Chronotropic incompetence in paediatric heart transplant recipients with prior congenital heart disease. Cardiol Young 2019 May;29(5):667-671
Date
06/07/2019Pubmed ID
31169095DOI
10.1017/S1047951119000714Scopus ID
2-s2.0-85066817669 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
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.
Author List
Singh NM, Loomba RS, Kovach JR, Kindel SJAuthors
Steven J. Kindel MD Associate Professor in the Pediatrics department at Medical College of WisconsinJoshua Kovach MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Nikki Singh MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentCardiomyopathies
Child
Child, Preschool
Echocardiography
Exercise Test
Exercise Tolerance
Female
Heart Defects, Congenital
Heart Rate
Heart Transplantation
Humans
Infant
Male
Oxygen Consumption