Reybrouck T, Rogers R, Weymans M, Dumoulin M, Vanhove M, Daenen W, Van der Hauwaert L, Gewillig M
Department of Cardiovascular Rehabilitation, Gasthuisberg University Hospital, Leuven, Belgium.
Eur J Pediatr. 1995 Oct;154(10):801-6. doi: 10.1007/BF01959785.
Aerobic capacity of patients with different forms of congenital heart disease was serially evaluated in 79 patients and the evolution was correlated with the lesion and the level of daily activity. The patients were divided into six groups: patients with a small ventricular septal defect (VSD) with mini shunt (n = 14), mild pulmonary valve stenosis with gradient < 40 mm Hg (PS) (n = 12), mild to moderate aortic valve stenosis (gradient 36 +/- 17 mmHg) (AS) (n = 12), patients 4.7 +/- 2.1 years after repair of tetralogy of Fallot (PO-TF) (n = 16), patients 2.2 +/- 2.9 years after closure of a high flow/high gradient VSD (PO-VSD) (n = 13), and patients 2.6 +/- 1.7 years after Fontan repair (Fontan-PO) (n = 12). Aerobic capacity was assessed by determination of the ventilatory anaerobic threshold (VAT). VAT reflects the highest aerobic exercise level prior to a disproportionate increase of CO2 and ventilation relative to O2 uptake; it is independent of patient motivation. Data are expressed as percentage of normal O2 uptake at VAT, determined in 234 age/gender matched controls. The habitual level of physical activity was assessed by a standardised questionnaire. Aerobic capacity in all subgroups of patients, even with very mild defects, was at or below the lower limit of normal. Children left unrestricted from physical exercise (VSD, PS, PO-VSD) had no change over the study period. However, aerobic capacity of patients with medically imposed physical restrictions (AS) and significant residual haemodynamic lesions (PO-TF, Fontan) decreased with age.(ABSTRACT TRUNCATED AT 250 WORDS)
对79例不同类型先天性心脏病患者的有氧能力进行了连续评估，并将其演变情况与病变及日常活动水平相关联。患者被分为六组：小型室间隔缺损（VSD）伴微量分流患者（n = 14）、肺动脉瓣狭窄轻度且压差<40 mmHg（PS）患者（n = 12）、主动脉瓣狭窄轻度至中度（压差36±17 mmHg）（AS）患者（n = 12）、法洛四联症修复术后4.7±2.1年的患者（PO-TF）（n = 16）、高流量/高压差VSD封堵术后2.2±2.9年的患者（PO-VSD）（n = 13）以及Fontan修复术后2.6±1.7年的患者（Fontan-PO）（n = 12）。通过测定通气无氧阈（VAT）来评估有氧能力。VAT反映了在二氧化碳和通气相对于氧气摄取不成比例增加之前的最高有氧运动水平；它与患者的动机无关。数据以VAT时正常氧气摄取的百分比表示，该百分比是在234名年龄/性别匹配的对照组中确定的。通过标准化问卷评估日常身体活动水平。所有患者亚组的有氧能力，即使是非常轻微缺陷的患者，也处于或低于正常下限。未受体育锻炼限制的儿童（VSD、PS、PO-VSD）在研究期间没有变化。然而，因医学原因受到身体限制的患者（AS）以及存在明显残余血流动力学病变的患者（PO-TF、Fontan）的有氧能力随年龄下降。（摘要截断于250字）
