CARDIAC PERFORMANCE DURING UPRIGHT EXERCISE BEFORE AND AFTER REPAIR OF COARCTATION

Abstract

Coarctation patients are reported to have enhanced cardiac performance in the remote post-operative period. We examined data from coarctation patients (N=22) studied both before (mean 1.7 mo.) and after (mean 32 mo.) repair to evaluate cardiac performance. Controls were 10 longitudinally studied normal children matched for mean age, wt., ht., and BSA at time of first (COA-1 vs CTR-1) and second study (COA-2 vs CTR-2). Heart rate, blood pressure, and carotid pulse pre-ejection pre-ejection period to LV ejection time ratio (P/L) were measured. Cardiac output (CO) in L/min was determined by acetylene rebreathing in 8 COA and 6 CTR pts, with calculation of stroke volume (SV) in cc. Data was obtained at maximal exercise on an upright bicycle ergometer:

At rest COA-1 also had significantly higher SBP, DBP and P/L. HR and CO did not differ at rest in COA-1 vs CTR-1, and no parameter differed at rest in COA-2 vs CTR-2. We conclude that patients studied both before and after repair of coarctation demonstrated a normalization of blood pressure and ventricular function (P/L). Cardiac performance was not elevated in either pre- or post-operative state.

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