Category: Heart

Assessment of Symptoms and Exercise Capacity in Cyanotic Patients With Congenital Heart Disease: Study Limitations

Due to the shunting of oxygen-poor and carbon dioxide-rich blood into the systemic circulation, a compensatory hyperventilation resulting in an appropriate alveolar and pulmonary venous hypocapnia did occur. Since shunt volume does increase with progressive exercise in Eisenmenger syndrome, alveolar hyperventilation increases proportionally to shunt volume in order to maintain a normal PaC02, whereas Pa02 cannot be improved by hyperventilation in central cardiac right-to-left shunt….

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Assessment of Symptoms and Exercise Capacity in Cyanotic Patients With Congenital Heart Disease: Acid-Base Balance and Ventilation

Despite this possible role of increased dead space ventilation, the major impact on ventilatory efficiency in cyanotic patients is most likely due to alveolar hyperventilation. Considering the correlation of end-tidal partial pressures for oxygen and carbon dioxide with ventilatory efficiency under exercise among patients and control subjects (Fig 4), alveolar hyperventilation with resulting alveolar hy-pocapnia can be expected as the most important mechanism influencing ventilatory…

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Assessment of Symptoms and Exercise Capacity in Cyanotic Patients With Congenital Heart Disease: Ventilatory Efficiency and Symptomatology of Patients

Based on the data we obtained, it remains difficult to differentiate whether these eight patients actually did not recruit anaerobic metabolism during exercise or the determination of AT was obscured by alterations in ventilatory pattern and control. Thus, VO2AT values should be carefully interpreted in patients with cyanotic heart disease. An increased VE had been reported for different causes of hypoxemia, eg, for persons living…

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Assessment of Symptoms and Exercise Capacity in Cyanotic Patients With Congenital Heart Disease: Acid-Base Balance and Ventilation

Fig2

As shown in Figure 2, despite large SDs there were marked and significant differences in the Ve/ VC02 ratio and the VE vs VC02 slope in patients with various NYHA and ability classes, while peak V02 did correlate to the symptomatic state to some extent. The results of blood gas analysis are shown in Table 3. At rest, reduced Pa02 and increased VE (Table 2)…

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Assessment of Symptoms and Exercise Capacity in Cyanotic Patients With Congenital Heart Disease: Statistical Analysis

Fig1

During the exercise period, Vo2AT (primarily according to the V-slope method and, if necessary, with further inspection of the Vo2, Vco2, Ve/Vo2, and Peto2 kinetics) and Ve vs Vco2 slope were determined, and at maximal exertion (peak Vo2), Peto2 and Petco2 were assessed. The terminal nonlinear part of the VE vs Vco2 relationship was excluded from the analysis of the VE vs Vco2 slope. Great…

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Assessment of Symptoms and Exercise Capacity in Cyanotic Patients With Congenital Heart Disease: Control Group

Two patients (patient 12/13 and patient 23/24) underwent evaluation twice with an interval of at least 6 months. Both patients were surgically palliated (with significant changes in clinical presentation, extent of cyanosis, and shunt volume) between both evaluations. The remaining patients did not undergo surgical corrections. Individual diagnoses are presented in Table 1. The control group consisted of 101 healthy volunteers aged 16 to 75…

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Assessment of Symptoms and Exercise Capacity in Cyanotic Patients With Congenital Heart Disease

Approximately 1.0% of all children are affected by congenital heart defects. In 1994, it was estimated that > 500,000 patients with significant functional cardiac malformations reach adulthood in the United States. Supplementing echocardiography and cardiac catheterization data with cardiopulmonary exercise testing (CPX) offers an objective method to further characterize the limitations of the cardiovascular system in these patients. fully

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