Cardiorespiratory functional assessment in young heart transplant recipients

A. Calzolari, E. Pastore, L. Attias, P. Cicini, U. Giordano, F. Parisi, P. Ragonese, C. Squitieri, A. Turchetta

Research output: Contribution to journalArticlepeer-review

Abstract

Limited data are available on exercise capacity after surgery in young heart transplant recipients. To examine this question we assessed cardiorespiratory responses to exercise in young heart transplant recipients and healthy controls. We then sought a relation between the patients's exercise performance and three clinical post-transplant factors (time since transplantation, rejections per year and immunosuppressive drugs). Fourteen consecutive heart transplant recipients (6 girls and 8 boys, mean age 9.4 ± 0.8 years, range 5-15 years) and 14 healthy matched controls underwent a Bruce treadmill test to determine duration of test, resting and maximum heart rate, maximum systolic blood pressure, peak oxygen consumption (VO2 peak), cardiac output and oxyhemoglobin saturation. Duration of test and heart rate increase were then compared with time since transplantation, rejections per year and immunosuppressive drugs received. Patients completed a questionnaire about their physical activity in and out of school and the reasons for eventual prohibition. Transplant recipients had tachycardia at rest (126 ± 4 b/min; p <0.001). During exercise they had significantly reduced tolerance (9.3 ± 0.4 min; p <0.001), maximum heart rate (169 ± 5 b/min; p <0.05) and cardiac output (5.65 ± 0.6 l/min; p <0.05), and a heart rate increase from rest to peak exercise lower than controls (p <0.001), but a similar VO2 peak. Heart rate increase correlated significantly with post-transplant time (r = 0.55; p <0.05), rejections per year (r = -0.63; p <0.05) and number of immunosuppressive drugs (r = -0.60; p <0.05). Cardiorespiratory functional assessment shows that young heart transplant recipients have significantly reduced exercise capacity. Heart rate increase depends on immunosuppressive drugs, numbers of rejections and time since transplant. After surgery few of these children do physical activity outside school, possibly owing to overprotective parents and teachers and to a lack of suitable supervised facilities.

Original languageEnglish
Pages (from-to)107-111
Number of pages5
JournalInternational Journal of Sports Cardiology
Volume7
Issue number3
Publication statusPublished - 1998

Keywords

  • Children
  • Exercise testing
  • Heart transplantation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Cardiology and Cardiovascular Medicine

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