Effects of exercise and respiration on blood flow in total cavopulmonary connection: a real-time magnetic resonance flow study
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Effects of exercise and respiration on blood flow in total cavopulmonary connection : a real-time magnetic resonance flow study. / Hjortdal, V E; Emmertsen, K; Stenbøg, E; Fründ, T; Schmidt, M Rahbek; Kromann, O; Sørensen, K; Pedersen, E M.
I: Circulation, Bind 108, Nr. 10, 09.09.2003, s. 1227-31.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Effects of exercise and respiration on blood flow in total cavopulmonary connection
T2 - a real-time magnetic resonance flow study
AU - Hjortdal, V E
AU - Emmertsen, K
AU - Stenbøg, E
AU - Fründ, T
AU - Schmidt, M Rahbek
AU - Kromann, O
AU - Sørensen, K
AU - Pedersen, E M
PY - 2003/9/9
Y1 - 2003/9/9
N2 - BACKGROUND: Little is known about blood flow and its relationship to respiration during exercise in patients with total cavopulmonary connection (TCPC).METHODS AND RESULTS: We studied 11 patients 12.4+/-4.6 years (mean+/-SD) of age 5.9+/-2.8 years (mean+/-SD) after TCPC operation. Real-time MRI was used to measure blood flow in the superior vena cava (SVC), inferior vena cava (IVC), and ascending aorta under inspiration and expiration during supine lower-limb exercise (rest, 0.5 and 1.0 W/kg) on an ergometer bicycle. IVC and aortic flow increased from 1.60+/-0.52 and 2.99+/-0.83 L/min per m2 at rest to 2.58+/-0.71 and 3.97+/-1.20 L/min per m2 at 0.5 W/kg and to 3.25+/-1.23 and 4.62+/-1.49 L/min per m2 at 1.0 W/kg (P< or =0.05). SVC flow remained unchanged. Resting flow in the IVC was greater during inspiration (2.99+/-1.25 L/min per m2) than during expiration (0.83+/-0.44 L/min per m2) (inspiratory/mean flow ratio, 1.9+/-0.5), and retrograde flow was present during expiration (11+/-12% of mean flow). The predominance of inspiratory flow in IVC diminished with exercise to an inspiratory/mean flow ratio of 1.5+/-0.2 (P< or =0.05) and 1.4+/-0.3 at 0.5 and 1.0 W/kg, respectively.CONCLUSIONS: In the TCPC, circulation IVC and aortic but not SVC flows increase with supine leg exercise. Inspiration facilitates IVC flow at rest but less so during exercise, when the peripheral pump seems to be more important.
AB - BACKGROUND: Little is known about blood flow and its relationship to respiration during exercise in patients with total cavopulmonary connection (TCPC).METHODS AND RESULTS: We studied 11 patients 12.4+/-4.6 years (mean+/-SD) of age 5.9+/-2.8 years (mean+/-SD) after TCPC operation. Real-time MRI was used to measure blood flow in the superior vena cava (SVC), inferior vena cava (IVC), and ascending aorta under inspiration and expiration during supine lower-limb exercise (rest, 0.5 and 1.0 W/kg) on an ergometer bicycle. IVC and aortic flow increased from 1.60+/-0.52 and 2.99+/-0.83 L/min per m2 at rest to 2.58+/-0.71 and 3.97+/-1.20 L/min per m2 at 0.5 W/kg and to 3.25+/-1.23 and 4.62+/-1.49 L/min per m2 at 1.0 W/kg (P< or =0.05). SVC flow remained unchanged. Resting flow in the IVC was greater during inspiration (2.99+/-1.25 L/min per m2) than during expiration (0.83+/-0.44 L/min per m2) (inspiratory/mean flow ratio, 1.9+/-0.5), and retrograde flow was present during expiration (11+/-12% of mean flow). The predominance of inspiratory flow in IVC diminished with exercise to an inspiratory/mean flow ratio of 1.5+/-0.2 (P< or =0.05) and 1.4+/-0.3 at 0.5 and 1.0 W/kg, respectively.CONCLUSIONS: In the TCPC, circulation IVC and aortic but not SVC flows increase with supine leg exercise. Inspiration facilitates IVC flow at rest but less so during exercise, when the peripheral pump seems to be more important.
KW - Aorta/physiology
KW - Blood Flow Velocity
KW - Child
KW - Echocardiography
KW - Electrocardiography
KW - Exercise/physiology
KW - Exercise Test
KW - Female
KW - Fontan Procedure
KW - Heart Bypass, Right
KW - Heart Defects, Congenital/physiopathology
KW - Heart Rate
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Respiration
KW - Rest/physiology
KW - Stroke Volume
KW - Vena Cava, Inferior/physiology
KW - Vena Cava, Superior/physiology
U2 - 10.1161/01.CIR.0000087406.27922.6B
DO - 10.1161/01.CIR.0000087406.27922.6B
M3 - Journal article
C2 - 12939218
VL - 108
SP - 1227
EP - 1231
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 10
ER -
ID: 242781442