Is Neurodevelopment Related to Exercise Capacity in Single Ventricle Patients Who Have Undergone Fontan Palliation?
- PDF / 1,128,976 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 61 Downloads / 187 Views
ORIGINAL ARTICLE
Is Neurodevelopment Related to Exercise Capacity in Single Ventricle Patients Who Have Undergone Fontan Palliation? Sean J. Cooney1 · Kristen Campbell2 · Kelly Wolfe3 · Michael V. DiMaria4 · Christopher M. Rausch4 Received: 3 April 2020 / Accepted: 7 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Survivors of palliative surgery for single ventricle heart disease (SVHD) are at risk of poor neurodevelopmental outcomes and reduced exercise capacity. In healthy populations, reduced exercise capacity is related to decreased cognition suggesting a possible relationship between exercise capacity and neurodevelopment. Using cardiopulmonary exercise testing (CPET) and neuropsychological testing (NPT) as indicators of exercise capacity and neurodevelopment, respectively, we hypothesized that in SVHD, higher CPET measures are related to better NPT performance. Patients were retrospectively identified. CPET variables included VO2max, anaerobic threshold, peak heart rate, ventilatory efficiency, and respiratory exchange ratio. NPT instruments were divided into domains measuring attention, executive functioning, adaptive functioning, and emotional functioning. Linear regression was used to test for associations between CPET and NPT. 23 subjects with SVHD met inclusion criteria. On both CPET and NPT, the cohort scored worse than healthy, age-matched subjects. Higher VO2max and anaerobic threshold were associated with better parent-rated overall adaptive functioning (p = 0.01 and p = 0.02, respectively). Higher peak heart rate was related to better sustained visual attention (p = 0.01). In SVHD, CPET measures indicating better exercise capacity were positively associated with a subset of scores on NPT. Larger, multisite studies implementing cardiorespiratory fitness intervention and incorporating cognitive outcome measures will be needed to better characterize the relationship between neurodevelopment and functional capacity in this population. Results may assist in providing anticipatory guidance and optimizing post-Fontan developmental trajectories. Keywords Fontan · Single ventricle heart disease · Exercise capacity · Neurodevelopment · Cardiopulmonary exercise testing · Neuropsychological testing
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00246-020-02497-7) contains supplementary material, which is available to authorized users. * Sean J. Cooney [email protected] 1
Graduate Medical Education, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 158, Aurora, CO 80045, USA
2
Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
3
Section of Neurology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
4
Heart Institute, Section of Pediatric Cardiology, Department of Pediatrics, University of Colorado School of Me
Data Loading...
