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Exercise capacity in the Fontan circulation

Published online by Cambridge University Press:  09 January 2014

David J. Goldberg ,
Catherine M. Avitabile ,
Michael G. McBride  and
Stephen M. Paridon
David J. Goldberg*
Affiliation:
Division of Cardiology, The Perelman School of Medicine, The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Catherine M. Avitabile
Affiliation:
Division of Cardiology, The Perelman School of Medicine, The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Michael G. McBride
Affiliation:
Division of Cardiology, The Perelman School of Medicine, The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Stephen M. Paridon
Affiliation:
Division of Cardiology, The Perelman School of Medicine, The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: D. J. Goldberg, Division of Cardiology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA 19104, United States of America. Tel: 267-426-8143; Fax: 267-425-6108; E-mail: goldbergda@email.chop.edu
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Abstract

The Fontan operation can create a stable circulation from childhood through early adulthood. However, the absence of a sub-pulmonary pumping chamber leads to a physiology in which exercise capacity is limited and decreases with age starting in adolescence. The limitation in exercise capacity is more pronounced at peak levels of exercise, but is still present during more modest levels of activity. The underlying causes of exercise impairment relate to both central cardiovascular factors (oxygen delivery) and peripheral factors (oxygen extraction). Interventions to improve cardiac preload and to improve lean muscle mass may help to improve exercise capacity and, perhaps, will alter the “natural history” of the progressive decline.

Keywords

Congenital heart diseaseexerciseFontan
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 6: HeartWeek 2013 , December 2013 , pp. 824 - 830
Copyright
Copyright © Cambridge University Press 2013 

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