Pediatric Cardiology

, Volume 39, Issue 4, pp 695–704 | Cite as

Respiratory Training Late After Fontan Intervention: Impact on Cardiorespiratory Performance

  • Lamia Ait Ali
  • Alessandro Pingitore
  • Paolo Piaggi
  • Fabio Brucini
  • Mirko Passera
  • Marco Marotta
  • Alessandra Cadoni
  • Claudio Passino
  • Giosuè Catapano
  • Pierluigi Festa
Original Article

Abstract

Fontan palliation allows patients with “single ventricle” circulation to reach adulthood with an acceptable quality of life, although exercise tolerance is significantly reduced. To assess whether controlled respiratory training (CRT) increases cardiorespiratory performance. 16 Adolescent Fontan patients (age 17. 5 ± 3.8 years) were enrolled. Patients were divided into CRT group (n = 10) and control group (C group, n = 6). Maximal cardiopulmonary test (CPT) was repeated at the end of CRT in the CRT group and after an average time of 3 months in the C group. In the CRT group a CPT endurance was also performed before and after CRT. In the CRT group there was a significant improvement in cardiovascular and respiratory response to exercise after CRT. Actually, after accounting for baseline values, the CRT group had decreased breathing respiratory reserve (− 15, 95% CI −22.3 to − 8.0, p = 0.001) and increased RR peak (+ 4.8, 95% CI 0.7–8.9, p = 0.03), VE peak (+ 13.7, 95% CI 5.6–21.7, p = 0.004), VO2 of predicted (+ 8.5, 95% CI 0.1–17.0, p = 0.05), VO2 peak (+ 4.3, 95% CI 0.3 to 8.2, p = 0.04), and VO2 workslope (+ 1.7, 95% CI 0.3–3.1, p = 0.02) as compared to the control group. Moreover, exercise endurance time increased from 8.45 to 17.7 min (p = 0.01). CRT improves cardiorespiratory performance in post-Fontan patients leading to a better aerobic capacity.

Keywords

Congenital heart disease Fontan circulation Controlled respiratory training Ergospirometry 

Notes

Acknowledgements

We gratefully thank Ms Elaine Laws for her precious help in the English editing of this manuscript.

Compliance with Ethical Standards

Conflict of interest

All the authors have not to declare conflict of interest.

Research involving Human Participants and/or Animals

The research protocol was approved by the local ethics-committee review board (Prot 0015-17 2014 P).

Informed Consent

All patients or legal guardians gave informed consent, and authorized physicians to use their clinical data in accordance with Italian law.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Lamia Ait Ali
    • 1
    • 2
  • Alessandro Pingitore
    • 1
  • Paolo Piaggi
    • 5
  • Fabio Brucini
    • 1
  • Mirko Passera
    • 1
  • Marco Marotta
    • 2
  • Alessandra Cadoni
    • 3
  • Claudio Passino
    • 2
    • 4
  • Giosuè Catapano
    • 2
  • Pierluigi Festa
    • 2
  1. 1.Clinical Physiology InstituteCNRPisaItaly
  2. 2.Fondazione G. Monasterio, Regione ToscanaPisaItaly
  3. 3.Pediatric CardiologyBrotzu HospitalCagliariItaly
  4. 4.Institute of Life SciencesScuola Superiore Sant’AnnaPisaItaly
  5. 5.National Institute of Diabetes and Digestive and Kidney DiseaseNational Institutes of HealthPhoenixUSA

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