scholarly journals Endurance training may improve exercise capacity, lung function and quality of life in Fontan patients

2021 ◽  
Author(s):  
Eva Hedlund ◽  
Bo Lundell
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Endurance Training ◽  
Exercise Capacity ◽  
Improve Exercise Capacity ◽  
Fontan Patients

Can endurance training improve physical capacity and quality of life in young Fontan patients?

2017 ◽  
Vol 28 (3) ◽  
pp. 438-446 ◽  
Author(s):  
Eva R. Hedlund ◽  
Bo Lundell ◽  
Liselott Söderström ◽  
Gunnar Sjöberg
Keyword(s):  
Quality Of Life ◽  
Endurance Training ◽  
Exercise Capacity ◽  
Maximal Exercise ◽  
Training Programme ◽  
Submaximal Exercise ◽  
6 Minute Walk Test ◽  
Fontan Patients ◽  
Maximal Exercise Capacity

AbstractObjectiveChildren after Fontan palliation have reduced exercise capacity and quality of life. Our aim was to study whether endurance training could improve physical capacity and quality of life in Fontan patients.MethodsFontan patients (n=30) and healthy age- and gender-matched control subjects (n=25) performed a 6-minute walk test at submaximal capacity and a maximal cycle ergometer test. Quality of life was assessed with Pediatric Quality of Life Inventory Version 4.0 questionnaires for children and parents. All tests were repeated after a 12-week endurance training programme and after 1 year.ResultsPatients had decreased submaximal and maximal exercise capacity (maximal oxygen uptake 35.0±5.1 ml/minute per·kg versus 43.7±8.4 ml/minute·per·kg, p<0.001) and reported a lower quality of life score (70.9±9.9 versus 85.7±8.0, p<0.001) than controls. After training, patients improved their submaximal exercise capacity in a 6-minute walk test (from 590.7±65.5 m to 611.8±70.9 m, p<0.05) and reported a higher quality of life (p<0.01), but did not improve maximal exercise capacity. At follow-up, submaximal exercise capacity had increased further and improved quality of life was sustained. The controls improved their maximal exercise capacity (p<0.05), but not submaximal exercise capacity or quality of life after training. At follow-up, improvement of maximal exercise capacity was sustained.ConclusionsWe believe that an individualised endurance training programme for Fontan patients improves submaximal exercise capacity and quality of life in Fontan patients and the effect on quality of life appears to be long-lasting.

scholarly journals Post-discharge critical COVID-19 lung function related to severity of radiologic lung involvement at admission

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Laurent Truffaut ◽  
Lucas Demey ◽  
Anne Violette Bruyneel ◽  
Alain Roman ◽  
Stephane Alard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Exercise Capacity ◽  
Lung Involvement ◽  
Post Discharge ◽  
Life Data ◽  
Icu Discharge ◽  
Function Impairment ◽  
Lung Function Impairment

AbstractLung function impairment persists in 55% of critical COVID-19 patients three months after ICU discharge. Patient lung function, exercise capacity, radiologic, and quality of life data suggest impairment is related to radiologic lung involvement at admission.

Co-morbidity (HFrEF and HFpEF): anaemia/iron deficiency

ESC CardioMed ◽  
2018 ◽  
pp. 1816-1822
Author(s):  
Michal Tkaczyszyn ◽  
Ewa A. Jankowska ◽  
Piotr Ponikowski
Keyword(s):  
Quality Of Life ◽  
Iron Deficiency ◽  
Exercise Capacity ◽  
Ferric Carboxymaltose ◽  
Mortality And Morbidity ◽  
Reduced Ejection Fraction ◽  
Co Morbidity ◽  
Poor Outcomes ◽  
Improve Exercise Capacity

Anaemia is a frequent co-morbidity in patients with heart failure (HF), its prevalence increases with disease severity, and it is associated with poor outcomes. The aetiology of anaemia in HF is multifactorial, with the following common underlying causes: gastrointestinal bleeding, renal dysfunction, haemodilution, haematinic deficiencies, deranged steroid metabolism, bone marrow dysfunction and iron deficiency (ID). Erythropoiesis-stimulating agents to correct anaemia in HF did not improve mortality and raised safety concerns, thus are not recommended in these patients. ID in HF has been traditionally linked with anaemia; however, recent studies report a high prevalence also in non-anaemic patients and independent adverse clinical and prognostic consequences (decreased exercise capacity, poor quality of life, and higher mortality) of this co-morbidity. A number of studies have demonstrated that ID can be safely corrected with intravenous iron (ferric carboxymaltose) with symptomatic improvement. According to the recent European Society of Cardiology Guidelines, active screening for the presence of ID is recommended in all HF patients, and in symptomatic HF patients with reduced ejection fraction and with ID, intravenous ferric carboxymaltose should be considered to alleviate symptoms, and improve exercise capacity and quality of life. Ongoing trials are investigating the effect of ID correction on mortality and morbidity.

scholarly journals Physical exercise training in patients with a Fontan circulation: A systematic review

2020 ◽  
pp. 204748732094286
Author(s):  
Linda E Scheffers ◽  
Linda EM vd Berg ◽  
Gamida Ismailova ◽  
Karolijn Dulfer ◽  
Johanna JM Takkenberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Exercise Training ◽  
Oxygen Uptake ◽  
Cardiac Function ◽  
Exercise Capacity ◽  
Peak Oxygen Uptake ◽  
Training Intervention ◽  
Fontan Patients

