Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium.
Faculty of Medicine, Ghent University, Ghent, Belgium.
PLoS One. 2020 Dec 18;15(12):e0244312. doi: 10.1371/journal.pone.0244312. eCollection 2020.
Few studies demonstrate delayed recovery after exercise in children and adults with heart disease. We assess the recovery patterns of gas exchange parameters and heart rate (HR) in children with repaired Tetralogy of Fallot (rToF) compared to healthy peers and investigate the correlation with ventricular function and QRS duration.
45 children after rToF and 45 controls performed a maximal incremental cardiopulmonary exercise test. In the subsequent recovery period, patterns of VO2, VCO2 and HR were analysed. Half-life time (T1/2) of the exponential decay and drop per minute (Recmin) were compared between groups. In the rToF group, correlations were examined between the recovery parameters and QRS-duration and ventricular function, described by fractional shortening (FS) and tricuspid annular plane systolic excursion (TAPSE) measured at baseline prior to exercise.
Recovery of VO2 and VCO2 was delayed in rToF patients, half-life time values were higher compared to controls (T1/2VO2 52.51 ±11.29 s vs. 44.31 ± 10.47 s; p = 0.001 and T1/2VCO2 68.28 ± 13.84 s vs. 59.41 ± 12.06 s; p = 0.002) and percentage drop from maximal value was slower at each minute of recovery (p<0.05). Correlations were found with FS (T1/2VO2: r = -0.517; p<0.001; Rec1minVO2: r = -0.636, p<0.001; Rec1minVCO2: r = -0.373, p = 0.012) and TAPSE (T1/2VO2: r = -0.505; p<0.001; Rec1minVO2: r = -0.566, p<0.001; T1/2VCO2: r = -0.466; p = 0.001; Rec1minVCO2: r = -0.507, p<0.001), not with QRS-duration. No difference was found in HR recovery between patients and controls.
Children after rToF show a delayed gas exchange recovery after exercise. This delay correlates to ventricular function, demonstrating its importance in recovery after physical activity.
很少有研究表明患有心脏病的儿童和成年人在运动后会有延迟恢复的情况。我们评估了与健康同龄人相比，法洛四联症修复后（rToF）儿童的气体交换参数和心率（HR）恢复模式，并探讨了与心室功能和 QRS 持续时间的相关性。
45 名 rToF 患儿和 45 名对照组进行了最大递增心肺运动试验。在随后的恢复期间，分析了 VO2、VCO2 和 HR 的恢复模式。比较两组间 VO2、VCO2 及 HR 半衰期（T1/2）和每分钟下降量（Recmin）。在 rToF 组，根据射血分数（FS）和三尖瓣环平面收缩期位移（TAPSE）在运动前的基线值，检查恢复参数与 QRS 持续时间和心室功能之间的相关性。
rToF 患者的 VO2 和 VCO2 恢复延迟，与对照组相比，半衰期值更高（T1/2VO2 52.51±11.29 s 比 44.31±10.47 s；p=0.001 和 T1/2VCO2 68.28±13.84 s 比 59.41±12.06 s；p=0.002），并且在每个恢复分钟的最大值下降百分比较慢（p<0.05）。与 FS 呈相关性（T1/2VO2：r=-0.517；p<0.001；Rec1minVO2：r=-0.636，p<0.001；Rec1minVCO2：r=-0.373，p=0.012）和 TAPSE（T1/2VO2：r=-0.505；p<0.001；Rec1minVO2：r=-0.566，p<0.001；T1/2VCO2：r=-0.466；p=0.001；Rec1minVCO2：r=-0.507，p<0.001），但与 QRS 持续时间无相关性。与对照组相比，患者的 HR 恢复无差异。
rToF 后儿童运动后气体交换恢复延迟。这种延迟与心室功能相关，表明其在体力活动后恢复中的重要性。
