PMID- 26937900
OWN - NLM
STAT- MEDLINE
DCOM- 20160721
LR  - 20231111
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 8
DP  - 2016 Feb
TI  - Comparison of the Degree of Exercise Tolerance in Children After Surgical 
      Treatment of Complex Cardiac Defects, Assessed Using Ergospirometry and the Level 
      of Brain Natriuretic Peptide.
PG  - e2619
LID - 10.1097/MD.0000000000002619 [doi]
LID - e2619
AB  - Children who underwent surgery for complex congenital heart defects present worse 
      exercise capacity than their healthy peers. In adults and adolescents, heart 
      failure is assessed on the basis of clinical symptoms using the New York Heart 
      Association (NYHA) score, while in an infant Ross scale; heart failure can also 
      be evaluated by other parameters. The purpose of this study was to compare the 
      degree of exercise tolerance in children after surgery for complex heart defects, 
      assessed by the ratio of maximum oxygen uptake (VO2max) and the brain natriuretic 
      peptide (N-terminal fragment of the prohormone brain-type natriuretic peptide 
      [NT-proBNP]) concentration.The study group consisted of 42 children, ages 9 to 17 
      years (mean 14.00 +/- 2.72). Among them there were 22 children with tetralogy of 
      Fallot (ToF) after total correction, 18 children with transposition of the great 
      arteries (d-TGA) after the arterial switch operation, and 2 children with single 
      ventricle (SV) after the Fontan operation. All but 1 child were in NYHA class I. 
      The control group consisted of 20 healthy children. Outcomes of interest were the 
      ratio of VO2max, determined during ergospirometry, and the level of NT-proBNP. 
      The statistical analysis was performed and the groups were considered 
      significantly different for P < 0.05.There was no statistically significant 
      correlation between NT-proBNP and maximum oxygen uptake (VO2) kg min in the study 
      group compared with the control group.The VO2max in the test group had a mean 
      value less (34.6 +/- 8.0) than controls (38.4 +/- 7.7), and the differences were 
      statistically significant (P = 0.041). In contrast, the average concentration of 
      NT-proBNP in the study group was higher than controls (117.9 +/- 74.3 vs 
      18.0 +/- 24.5), and these differences were statistically significant 
      (P < 0.001).After operations for complex heart defects (ToF, TGA, and SV), 
      children have worse heart function parameters and exercise capacity than the 
      healthy population. To control this, we recommend postoperative ergospirometry 
      and determination of NT-proBNP concentrations.
FAU - Mazurek, Boguslaw
AU  - Mazurek B
AD  - From the Department of Pediatrics Cardiology, School of Medicine (BM, LS, JP) and 
      Department of Nursing and Social Medical Problems Chair of Nursing, School of 
      Health Sciences (GM-L), Medical University of Silesia, Katowice, Poland; Upper 
      Silesian Center of Children's Health, Katowice (MM); Department of Pediatric 
      Cardiosurgery and Cardiosurgical Intensive Care University Children Hospital, 
      Faculty of Medicine and Faculty of Health Sciences Jagiellonian University 
      Medical College, Krakow, Poland (AM); and Faculty of Medicine, Department of 
      Pediatric Cardiosurgery, Polish-American Institute of Pediatrics, and Faculty of 
      Health Sciences, Jagiellonian University Medical College (AM), Krakow, Poland.
FAU - Szydlowski, Leslaw
AU  - Szydlowski L
FAU - Mazurek, Magdalena
AU  - Mazurek M
FAU - Markiewicz-Loskot, Grazyna
AU  - Markiewicz-Loskot G
FAU - Pajak, Jacek
AU  - Pajak J
FAU - Morka, Aleksandra
AU  - Morka A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adolescent
MH  - *Cardiac Surgical Procedures
MH  - Child
MH  - Exercise Test/*methods
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Heart Defects, Congenital/*physiopathology/*surgery
MH  - Heart Failure/*diagnosis/etiology
MH  - Humans
MH  - Male
MH  - Natriuretic Peptide, Brain/*blood
MH  - Oxygen Consumption/physiology
MH  - Peptide Fragments/*blood
MH  - Postoperative Complications
MH  - Spirometry
PMC - PMC4778997
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2016/03/05 06:00
MHDA- 2016/07/22 06:00
PMCR- 2016/03/03
CRDT- 2016/03/04 06:00
PHST- 2016/03/04 06:00 [entrez]
PHST- 2016/03/05 06:00 [pubmed]
PHST- 2016/07/22 06:00 [medline]
PHST- 2016/03/03 00:00 [pmc-release]
AID - 00005792-201602230-00017 [pii]
AID - 10.1097/MD.0000000000002619 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Feb;95(8):e2619. doi: 10.1097/MD.0000000000002619.