Background Patients with a Fontan circulation have a reduced exercise capacity, which is an important prognostic predictor of morbidity and mortality. A way to increase exercise capacity in Fontan patients might be exercise training. This systematic review assesses the effects of exercise training investigated in Fontan patients in order to provide an overview of current insights. Design and methods Studies evaluating an exercise training intervention in Fontan patients published up to February 2020 were included in this systematic review. Results From 3000 potential studies, 16 studies reported in 22 publications met the inclusion criteria. In total, 264 Fontan patients with mean age range 8.7–31 years, were included. Different training types including inspiratory muscle training, resistance training and aerobic training were investigated. Main outcome measures reported were peak oxygen uptake, cardiac function, lung function, physical activity levels and quality of life. Peak oxygen uptake increased significantly in 56% of the studies after training with an overall mean increase of +1.72 ml/kg/min (+6.3%). None of the studies reported negative outcome measures related to the exercise programme. In four studies an adverse event was reported, most likely unrelated to the training intervention. Conclusions Exercise training in Fontan patients is most likely safe and has positive effects on exercise capacity, cardiac function and quality of life. Therefore exercise training in Fontan patients should be encouraged. Further studies are required to assess the optimal training type, intensity, duration and long-term effects.

Abstract 2206: Exercise Capacity and Quality of Life late after Fontan Surgery.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yves d’Udekem ◽  
Michael H Cheung ◽  
Stella Setyapranata ◽  
Ajay J Iyengar ◽  
Melissa Newton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Exercise Capacity ◽  
Family Relationships ◽  
Psychiatric Symptoms ◽  
Short Form ◽  
Quality Of Life Measures ◽  
Lateral Tunnel ◽  
Fontan Surgery ◽  
Fontan Patients

Objectives. Determine the exercise capacity and quality of life in a longitudinal cohort of Fontan patients and identify parameters influencing these outcomes. Methods and Results. Fontan survivors operated in our institution and living in the same state were invited to participate in the study if they were aged more than 10 years, and free of arrhythmias. Thirty-six patients, 23 with a classical atrio-pulmonary connection (AP) and 13 with a lateral tunnel operation (LT) underwent transthoracic echocardiography, a cycloergometer exercise study, were tested for resting ANP and BNP levels, and completed the following quality of life measures: Short Form-36 Questionnaire, the Hopkins Symptom Checklist, the Dyadic Adjustment Scale and the Family Assessment Device. A mean of 17±4 years after Fontan, VO2max ranged between 14 and 34 ml/kg/min and anaerobic threshold (AT) between 11 and 34 ml/kg/min. Diastolic dysfunction was identified in 23 pts (E wave velocity z-score <−2: 17/23 pts with AP vs 6/13 pts with LT, p=0.1). ANP and BNP levels were elevated in AP Fontan and normal in LT (p0.1). The only factor predicting worse exercise capacity was the type of Fontan performed, with patients with lateral tunnel having better exercise capacity than those with atrio-pulmonary connections (percentage of predicted AT: 88±14% vs 72±14%, p<0.005; percentage of predicted VO2max: 62±8% vs 54±7%, p<0.005). Responses from quality of life measures placed our Fontan cohort within the normal population range. None of the pre and postoperative variables adversely affected patients’ quality of life. Conclusion: Optimal blood streaming seems to be the most important determinant of exercise capacity late after Fontan surgery. Patients with lateral tunnel performed better than those with atrio-pulmonary connections. Despite limited exercise capacity, Fontan patients appear to have a normal quality of life, reflected in their reports of psychiatric symptoms and family relationships.

Co-morbidity (HFrEF and HFpEF): anaemia/iron deficiency

ESC CardioMed ◽  
2018 ◽  
pp. 1816-1822
Author(s):  
Michal Tkaczyszyn ◽  
Ewa A. Jankowska ◽  
Piotr Ponikowski
Keyword(s):  
Quality Of Life ◽  
Iron Deficiency ◽  
Exercise Capacity ◽  
Ferric Carboxymaltose ◽  
Mortality And Morbidity ◽  
Reduced Ejection Fraction ◽  
Co Morbidity ◽  
Poor Outcomes ◽  
Improve Exercise Capacity

Anaemia is a frequent co-morbidity in patients with heart failure (HF), its prevalence increases with disease severity, and it is associated with poor outcomes. The aetiology of anaemia in HF is multifactorial, with the following common underlying causes: gastrointestinal bleeding, renal dysfunction, haemodilution, haematinic deficiencies, deranged steroid metabolism, bone marrow dysfunction and iron deficiency (ID). Erythropoiesis-stimulating agents to correct anaemia in HF did not improve mortality and raised safety concerns, thus are not recommended in these patients. ID in HF has been traditionally linked with anaemia; however, recent studies report a high prevalence also in non-anaemic patients and independent adverse clinical and prognostic consequences (decreased exercise capacity, poor quality of life, and higher mortality) of this co-morbidity. A number of studies have demonstrated that ID can be safely corrected with intravenous iron (ferric carboxymaltose) with symptomatic improvement. According to the 2016 recent European Society of Cardiology Guidelines, an active screening for the presence of ID is recommended in all HF patients, and in symptomatic HF patients with reduced ejection fraction and with ID, intravenous ferric carboxymaltose should be considered to alleviate symptoms, and improve exercise capacity and quality of life. Ongoing trials are investigating the effects of ID correction in HF on mortality and morbidity.

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