Heart Rate Reserve in Fontan Patients: Chronotropic Incompetence or Hemodynamic Limitation?
Guido Claessen, Andre La Gerche, Alexander Van De Bruaene, Mathias Claeys, Rik Willems, Steven Dymarkowski, Jan Bogaert, Piet Claus, Werner Budts, Hein Heidbuchel, Marc Gewillig
Journal of the American Heart Association | WILEY | Published : 2019
Background Patients with a Fontan circulation achieve lower peak heart rates ( HR ) during exercise. Whether this impaired chronotropic response reflects pathology of the sinoatrial node or is a consequence of altered cardiac hemodynamics is uncertain. We evaluated the adequacy of HR acceleration throughout exercise relative to metabolic demand and cardiac output in patients with a Fontan circulation relative to healthy controls. Methods and Results Thirty subjects (20 healthy controls and 10 Fontan patients) underwent cardiac magnetic resonance imaging with simultaneous invasive pressure recording via a pulmonary and radial artery catheter during supine bicycle exercise to near maximal exer..View full abstract
This study was funded by a grant from the Fund for Scientific Research Flanders (FWO) and by The Van Itterbeek and the Eddy Merckx Research grant. Claessen is supported by a postdoctoral research grant from the Frans Van De Werf Fund for Clinical Cardiovascular Research, the UZ Leuven Future Fund, and from the Mathilde Horlait-Dapsens Scholarship. La Gerche is supported by the Fund for Scientific Research Flanders (FWO) and from the National Health and Medical Research Council (NHMRC) of Australia; Willems is supported as a postdoctoral clinical researcher by the Fund for Scientific Research Flanders (FWO).