大动脉转位Senning手术后的心肺运动表现

Cardiorespiratory exercise performance after Senning operation for transposition of the great arteries.

作者信息

Reybrouck T, Gewillig M, Dumoulin M, van der Hauwaert L G

机构信息

Department of Paediatric Cardiology, Gasthuisberg University Hospital, University of Leuven, Belgium.

出版信息

Br Heart J. 1993 Aug;70(2):175-9. doi: 10.1136/hrt.70.2.175.

DOI:10.1136/hrt.70.2.175

PMID:8038030

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1025281/

Abstract

OBJECTIVE

To assess the cardiorespiratory response to graded exercise in patients after the Senning operation for transposition of the great arteries.

DESIGN

Cross sectional study. Exercise performance was assessed by determination of the ventilatory anaerobic threshold. This was defined as the exercise intensity at which the ventilatory equivalent for oxygen (VE/VO2) started to increase systematically without a concomitant increase in the ventilatory equivalent for carbon dioxide (VE/VCO2).

SETTING

Outpatient department.

PATIENTS

Sequential sample of 20 patients studied 5-10 years (mean 7.3 years) after the Senning operation. Age at exercise testing varied from 5 to 11 (mean 7.8) years.

RESULTS

The ventilatory threshold in the patients was significantly lower than normal (p < 0.005) and averaged 79.3% (SD 13%) and 80% (12%) of the predicted normal value for age and weight, respectively. Also, the ventilatory threshold was surpassed sooner (mean 3.2 (range 2-5) minutes) in the patients than in normal controls (3.9 (2.6-4.6) minutes). The lower ventilatory threshold was associated with a subnormal oxygen uptake (ml/min/kg) during submaximal exercise, a higher than normal ventilatory equivalent for oxygen ratio, and a lower end tidal carbon dioxide tension in the patients compared with normal controls. In half of the patients heart rate was lower during graded exercise. This relative bradycardia was not associated with a normal ventilatory threshold, as often seen in fit young people. No major disturbances in rhythm were observed during exercise.

CONCLUSION

Exercise performance, assessed by respiratory gas exchange, was slightly but significantly lower than normal in patients after the Senning operation. A subnormal ventilatory threshold, associated with a higher than normal ventilatory response during submaximal exercise, supports the hypothesis that oxygen delivery to tissues is slightly impaired in these patients.

摘要

目的

评估大动脉转位行森宁手术后患者对分级运动的心肺反应。

设计

横断面研究。通过测定通气无氧阈评估运动表现。通气无氧阈定义为氧通气当量（VE/VO2）开始系统性增加而二氧化碳通气当量（VE/VCO2）无相应增加时的运动强度。

地点

门诊部。

患者

对20例患者进行序贯抽样研究，这些患者在森宁手术后5 - 10年（平均7.3年）。运动测试时的年龄为5至11岁（平均7.8岁）。

结果

患者的通气阈显著低于正常水平（p < 0.005），分别平均为年龄和体重预测正常值的79.3%（标准差13%）和80%（12%）。此外，患者达到通气阈的时间比正常对照组更早（平均3.2（范围2 - 5）分钟），而正常对照组为3.9（2.6 - 4.6）分钟。较低的通气阈与次最大运动时低于正常的摄氧量（毫升/分钟/千克）、高于正常的氧通气当量比值以及患者与正常对照组相比更低的呼气末二氧化碳分压相关。在一半的患者中，分级运动时心率较低。这种相对心动过缓与正常通气阈无关，而正常通气阈常见于健康的年轻人。运动期间未观察到严重的节律紊乱。