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Calf Muscle Oxygenation is Impaired and May Decline with Age in Young Patients with Total Cavopulmonary Connection
Pediatric Cardiology ( IF 1.5 ) Pub Date : 2021-10-08 , DOI: 10.1007/s00246-021-02743-6
Magne Sthen Bergdahl 1, 2 , Albert G Crenshaw 3 , Eva Rylander Hedlund 4 , Gunnar Sjöberg 4 , Annika Rydberg 1 , Camilla Sandberg 5, 6
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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.



中文翻译:

在全腔静脉肺连接的年轻患者中,小腿肌肉氧合受损并可能随着年龄的增长而下降

使用全腔静脉肺连接缓解的患者肌肉质量较低,运动能力较低。与健康同龄人相比,我们评估了年轻 TCPC 患者在足跟抬高运动至力竭期间和之后的小腿肌肉氧化代谢。近红外光谱用于测量腓肠肌内侧部分的氧代谢。将 43 名年龄在 6-18 岁的 TCPC 患者与 43 名年龄和性别匹配的健康对照受试者进行了比较。亚组包括儿童(6-12 岁)和青少年(13-18 岁),以确定这些年龄组是否影响结果。在运动过程中,与对照组相比,患者的脱氧血红蛋白(氧气提取)增加较低(5.13 ± 2.99au7.75 ± 4.15au,p = 0.001)和总血红蛋白(血容量)的较慢变化率(0.004 ± 0.015au vs 0.016 ± 0.01au,p  = 0.001)。运动后,患者的组织氧合饱和指数初始增加较慢(0.144 ± 0.11au vs 0.249 ± 0.226au,p  = 0.007),达到最大充血的半衰期更长(23.7 ± 11.4 s vs 16.8 ± 7.5 s,p  = 0.001)。在亚组水平上,青少年与健康同龄人相比存在差异,而儿童则没有。年轻的 TCPC 患者在运动过程中氧化代谢受损,需要更长的时间才能恢复。因为在青少年组而不是在儿童组中看到了差异,这可能表明功能随着年龄的增长而下降。

更新日期:2021-10-08
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