors.affiliation: Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Taylor Street, 454 AHSB, Chicago IL60612, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil.
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Gomes
authors.affiliation: Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital - Federal University of Sao Paulo - Brazil, Rua Napoleão de Barros, 715, 3 andar, 04024002 Vila Clementino, Sao Paulo, Brazil; Department of Human Motion Sciences, Physical Therapy School, Federal University of Sao Paulo-Santos, Rua Silva Jardim, Edifício Central 136, 11015-020 Santos, SP, Brazil. Electronic address: sguizilini@unifesp.br.
authors.forename: Solange
authors.initials: S
authors.lastname: Guizilini
mesh_terms: D000328:Adult; D004452:Echocardiography; D004541:Eisenmenger Complex / Q000503:physiopathology / Q000628:therapy*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D014655:Vascular Resistance / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Congenital heart disease; Eisenmenger syndrome; Functional capacity; Oxygen supplementation; Pulmonary hypertension