Abstract
We assessed heart rate (HR) recovery following peak exercise before and after a 12-week cardiac rehabilitation program in 14 children, 12.1 ± 1.8 years of age, with repaired complex congenital heart disease (CHD; 11 with Fontan surgery) and impaired exercise performance. Exercise testing using bicycle ergometry was performed at baseline, after completion of the rehab program and 1.0 ± 0.2 years after the baseline test. These data were compared to HR recovery in 15 controls (age, 12.7 ± 2.4 years) with CHD (13 with Fontan surgery) with two serial exercise tests at an interval of 1.1± 0.3 years. There was no change in peak HR between the two serial tests in either group. Peak VO2 improved in the rehab group (26.3 ± 9.6 ml/kg/min at baseline vs 30.9 ± 9.6 ml/kg/min after rehab, p = 0.01) but remained unchanged in controls on serial testing. One-minute HR recovery (in beats per minute) improved significantly following completion of the rehab program (27 ± 15 at baseline vs 40 ± 23 after rehab, p = 0.01). Partial improvement in 1-minute HR recovery in the rehab group persisted 1 year later (1-minute HR recovery, 35 ± 19; p = 0.1 compared to baseline). There was no change in 1-minute HR recovery over time in the control group (37 ± 16 vs 40 ± 13, p = not significant). In conclusion, HR recovery following peak exercise improves in children with CHD after participation in a cardiac rehab program.
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Coats AJ, Adamopoulos S, Radaelli A, et al. (1992) Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation 85:2119–2131
Cole CR, Blackstone EH, Pashkow FJ, et al. (1999) Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 341:1351–1357
Davos CH, Davlouros PA, Wensel R, et al. (2002) Global impairment of cardiac autonomic nervous activity late after repair of tetralogy of Fallot. Circulation 106:I69–I75
Davos CH, Francis DP, Leenarts MF, et al. (2003) Global impairment of cardiac autonomic nervous activity late after the Fontan operation. Circulation 108(Suppl 1):II180–II185
Imai K, Sato H, Hori M, et al. (1994) Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol 24:1529–1535
Jouven X, Empana JP, Schwartz PJ, et al. (2005) Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 352:1951–1958
Legramante JM, Iellamo F, Massaro MC, et al. (2007) Effects of residential exercise training on heart rate recovery in coronary artery patients. Am J Physiol Heart Circ Physiol 292:H510–H515
Morise AP (2004) Heart rate recovery: predictor of risk today and target of therapy tomorrow? Circulation 110:2778–2780
Ohuchi H, Hamamichi Y, Hayashi T, et al. (2005) Post-exercise heart rate, blood pressure and oxygen uptake dynamics in pediatric patients with Fontan circulation. Comparison with patients after right ventricular outflow tract reconstruction. Int J Cardiol 101:129–136
Ohuchi H, Hasegawa S, Yasuda K, et al. (2001) Severely impaired cardiac autonomic nervous activity after the Fontan operation. Circulation 104:1513–1518
Ohuchi H, Ohashi H, Park J, et al. (2002) Abnormal postexercise cardiovascular recovery and its determinants in patients after right ventricular outflow tract reconstruction. Circulation 106:2819–2826
Ohuchi H, Suzuki H, Toyohara K, et al. (2000) Abnormal cardiac autonomic nervous activity after right ventricular outflow tract reconstruction. Circulation 102:2732–2738
Ohuchi H, Suzuki H, Yasuda K, et al. (2000) Heart rate recovery after exercise and cardiac autonomic nervous activity in children. Pediatr Res 47:329–335
Ohuchi H, Takasugi H, Ohashi H, et al. (2004) Abnormalities of neurohormonal and cardiac autonomic nervous activities relate poorly to functional status in Fontan patients. Circulation 110:2601–2608
Rahimi K, Thomas A, Adam M, et al. (2006) Implications of exercise test modality on modern prognostic markers in patients with known or suspected coronary artery disease: treadmill versus bicycle. Eur J Cardiovasc Prev Rehabil 13:45–50
Rhodes J, Curran TJ, Camil L, et al. (2005) Impact of cardiac rehabilitation on the exercise function of children with serious congenital heart disease. Pediatrics 116:1339–1345
Savin WM, Davidson DM, Haskell WL (1982) Autonomic contribution to heart rate recovery from exercise in humans. J Appl Physiol 53:1572–1575
Streuber SD, Amsterdam EA, Stebbins CL (2006) Heart rate recovery in heart failure patients after a 12-week cardiac rehabilitation program. Am J Cardiol 97:694–698
Acknowledgments
This study was supported by a grant from the Deborah Munroe Noonan Memorial Fund and by grant 5U01 HL068285 from the Pediatric Heart Network.
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Singh, T., Curran, T. & Rhodes, J. Cardiac Rehabilitation Improves Heart Rate Recovery Following Peak Exercise in Children with Repaired Congenital Heart Disease. Pediatr Cardiol 28, 276–279 (2007). https://doi.org/10.1007/s00246-006-0114-0
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DOI: https://doi.org/10.1007/s00246-006-0114-0