Exercise capacity following pediatric heart transplantation: A systematic review

Peterson, Sara; Su, Jennifer; Szmuszkovicz, Jacqueline R.; Johnson, Robert; Sargent, Barbara

doi:10.1111/petr.12922

Cited by 19 publications

(17 citation statements)

References 42 publications

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“…18 More recently, a systematic review looking at six major databases comparing cardiopulmonary exercise tests using treadmill or electronically braked cycle ergometer in children who received heart transplant to a healthy control group found that resting heart rate was higher compared to controls but that peak heart rate, heart rate reserve, peak oxygen consumption, exercise duration, and minute ventilation were significantly lower compared to controls or normative data. 20 In our study, we were unable to compare serial cardiopulmonary exercise tests in this cohort as routine testing was not routinely performed following heart transplant; however, in the last few years, our practice has now incorporated cardiopulmonary exercise testing as an additional clinical test to monitor patients with plans for serial testing every 2-3 years.…”

Section: Discussionmentioning

confidence: 94%

Chronotropic incompetence in paediatric heart transplant recipients with prior congenital heart disease

et al. 2019

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Background:Cardiopulmonary exercise testing has been used to measure functional capacity in children who have undergone a heart transplant. Cardiopulmonary exercise testing results have not been compared between children transplanted for a primary diagnosis of CHD and those with a primary diagnosis of cardiomyopathy despite differences in outcomes. This study is aimed to compare cardiopulmonary exercise testing performance between these two groups.Methods:Patients who underwent heart transplant with subsequent cardiopulmonary exercise testing at least 6 months after transplant at our institution were identified. They were then divided into two groups based on primary cardiac diagnosis: CHD or cardiomyopathy. Patient characteristics, echocardiograms, cardiac catheterisations, outcomes, and cardiopulmonary exercise test results were compared between the two groups.Results:From the total of 35 patients, 15 (43%) had CHD and 20 (57%) had cardiomyopathy. Age at transplant, kidney disease, lung disease, previous rejection, coronary vasculopathy, catheterisation, and echocardiographic data were similar between the groups. Mean time from transplant to cardiopulmonary exercise testing, exercise duration, and maximum oxygen consumption were similar in both groups. There was a difference in heart rate response with CHD heart rate response of 63 beats per minute compared to cardiomyopathy group of 78 (p = 0.028). Patients with CHD had more chronotropic incompetence than those with cardiomyopathy (p = 0.036).Conclusion:Primary diagnosis of CHD is associated with abnormal heart rate response and more chronotropic incompetence compared to those transplanted for cardiomyopathy.

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Section: Discussionmentioning

confidence: 94%

Chronotropic incompetence in paediatric heart transplant recipients with prior congenital heart disease

et al. 2019

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“…In favor of the high-intensity interval training group the mean [95% CI] change in peak oxygen consumption between groups was 7.0 [2.6, 11.3] ml/kg/min (p = 0.005) at follow-up (Table 2) also in this study. Maximum muscle strength was also significantly higher in the high-intensity interval training group at follow-up, with a mean [95% CI] difference of 41 [5,77] Newton meters (p = 0.031) (Figure 3), while the difference in muscular exercise capacity was non-significant ( Figure 4).…”

Section: Young Recipients In the Tex-studymentioning

confidence: 99%

“…Little is known about the effect of exercise in young heart transplant recipients, but most of the few studies that exist report benefits in overall exercise capacity as well as improved health-related quality of life. [1][2][3][4][5] Furthermore, the literature demonstrates individuals´ participation and excellent achievements in national and international transplant games; in competitive cycling, in grueling endurance competitions as the Ironman, and in climbing the world´s tallest peaks. 6 Yet, results on group level is lacking, and more research in this area is highly warranted.…”

Section: Introductionmentioning

confidence: 99%

Effect of high-intensity interval training in young heart transplant recipients: results from two randomized controlled trials

