Regional ventricular performance and exercise training in children and young adults after repair of tetralogy of Fallot: randomized controlled pilot study.

Circ Cardiovasc Imaging

From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.).

Published: April 2015

Background: Public-health guidelines recommend patients with congenital heart disease to exercise. Studies have shown that patients with congenital heart disease can improve physical exercise capacity. The effect of training on regional ventricular performance has hardly been studied. We performed a pilot study to assess whether an exercise training program would result in adverse changes of regional ventricular performance in patients with corrected tetralogy of Fallot.

Methods And Results: Multicenter prospective randomized controlled pilot study in patients with tetralogy of Fallot aged 10 to 25 years. A 12-week standardized aerobic dynamic exercise training program (3 one-hour sessions per week) was used. Pre- and post-training cardiopulmonary exercise tests, MRI, and echocardiography, including tissue-Doppler imaging, were performed. Patients were randomized to the exercise group (n=28) or control group (n=20). One patient in the exercise group dropped out. Change in tissue-Doppler imaging parameters was similar in the exercise group and control group (change in right ventricle free wall peak velocity E' exercise group, 0.8±2.6 cm/s; control group, 0.9±4.1; peak velocity A' exercise group, 0.4±2.4 m/s; control group 4.6±18.1 cm/s).

Conclusions: This randomized controlled pilot study provides preliminary data suggesting that regional ventricular performance is well maintained during 3-month aerobic dynamic exercise training in children and young adults with repaired tetralogy of Fallot. This information might help patients adhere to current public-health guidelines.

Clinical Trial Registration: URL: http//:www.trialregister.nl. Unique identifier: NTR2731.

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http://dx.doi.org/10.1161/CIRCIMAGING.114.002006DOI Listing

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