Abstract 14149: Daily Physical Activity in Patients After a Fontan Operation Improves Functional Capacity, Which is Related to Endothelial Function and Skeletal Muscle Hemodynamics
Background: Physical activity has well-documented positive effects on endothelial function and exercise capacity in various heart diseases. We previously reported that exercise capacity in patients after a Fontan operation was closely related to endothelial function and skeletal muscle oxygenation during exercise. However, little is known about the possible benefits of physical activity for patients after a Fontan operation.
Methods and Results: We evaluated 78 patients who had received a Fontan operation (age: 23+/-5 years old) and 20 age-matched healthy controls. The Fontan patients completed a questionnaire on their daily physical activity, and the results were used to divide them into three groups: sedentary, moderate activity and vigorous activity. All subjects performed a cardiopulmonary exercise test with expired gas measurements. During this test, near-infrared spectroscopy was performed on the vastus lateralis muscle to assess the skeletal muscle hemodynamics during exercise. Endothelium-dependent vasodilation was determined by the flow-mediated change in the brachial artery diameter using high-resolution ultrasonography. Peak oxygen consumption (pVO2) was lowest in the sedentary group (17.4+/-4.9vs23.0+/-4.8vs30.9+/-4.4). This group also had the lowest total hemoglobin level during exercise and the lowest levels of both post-exercise oxygen resaturation in the skeletal muscle and flow-mediated vasodilation (3.5+/-1.0%vs5.7+/-1.6%vs8.6+/-1.9%). Twelve patients in the sedentary group were encouraged to increase their daily physical activity. Serial evaluations were performed one year later. We found improved pVO2, flow-mediated vasodilation and skeletal muscle hemodynamics parameters in accordance with levels of physical activity.
Conclusions: Increased levels of daily physical activity should improve exercise capacity in Fontan patients; physical activity levels are closely related to endothelial function and skeletal muscle oxygenation.
- © 2011 by American Heart Association, Inc.