University of Arizona, Department of Pediatrics (Cardiology), Tucson, Arizona.
University of Arizona, Department of Pediatrics (Cardiology), Tucson, Arizona.
Am J Cardiol. 2021 Jun 15;149:119-125. doi: 10.1016/j.amjcard.2021.03.018. Epub 2021 Mar 21.
In the pediatric population, exercise capacity differs between females and males and the gap widens through adolescence. However, specific age- and sex-based changes in adolescents with congenital heart disease and Fontan palliation have not been reported. The purpose of the current study is to identify age- and sex-specific changes in exercise performance at peak and ventilatory anaerobic threshold (AT) for adolescents with Fontan physiology. Retrospective review of the Pediatric Heart Network Fontan cross sectional study (Fontan 1) public use dataset. Comparisons were made for peak and AT exercise parameters for females and males at 2-year age intervals. In addition, normative values were generated by sex and age at 2-year intervals. χ test was used for comparison for categorical variables. Changes in exercise parameters between age groups by sex were compared by ANOVA with post-hoc analysis. Exercise testing was performed in 411 patients. AT was reached in 317 subjects (40% female), of whom, 166 (43% female) reached peak exercise. Peak oxygen consumption decreased 32% through adolescence in females and did not have the typical increase through adolescence for males. Oxygen consumption at AT also decreased with age in both sexes. In conclusion, age- and sex-based exercise performance for adolescents with Fontan physiology are predictably low, but there are additional significant decreases through adolescence for this population, especially in females. We have established normative exercise values for several parameters for this population which will better identify at risk patients and allow for earlier intervention.
在儿科人群中，女性和男性的运动能力存在差异，并且这种差距在青春期会进一步扩大。然而，患有先天性心脏病和 Fontan 姑息术的青少年的具体年龄和性别相关的变化尚未报道。本研究的目的是确定 Fontan 生理学青少年在峰值和通气无氧阈值（AT）的运动表现的年龄和性别特异性变化。回顾性分析儿科心脏网络 Fontan 横向研究（Fontan 1）的公共数据集。以 2 年为间隔，比较女性和男性的峰值和 AT 运动参数。此外，按性别和年龄以 2 年为间隔生成正常值。使用卡方检验比较分类变量。通过方差分析和事后分析比较性别间各年龄组的运动参数变化。在 411 名患者中进行了运动测试。在 317 名受试者（40%为女性）中达到了 AT，其中 166 名（43%为女性）达到了峰值运动。女性在青春期的峰值耗氧量下降了 32%，而男性则没有典型的青春期增加。两性的 AT 时耗氧量也随年龄而下降。总之，Fontan 生理学青少年的年龄和性别相关的运动表现可预测性较低，但该人群在青春期仍会出现显著下降，尤其是女性。我们为该人群的几个参数建立了正常运动值，这将更好地识别高危患者并允许早期干预。
