Exercise training in adults with congenital heart disease: Feasibility and benefits

Congenital Heart Disease in the Older Adult

“…178 Recently, several small series have been published that examined the utility of training and cardiac rehabilitation in the ACHD patient. 179,180 Preliminary data are encouraging and indicate that many determinants of exercise capacity may demonstrate improvement.…”

Exercise Standards for Testing and Training

“…One study 591 of 17 adults with tetralogy of Fallot (of whom 9 participated in a home/hospital-based exercise program for 12 weeks, and 8 continued to pursue their habitual daily activities) reported a small (7.8%) but statistically significant increase in peak Vȯ 2 in the exercise group but not in the control subjects. In another study, 592 the exercise duration of a group of 61 adult patients with a variety of congenital heart disease diagnoses improved after a 10-week home-based exercise program. Similar beneficial effects were detected in another study of 11 patients.…”

Reference values for cardiopulmonary exercise testing in children and adolescents in northwest Croatia

“…The fourth indication is to assess the risk of future disease complications, for instance, complex premature ventricular contractions (PVCs) during exercise in hypertrophic cardiomyopathy, arrhythmias and risk of sudden death late after tetralogy of Fallot repair (12), to assess ability to increase oxygen delivery and CO2 elimination in patients with half of the heart, where there is no ventricle that is pumping blood in the lung and all pulmonary infl ow depends on total cavopulmonary connection and pulmonary resistance (13). An additional indication for CPET is to inspire confi dence in children and parents, to teach children and parents about preventive eff ects of sports in life in healthy children or in a population of children with CHD, where parents are often overprotecting their children, even though the underlying disorder is only mild and might not be restrictive for performing physical activities including competitive sports (9,(13)(14)(15)(16)(17) The parameters that are measured during CPET include simple measures such as peak work rate (WRpeak) and heart rate (HR) response to exercise, peak oxygen uptake (VO2peak), and more recently proposed measures as the ventilation to carbon dioxide exhalation (VE/VCO2) slope. Additional ventilatory control parameters during exercise in children are minute ventilation (VE), assessment of anaerobic threshold (AT), respiratory compensation point (RCP), oxygen uptake (VO2), carbon dioxide output (VCO2), ventilatory equivalents for carbon dioxide and oxygen (VE/VCO2, VE/VCO2), oxygen pulse (VO2/HR), physiological dead space-tidal volume ratio (VD/VT), end-tidal pCO2 (PETCO2), end-tidal pO2 (PETO2), gas exchange ratio (R), the increase in oxygen uptake in response to a simultaneous increase in work rate (ΔVO2/ΔWR), breathing reserve (BR), and heart rate reserve (HRR) (1).…”