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Correlation of exercise-induced peripheral venous hypertension with exercise intolerance in patients with Fontan circulation

Published online by Cambridge University Press:  22 October 2021

Shin Ono Open the ORCID record for Shin Ono [Opens in a new window] ,
Sadamitsu Yanagi ,
Takuya Wakamiya ,
Yasuhiro Ichikawa Open the ORCID record for Yasuhiro Ichikawa [Opens in a new window] ,
Shun Kawai ,
Ki-Sung Kim  and
Hideaki Ueda
Shin Ono*
Affiliation:
Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, Yokohama, Japan
Sadamitsu Yanagi
Affiliation:
Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, Yokohama, Japan
Takuya Wakamiya
Affiliation:
Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, Yokohama, Japan
Yasuhiro Ichikawa
Affiliation:
Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, Yokohama, Japan
Shun Kawai
Affiliation:
Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, Yokohama, Japan
Ki-Sung Kim
Affiliation:
Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, Yokohama, Japan
Hideaki Ueda
Affiliation:
Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, Yokohama, Japan
*
Author for correspondence: Dr S. Ono, Department of Pediatric Cardiology, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan. Tel: +81-45-711-2351; Fax: +81-45-721-3324. E-mail: sono@kcmc.jp
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Abstract

Owing to the absence of a sub-pulmonary ventricle, the central venous pressure rises in patients with Fontan circulation. During exercise, central venous pressure may rise further to increase the systemic ventricular preload and cardiac output. We performed a single-centre prospective trial of cardiopulmonary exercise test while monitoring peripheral venous pressure which strongly correlates with central venous pressure. The objective of this study was to test the hypothesis that peripheral venous pressure at peak exercise inversely correlates with exercise capacity in patients with Fontan circulation. Seventeen patients following Fontan operation performed cardiopulmonary exercise test while monitoring peripheral venous pressure. Peak oxygen uptake, heart rate reserve, peak oxygen pulse (divided by body surface area), and peripheral venous pressure at peak exercise were measured. Correlations of peripheral venous pressure at peak exercise with the peak oxygen uptake, heart rate reserve, and peak oxygen pulse were evaluated. The peripheral venous pressure at peak exercise inversely correlated with the peak oxygen uptake (R = −0.66, p < 0.01), heart rate reserve (R = −0.6, p < 0.05), and peak oxygen pulse (R = −0.48, p < 0.05). Exercise-induced peripheral venous hypertension correlates with exercise intolerance in patients with Fontan circulation. Peak oxygen uptake is a useful index for evaluating the status of congestion in the daily life of patients with Fontan circulation.

Keywords

Fontanvenous pressureexercise intolerancecardiopulmonary exercise test
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 9 , September 2022 , pp. 1427 - 1431
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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