Nytrøen

Rolid²,

Yardley³

et al. 2019

Preprint

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Background Little is known about the effect of exercise in young heart transplant recipients, and results on group level is lacking. This study summarizes the findings of the youngest participants in two previous randomized controlled trials.Method This is a hypothesis-generating study reporting the main results from the youngest participants in two larger randomized controlled trials investigating the effect of high-intensity interval training (HIT). The article summarizes the main results from 28 young participants (< 40 year of age) who have participated in two previous studies which evaluated the effect of HIT vs. controls in adult heart transplant recipients. One of the studies included de novo heart transplant recipients and the other included maintenance heart transplant recipients. All study tests were performed in-hospital, in the specialist health care setting, but the exercise intervention was carried out locally, in cooperation with the primary health care. In both studies the exercise intervention lasted for 9-12 months. In one study, HIT was compared to controls (no specific intervention), and in the other study HIT was compared to moderate, continuous exercise (MICT). The main outcome measure was peak oxygen uptake (VO 2peak ).Results The summarized findings from the youngest heart transplant recipients in these two studies demonstrated mainly that the improvement in peak oxygen uptake among the younger recipients (< 40 years) was much larger compared to the improvement among the older recipients (≥ 40 years), and in accordance with results from adult heart transplant populations: HIT, compared to MICT, induced the largest improvement in peak oxygen consumption, also in the younger heart transplant recipients.Conclusions This result may suggest that younger recipients benefit more from high-intensity interval training than their older co-patients. However, larger randomized studies focusing on the young heart transplant population is strongly needed to confirm this hypothesis.

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“…Little is known about the effect of exercise in young heart transplant recipients, but most of the few studies that exist report benefits in overall exercise capacity as well as improved health-related quality of life [1][2][3][4][5]. Furthermore, the literature demonstrates individuals' participation and excellent achievements in national and international transplant games; in competitive cycling, in grueling endurance competitions as the Ironman, and in climbing the world's tallest peaks [6].…”

Section: Introductionmentioning

confidence: 99%

Effect of high-intensity interval training in young heart transplant recipients: results from two randomized controlled trials

Nytrøen

Rolid

Yardley

et al. 2020

BMC Sports Sci Med Rehabil

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Background: Little is known about the effect of exercise in young heart transplant recipients, and results on group level is lacking. This study summarizes the findings of the youngest participants in two previous randomized controlled trials. Method: This is a hypothesis-generating study reporting the main results from the youngest participants in two larger randomized controlled trials investigating the effect of high-intensity interval training (HIT). The article summarizes the main results from 28 young participants (< 40 year of age) who have participated in two previous studies which evaluated the effect of HIT vs. controls in adult heart transplant recipients. One of the studies included de novo heart transplant recipients and the other included maintenance heart transplant recipients. All study tests were performed in-hospital, in the specialist health care setting, but the exercise intervention was carried out locally, in cooperation with the primary health care. In both studies the exercise intervention lasted for 9-12 months. In one study, HIT (85-95% of peak effort) was compared to controls (no specific intervention), and in the other study HIT was compared to moderate, continuous exercise (MICT, 60-80% of peak effort). The main outcome measure was peak oxygen uptake (VO 2peak) and a secondary endpoint was muscle strength. Results: The summarized findings from the youngest heart transplant recipients in these two studies demonstrated mainly that the improvement in peak oxygen uptake among the younger recipients (< 40 years) was much larger (4.7 vs. 1.2 ml/kg/min and 7.0 vs. 2.2 ml/kg/min) compared to the improvement among the older recipients (≥ 40 years), and in accordance with results from adult heart transplant populations: HIT, compared to MICT, induced the largest improvement in peak oxygen consumption, also in the younger heart transplant recipients. Conclusions: These results suggest that young heart transplant recipients have a greater effect of HIT than of MICT and may also suggest that younger recipients benefit more from high-intensity interval training than their older copatients. However, larger randomized studies focusing on the young heart transplant population is strongly needed to confirm this hypothesis. Trial registration: Clinical trial registrations: NCT01796379 and NCT01091194.

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Exercise capacity following pediatric heart transplantation: A systematic review

Cited by 19 publications

References 42 publications

Chronotropic incompetence in paediatric heart transplant recipients with prior congenital heart disease

Chronotropic incompetence in paediatric heart transplant recipients with prior congenital heart disease

Effect of high-intensity interval training in young heart transplant recipients: results from two randomized controlled trials

Effect of high-intensity interval training in young heart transplant recipients: results from two randomized controlled trials

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