Congenital Heart Disease
Conditions
Keywords
pediatric, fontan, congenital heart disease, cardiac and musculoskeletal funion, cardiac and/or musculoskeletal metabolism, exercise training intervention
Brief summary
Primary Objective: To determine if impairments in cardiac and musculoskeletal function and metabolism exist in Fontan children. Secondary Objectives: 1. To determine if impairments do exist, are they related to exercise capacity. 2. To determine if a 12-week exercise training intervention improves cardiac and/or musculoskeletal metabolism. Hypothesis: The investigators hypothesize that abnormalities in cardiac and skeletal function are evident, influence exercise capacity, and can be improved with exercise training.
Detailed description
This proposed research provides an interdisciplinary approach to understanding exercise intolerance by examining cardiac and musculoskeletal metabolism in a unique cohort of children with congenital heart disease. Study findings may more importantly lead to evidence-based exercise interventions that promote improvements in overall physical health, quality of life, and functional status for Fontan children. Furthermore, this pilot study will lead to the development of a novel research protocol which may be applied to larger Fontan and other congenital heart disease cohorts. This study will also provide preliminary data to develop and conduct a larger clinical research project.
Interventions
OTHERExercise Program
The Fontan cohort will subsequently complete a 12-week moderate intensity exercise intervention whereby individualized activity-based home interventions will be prescribed (i.e., sample activities: walking, jogging, swimming, cycling, soccer). More specifically, individualized weekly exercise programs for participants will be provided incorporating two specific exercise components.
Sponsors
The Hospital for Sick Children
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
10 Years to 16 Years
Healthy volunteers
Yes
Inclusion criteria
Fontan Patients: 1. Patients who have had the Fontan cardiac procedure 2. 10-16 years of age 3. Written Informed Consent Healthy Controls: 1. 10 - 16 years of age 2. Written Informed Consent
Exclusion criteria
Fontan Patients: 1. Contraindication to exercise 2. Physically active (i.e., ≥ 60 minute of moderate-vigorous activity) (Strong et al., 2005) 3. Patients in whom MRI is contraindicated (e.g. pacemaker, ocular metal, claustrophobia, tattoos) 4. Patients with a known allergy to gadolinium. 5. Patients with a history of allergic disposition or have anaphylactic reactions 6. Moderate-to-severe renal impairment (defined as having a GFR/ eGFR \< 60 mL/min) 7. Have Sickle Cell anemia 8. Known pregnancy, or breast feeding 9. Patient is uncooperative during a MRI without sedation or anesthesia Healthy Controls: 1. Contraindication to exercise 2. Physically active (i.e., ≥ 60 minute of moderate-vigorous activity) (Strong et al., 2005) 3. Patients in whom MRI is contraindicated (e.g. pacemaker, ocular metal, claustrophobia, tattoos, pregnancy) 4. Patient is uncooperative during a MRI without sedation or anesthesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac and skeletal function and metabolism | 1 day | Blood oxygen level dependent functional magnetic resonance imaging (BOLD fMRI), and 31P-MRS will allow for the precise measurement of cardiac and musculoskeletal function, circulatory perfusion and vascular reactivity, and aerobic and anaerobic metabolism, respectively. Cardiac function will be examined via MRI and exercise echocardiography. |
Countries
Canada
Outcome results
None listed