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Calf Muscle Oxygenation is Impaired and May Decline with Age in Young Patients with Total Cavopulmonary Connection
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Centre for Pediatrics and Adolescent Medicine, Norrlands University Hospital, Umeå, Sweden.
Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
Department of Women’s and Children’s Health, Division of Pediatric Cardiology, Karolinska Institutet, Stockholm, Sweden.
Department of Women’s and Children’s Health, Division of Pediatric Cardiology, Karolinska Institutet, Stockholm, Sweden.
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2022 (English)In: Pediatric Cardiology, ISSN 0172-0643, E-ISSN 1432-1971, Vol. 43, no 2, p. 449-456Article in journal (Refereed) Published
Abstract [en]

Patients palliated with Total Cavopulmonary Connection have a lower muscle mass and a lower exercise capacity. We assessed calf muscle oxidative metabolism during and after heel raise exercise to exhaustion in young patients with TCPC compared to healthy peers. Near-infrared spectroscopy was used for measuring oxygen metabolism in the medial portion of the gastrocnemius muscle. Forty-three patients with TCPC, aged 6–18 years, were compared with 43 age and sex-matched healthy control subjects. Subgroups were formed to include children (6–12 years) and adolescents (13–18 years) to determine if these age groups influenced the results. During exercise, for the patients compared to controls there was a lower increase in deoxygenated hemoglobin (oxygen extraction) (5.13 ± 2.99au vs. 7.75 ± 4.15au, p = 0.001) and a slower rate of change in total hemoglobin (blood volume) (0.004 ± 0.015au vs 0.016 ± 0.01au, p = 0.001). Following exercise, patients exhibited a slower initial increase in tissue oxygenation saturation index (0.144 ± 0.11au vs 0.249 ± 0.226au, p = 0.007) and a longer half-time to maximum hyperemia (23.7 ± 11.4 s vs 16.8 ± 7.5 s, p = 0.001). On the subgroup level, the adolescents differed compared to healthy peers, whereas the children did not. Young patients with TCPC had impaired oxidative metabolism during exercise and required a longer time to recover. In that the differences were seen in the adolescent group and not in the children group may indicate a declining function with age.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 43, no 2, p. 449-456
Keywords [en]
Exercise, Fontan, Near-infrared spectroscopy, NIRS, TCPC, Total cavopulmonary connection
National Category
Pediatrics Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-191382DOI: 10.1007/s00246-021-02743-6ISI: 000705716400001PubMedID: 34623455Scopus ID: 2-s2.0-85116846174OAI: oai:DiVA.org:umu-191382DiVA, id: diva2:1627757
Funder
Swedish Heart Lung Foundation, 20160496Available from: 2022-01-14 Created: 2022-01-14 Last updated: 2024-04-10Bibliographically approved

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Rydberg, AnnikaSandberg, Camilla

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