Heal M Elisabeth, Jackson Lanier B, Atz Andrew M, Butts Ryan J
Children's Hospital of Philadelphia, Department of Pediatrics, Division of Cardiology, Philadelphia, PA 19104, USA.
Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, SC 29425.
Congenit Heart Dis. 2017 Jul;12(4):399-402. doi: 10.1111/chd.12451. Epub 2017 Jun 15.
Cardiopulmonary exercise testing (CPET) aids in clinical assessment of patients with Fontan circulation. Effects of persistent fenestration on CPET variables have not been clearly defined. Associations between fenestration and CPET variables at anaerobic threshold (AT) and peak exercise were explored in the Pediatric Heart Network Fontan Cross-Sectional Study cohort. Fenestration patency was associated with a greater decrease in oxygen saturation from rest to peak exercise (fenestration -4.9 ± 3.8 v. nonfenestration -3 ± 3.5; P < .001). Physiological dead space at peak exercise was higher in fenestrated v. nonfenestrated (25.2 ± 16.1 v. 21.4 ± 15.2; P = .03). There was a weak association between fenestration patency and maximal work and heart rate. Fenestration patency was also weakly correlated with oxygen pulse, work and VE/VCO2 at AT. The effect of persistent fenestration on CPET measurements was minimal in this study, likely due to the cross-sectional design.
心肺运动试验（CPET）有助于对Fontan循环患者进行临床评估。持续存在的开窗对CPET变量的影响尚未明确界定。在儿科心脏网络Fontan横断面研究队列中，探讨了开窗与无氧阈值（AT）和运动峰值时CPET变量之间的关联。开窗通畅与静息至运动峰值时氧饱和度的更大下降相关（开窗组为-4.9±3.8，未开窗组为-3±3.5；P<.001）。开窗组运动峰值时的生理死腔高于未开窗组（分别为25.2±16.1和21.4±15.2；P = .03）。开窗通畅与最大功和心率之间存在弱关联。开窗通畅与AT时的氧脉搏、功和VE/VCO2也呈弱相关。在本研究中，持续开窗对CPET测量的影响最小，这可能是由于横断面设计所致。
