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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Impact of cardiac rehabilitation on the exercise function of children with serious congenital heart disease.
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Impact of cardiac rehabilitation on the exercise function of children with serious congenital heart disease.

机译：心脏康复对患有严重先天性心脏病的儿童运动功能的影响。

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OBJECTIVES: The exercise capacity of children with congenital heart disease (CHD) is often depressed. This depression is thought to be attributable to (1) residual hemodynamic defects and (2) deconditioning secondary to physical inactivity. We hypothesized that this latter component would be ameliorated by a formal cardiac rehabilitation program designed specifically for children. The objective of this study was to characterize the effect of a cardiac rehabilitation program on the exercise performance of children with CHD and to define the physiologic mechanisms that might account for any improvements that are observed. METHODS: Nineteen patients with CHD who were referred for exercise testing and found to have a peak oxygen consumption (VO2) and/or peak work rate <80% of predicted were enrolled in the study. Sixteen patients (11 Fontan patients, 5 with other CHD) completed the program and had postrehabilitation exercise tests, results of which were compared with the prerehabilitation studies. RESULTS: Improvements were found in 15 of 16 patients. Peak VO2 rose from 26.4 +/- 9.1 to 30.7 +/- 9.2 mL/kg per min; peak work rate from 93 +/- 32 to 106 +/- 34 W, and the ventilatory anaerobic threshold from 14.2 +/- 4.8 to 17.4 +/- 4.5 mL/kg per min. The peak heart rate and peak respiratory exchange ratio did not change, suggesting that the improvements were not attributable merely to an increased effort. In contrast, the peak oxygen pulse rose significantly, from 7.6 +/- 2.8 to 9.7 +/- 4.1 mL/beat, an improvement that can be attributed only to an increase in stroke volume and/or oxygen extraction at peak exercise. No patient experienced rehabilitation-related complications. CONCLUSION: Cardiac rehabilitation can improve the exercise performance of children with CHD. This improvement is mediated by an increase in stroke volume and/or oxygen extraction during exercise. Routine use of formal cardiac rehabilitation may greatly reduce the morbidity of complex CHD.
机译：目的：患有先天性心脏病（CHD）的儿童的运动能力通常会下降。认为这种抑郁症可归因于（1）残留的血液动力学缺陷和（2）继发于缺乏身体活动的身体不适。我们假设通过专门为儿童设计的正式心脏康复计划可以改善后一部分。这项研究的目的是表征心脏康复计划对冠心病儿童运动表现的影响，并确定可能解释观察到的任何改善的生理机制。方法：本研究招募了19名冠心病患者，接受运动测试，发现其峰值耗氧量（VO2）和/或峰值工作率低于预期的80％。 16名患者（11名Fontan患者，5名患有其他CHD）完成了该程序并接受了康复后运动测试，并将其结果与康复前研究进行了比较。结果：16例患者中有15例得到了改善。 VO2峰值从每分钟26.4 +/- 9.1升至30.7 +/- 9.2 mL / kg;最高工作速率从93 +/- 32到106 +/- 34 W，通气性厌氧阈值从14.2 +/- 4.8到17.4 +/- 4.5 mL / kg每分钟。峰值心率和峰值呼吸交换率没有变化，表明这种改善不仅仅归因于增加的努力。相反，峰值氧脉冲显着上升，从7.6 +/- 2.8升至9.7 +/- 4.1 mL /次，这只能归因于峰值运动时每搏量的增加和/或吸氧量的增加。没有患者经历过康复相关的并发症。结论：心脏康复可以改善冠心病患儿的运动表现。这种改善是由运动过程中每搏量和/或吸氧量的增加所介导的。常规使用正规的心脏康复可能会大大降低复杂冠心病的发病率。

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