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Exercise Capacity and Pulmonary Function in Pediatric Patients With Anomalous Pulmonary Venous Connection
Yen-Hsien Wu1, Yen-Sen Lu2, Sheng-Hui Tuan3,4,5
1Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Insights
Children with repaired anomalous pulmonary venous connection (APVC) have reduced exercise capacity. Despite normal resting lung function, these patients experience persistent limitations, highlighting the need for functional assessments and rehabilitation.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Pulmonary Medicine
Background:
- Anomalous pulmonary venous connection (APVC) is a congenital heart defect affecting pulmonary vein drainage.
- Surgical repair improves survival but long-term cardiopulmonary effects are not fully understood.
Purpose of the Study:
- To evaluate exercise capacity and pulmonary function in pediatric patients after APVC repair.
- To compare functional outcomes between APVC patients and healthy controls.
Main Methods:
- Retrospective study of 26 pediatric APVC patients (17 total APVC, 9 partial APVC) and 63 age-matched controls.
- Cardiopulmonary exercise testing (CPET) was used to assess exercise capacity.
- Exclusion of patients with complex defects or significant comorbidities.
Main Results:
- APVC patients demonstrated significantly lower anaerobic threshold VO2, peak VO2, and peak heart rate compared to controls.
- No significant differences in exercise capacity were observed between TAPVC and PAPVC subgroups.
- Resting lung function was preserved in the APVC group.
Conclusions:
- Repaired APVC in children is associated with persistent exercise limitations, despite normal resting lung function.
- Routine functional assessment and potential rehabilitation are crucial for managing these patients.
- Further research is needed to elucidate the mechanisms behind these limitations and guide long-term care.
Abstract:
Anomalous pulmonary venous connection (APVC), including total (TAPVC) and partial (PAPVC) forms, is a congenital heart defect with abnormal pulmonary vein drainage; and while surgical repair has improved survival, its long-term impact on cardiopulmonary function remains unclear. This retrospective study evaluated exercise capacity and pulmonary function in 26 pediatric APVC patients (17 TAPVC, 9 PAPVC) using cardiopulmonary exercise testing (CPET) and compared them with 63 age-matched healthy controls. Patients with complex defects or significant comorbidities were excluded. Results showed significantly lower anaerobic threshold VO2 (p = 0.03), peak VO2 (p < 0.001) and peak heart rate (p = 0.02) in the APVC group, indicating impaired exercise capacity; though no differences were found between TAPVC and PAPVC subgroups. Despite preserved resting lung function, these findings suggest that children with repaired APVC experience persistent exercise limitations, underscoring the importance of routine functional assessment and potential rehabilitation, with further studies needed to clarify underlying mechanisms and guide long-term care.
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