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Decreased exercise performance with age in children with hypoplastic left heart syndrome

Pamela C Jenkins1, Richard E Chinnock, Kathy J Jenkins

  • 1Department of Pediatrics, Dartmouth Medical School, Hanover, NH 03756, USA. pcj@hitchcock.org

The Journal of Pediatrics
|March 19, 2008
PubMed

Insights

Children with hypoplastic left heart syndrome (HLHS) experience declining exercise capacity with age. Exercise testing reveals age-related decreases in cardiovascular function, highlighting the need for interventions to improve quality of life.

Area of Science:

  • Pediatric Cardiology
  • Exercise Physiology
  • Congenital Heart Disease

Background:

  • Hypoplastic left heart syndrome (HLHS) can lead to cardiac dysfunction.
  • This dysfunction may worsen with age following surgical interventions or transplantation.
  • Exercise testing may identify cardiovascular limitations and guide interventions.

Purpose of the Study:

  • To investigate the hypothesis that exercise testing can assess cardiovascular capacity in children with HLHS.
  • To identify potential interventions to improve quality of life in this population.

Main Methods:

  • Treadmill or bicycle ergometric testing was performed on 42 children with HLHS (age ≥ 8 years) across four centers.
  • Exercise test results were compared to age and sex-matched norms.
  • Participants were stratified by age groups (8-12 vs. 13-17 years) and surgical history (staged surgery vs. transplant).

Main Results:

  • Exercise performance, including maximal oxygen uptake (mVO2) and peak heart rate, declined with age.
  • Older children (13-17 years) showed significantly lower predicted mVO2 compared to younger children (8-12 years).
  • Transplanted patients demonstrated better exercise time and peak rate-pressure product than those with staged surgery, though mVO2 did not differ significantly.

Conclusions:

  • Children with HLHS exhibit a notable age-related decline in exercise performance.
  • This decline is observed irrespective of the surgical strategy employed (staged surgery or transplantation).
  • Exercise testing is a valuable tool for assessing functional capacity and guiding management in pediatric HLHS patients.
Abstract

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