Serial exercise testing in children, adolescents and young adults with Senning repair for transposition of the great arteries.

Background: Patients with Senning repair for complete transposition of the great arteries (d-TGA) show an impaired exercise tolerance. Our aim was to investigate changes in exercise capacity in children, adolescents and adults with Senning operation.

Methods: Peak oxygen uptake (peak VO2), oxygen pulse and heart rate were assessed by cardiopulmonary exercise tests (CPET) and compared to normal values.

Tilt training and pacing: a report on 9 patients with neurally mediated syncope.

Objective: In patients with neurally mediated syncope (NMS), pacing has been used to prevent bradycardia and syncope. However, recurrence due to the vasodepressor component remains a problem.

Methods: We report on tilt training in 9 patients with a pacemaker (PM) implantation.

Impaired chronotropic response to exercise in children with repaired cyanotic congenital heart disease.

Objective: Conventionally the heart rate response to exercise has been considered as a useful parameter for the assessment of exercise performance. However, in patients with surgical repair of congenital heart defects sino-atrial dysfunction has been observed after cardiac surgery.The purpose of this study was to assess whether the heart rate response to exercise can be used in the assessment of exercise performance.

Steep fall in cardiac output is main determinant of hypotension during drug-free and nitroglycerine-induced orthostatic vasovagal syncope.

Background: How much of the hypotension occurring during postural syncope is cardiac output-mediated and how much can be ascribed to a fall in systemic vascular resistance are unknown. The contribution of both determinants may be influenced by the use of vasoactive drugs.

Objective: The purpose of this study was to assess the determinants of hypotension during drug-free and nitroglycerine (NTG)-induced vasovagal presyncope in routine tilt table testing.

Tilt training increases the vasoconstrictor reserve in patients with neurally mediated syncope evoked by head-up tilt testing.

Aims: Tilt training is a useful therapeutic option in neurally mediated syncope (NMS). We tested the hypothesis that tilt training will restore orthostatic tolerance by increasing the degree of vasomotor reserve during sustained orthostatic stress. METHODS AND RESULTS In this follow-up study we enrolled 17 patients (age 31 +/- 22 years, 11 females) with a clinical diagnosis of NMS and two consecutive positive tilt tests.

Recommendations for participation in competitive and leisure sports in patients with congenital heart disease: a consensus document.

Background: Physical activity is important for patients with congenital heart disease. The aim of this paper is to provide a consensus document for participation in competitive or leisure sport activity in children and adults with congenital heart disease.

Methods: The recommendations are based on expert consensus meetings, personal experience of the contributing authors and an updated review of the literature regarding exercise performance and risk stratification in patients with congenital heart disease.

Tilt training: a new challenge in the treatment of neurally mediated syncope.

Clinical experience with repeated tilt testing and standing training has shown that this procedure can be used as a new therapy for the restoration of abnormal autonomic orthostatic reflexes. The introduction of tilt training therapy for neurally mediated syncope is a new and effective treatment. This new therapy has been used recently in several centres with excellent results.

Repeated tilt testing in patients with tilt-positive neurally mediated syncope.

In this study we have included 222 patients with apparent neurally mediated syncope and with a positive diagnostic tilt test. The mean age was 33.4+/-21.

Physical performance and physical activity in grown-up congenital heart disease.

Aim: To review exercise performance and exercise habits in patients with congenital heart disease (CHD).

Background And Methods: Physical exercise and physical activity has shown beneficial effects on the physical, psychological and social level in adult patients with cardiovascular disease. Favourable effects have also been documented in children with CHD.

A Java software for calculating mean breath-by-breath variability in gas exchange parameters: application in young cardiac patients with exercise-related periodic breathing.

Oscillatory changes in parameters of gas exchange have been reported during rest and exercise in cardiac patients with severely depressed left ventricular function. As a result of the growing interest in this oscillatory phenomenon, several methods for assessment of this ventilatory response have been presented in cardiovascular research. Nowadays, objective measurement becomes more important.

A mitochondrial tRNA aspartate mutation causing isolated mitochondrial myopathy.

Several mutations in mitochondrial transfer RNA (tRNA) genes can cause mitochondrial myopathy. We describe a young girl who presented with pronounced exercise intolerance. The anaerobic threshold and the maximal oxygen consumption were decreased.

Influence of work rate on the determinants of oxygen deficit during short-term submaximal exercise: implications for clinical research.

Objective: The effect of increasing work rate was studied on the determinants of the oxygen deficit.

Methods: Exercise testing was performed on a treadmill and gas exchange was measured on a breath-by-breath basis. Eleven healthy subjects, aged 18-25 years, performed three square wave exercise tests of different intensity.

Long-term follow-up results of tilt training therapy in patients with recurrent neurocardiogenic syncope.

Tilt twining therapy is considered as a first choice treatment for neurocardiogenic syncope in the Department of Cardiology, University of Leuven. However, long-term compliance to therapy may be difficult when patients become asymptomatic. In a single center uncontrolled study, the long-term clinical outcome of 38 patients was studied after a follow-up period of 43 +/- 7.