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Impaired lung function in children and adolescents with Fontan circulation may improve after endurance training

Published online by Cambridge University Press:  04 July 2018

Eva R. Hedlund ,
Henrik Ljungberg ,
Liselott Söderström ,
Bo Lundell  and
Gunnar Sjöberg
Eva R. Hedlund*
Affiliation:
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
Henrik Ljungberg
Affiliation:
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
Liselott Söderström
Affiliation:
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
Bo Lundell
Affiliation:
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
Gunnar Sjöberg
Affiliation:
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
*
Author for correspondence: E. R. Hedlund, MD, Karolinska University Hospital, Astrid Lindgren Children’s Hospital Solna, Barnhjärtcentrum, Eugeniavägen 23, C8:34, S-171 76 Stockholm, Sweden. Tel: +46 707421285; Fax: +46 8 51777778; E-mail: eva.rylander-hedlund@sll.se
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Abstract

Objectives

The objective of this research was to study lung function, physical capacity, and effect of endurance training in children and adolescents after Fontan palliation compared with healthy matched controls.

Methods

Fontan patients (n=30) and healthy matched control patients (n=25) performed dynamic and static spirometry, and pulmonary diffusing capacity and maximal oxygen uptake tests, before and after a 12-week endurance training programme and at follow-up after 1 year.

Results

Fontan patients had a restrictive lung pattern, reduced pulmonary diffusing capacity (4.27±1.16 versus 6.61±1.88 mmol/kPa/minute, p<0.001), and a reduced maximal oxygen uptake (35.0±5.1 versus 43.7±8.4 ml/minute/kg, p<0.001) compared with controls. Patients had air trapping with a higher portion of residual volume of total lung capacity compared with controls (26±6 versus 22±5%, p<0.05). Vital capacity increased for patients, from 2.80±0.97 to 2.91±0.95 L, p<0.05, but not for controls after endurance training. The difference in diffusing capacity between patients and controls appeared to be greater with increasing age.

Conclusions

Fontan patients have a restrictive lung pattern, reduced pulmonary diffusing capacity, and reduced maximal oxygen uptake compared with healthy controls. Endurance training may improve vital capacity in Fontan patients. The normal increase in pulmonary diffusing capacity with age and growth was reduced in Fontan patients, which is concerning. Apart from general health effects, exercise may improve lung function in young Fontan patients and should be encouraged.

Keywords

Endurance trainingexercise capacityFontan palliationlung functionpulmonary diffusing capacity
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 9 , September 2018 , pp. 1115 - 1122
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Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Hedlund ER, Ljungberg H, Söderström L, Lundell B, Sjöberg G. (2018) Impaired lung function in children and adolescents with Fontan circulation may improve after endurance training. Cardiology in the Young28: 1115–1122. doi: S1047951118000902

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