Siyanotik Doğuştan Kalp Hastalıkları ve Spora Katılım
Özet
Günümüzde siyanotik konjenital kalp hastalığı (KKH) olan hastalar, gelişen palyatif / düzeltici cerrahi ve girişimsel yöntemler sayesinde erişkin yaşlara ulaşmaktadır. Bu hastaların yaşam kalitelerini artırmak ve morbiditelerini azaltmak için egzersiz yapmanın önemi bilinmektedir. Ancak siyanotik hasta grubunda egzersiz toleransı önemli ölçüde azalmıştır. Bu hastalarda herhangi bir fiziksel aktiviteye katılımdan önce kardiyoloji derneklerinin mevcut önerileri doğrultusunda hastaların yönetimi yapılmalıdır. Altta yatan anatomiyi değerlendirmek için ayrıntılı bir ekokardiyografik değerlendirme ve egzersiz testini de içeren tam bir değerlendirme yapılmalıdır. Hastaların klinik durumlarına ve semptomlarına göre uygun bir egzersiz reçetesi verilmelidir. Spora katılım süresi boyunca da seri klinik değerlendirmelere devam edilmelidir.
Referanslar
Ginsburg KR, Child CoPAo, Health F. The importance of play in promoting healthy child development and maintaining strong parent-child bonds. Pediatrics. 2007;119(1):182-91.
Timmons BW, Naylor P-J, Pfeiffer KA. Physical activity for preschool children—how much and how? Applied Physiology, Nutrition, and Metabolism. 2007;32(S2E):S122-S34.
Ramanan N, Lee S, Maharajh G, Webster R, Longmuir PE. Preventing sedentary lifestyles among young children born with congenital heart defects: A feasibility study of physical activity rehabilitation after surgical or catheterization intervention. Plos one. 2023;18(8):e0284946.
Van Hare GF, Ackerman MJ, Evangelista J-aK, Kovacs RJ, Myerburg RJ, Shafer KM, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 4: congenital heart disease: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 2015;132(22):e281-e91.
Kempny A, Dimopoulos K, Uebing A, Moceri P, Swan L, Gatzoulis MA, et al. Reference values for exercise limitations among adults with congenital heart disease. Relation to activities of daily life—single centre experience and review of published data. European Heart Journal. 2011;33(11):1386-96.
Koyak Z, Harris L, de Groot JR, Silversides CK, Oechslin EN, Bouma BJ, et al. Sudden cardiac death in adult congenital heart disease. Circulation. 2012;126(16):1944-54.
Tran D, Maiorana A, Ayer J, Lubans DR, Davis GM, Celermajer DS, et al. Recommendations for exercise in adolescents and adults with congenital heart disease. Progress in cardiovascular diseases. 2020;63(3):350-66.
Inuzuka R, Diller G-P, Borgia F, Benson L, Tay EL, Alonso-Gonzalez R, et al. Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term. Circulation. 2012;125(2):250-9.
Marcuccio E, Arora G, Quivers E, Yurchak MK, McCaffrey F. Noninvasive measurement of cardiac output during exercise in children with tetralogy of Fallot. Pediatric cardiology. 2012;33:1165-70.
Alonso-Gonzalez R, Borgia F, Diller G-P, Inuzuka R, Kempny A, Martinez-Naharro A, et al. Abnormal lung function in adults with congenital heart disease: prevalence, relation to cardiac anatomy, and association with survival. Circulation. 2013;127(8):882-90.
Schuermans A, Boerma M, Sansoni GA, Van den Eynde J, Takkenberg JJ, Helbing WA, et al. Exercise in patients with repaired tetralogy of Fallot: a systematic review and meta-analysis. Heart. 2023;109(13):984-91.
Gallego P, Gonzalez AE, Sanchez-Recalde A, Peinado R, Polo L, Gomez-Rubin C, et al. Incidence and predictors of sudden cardiac arrest in adults with congenital heart defects repaired before adult life. The American journal of cardiology. 2012;110(1):109-17.
Lange Rd, Hörer Jr, Kostolny M, Cleuziou J, Vogt M, Busch R, et al. Presence of a ventricular septal defect and the Mustard operation are risk factors for late mortality after the atrial switch operation: thirty years of follow-up in 417 patients at a single center. Circulation. 2006;114(18):1905-13.
Schwerzmann M, Salehian O, Harris L, Siu SC, Williams WG, Webb GD, et al. Ventricular arrhythmias and sudden death in adults after a Mustard operation for transposition of the great arteries. European heart journal. 2009;30(15):1873-9.
Kammeraad JA, Van Deurzen CH, Sreeram N, Bink-Boelkens MTE, Ottenkamp J, Helbing WA, et al. Predictors of sudden cardiac death after Mustard or Senning repair for transposition of the great arteries. Journal of the American College of Cardiology. 2004;44(5):1095-102.
Winter MM, van der Bom T, de Vries LC, Balducci A, Bouma BJ, Pieper PG, et al. Exercise training improves exercise capacity in adult patients with a systemic right ventricle: a randomized clinical trial. European heart journal. 2012;33(11):1378-85.
Legendre A, Losay J, Touchot-Kone A, Serraf A, Belli E, Piot J, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation. 2003;108(10_suppl_1):II-186-II-90.
Rog B, Salapa K, Okolska M, Dluzniewska N, Werynski P, Podolec P, et al. Clinical evaluation of exercise capacity in adults with systemic right ventricle. Texas Heart Institute Journal. 2019;46(1):14-20.
Graham TP, Bernard YD, Mellen BG, Celermajer D, Baumgartner H, Cetta F, et al. Long-term outcome in congenitally corrected transposition of the great arteries: a multi-institutional study. Journal of the American College of Cardiology. 2000;36(1):255-61.
Grewal J, Crean A, Garceau P, Wald R, Woo A, Rakowski H, et al. Subaortic right ventricular characteristics and relationship to exercise capacity in congenitally corrected transposition of the great arteries. Journal of the American Society of Echocardiography. 2012;25(11):1215-21.
van der Bom T, Winter MM, Knaake JL, Cervi E, de Vries LS, Balducci A, et al. Long-term benefits of exercise training in patients with a systemic right ventricle. International journal of cardiology. 2015;179:105-11.
Polat MG. Pulmoner rehabilitasyon açılımı: kavramlar ve uygulama modelleri. Bulletin of Thoracic Surgery/Toraks Cerrahisi Bülteni. 2015;6(1).
Diller G-P, Giardini A, Dimopoulos K, Gargiulo G, Müller J, Derrick G, et al. Predictors of morbidity and mortality in contemporary Fontan patients: results from a multicenter study including cardiopulmonary exercise testing in 321 patients. European heart journal. 2010;31(24):3073-83.
Cordina RL, O'Meagher S, Karmali A, Rae CL, Liess C, Kemp GJ, et al. Resistance training improves cardiac output, exercise capacity and tolerance to positive airway pressure in Fontan physiology. International journal of cardiology. 2013;168(2):780-8.
Mahendran AK, Katz D, Opotowsky AR, Lubert AM. Exercise pathophysiology and testing in individuals with a Fontan circulation. CJC Pediatric and Congenital Heart Disease. 2023.
Zipes DP, Link MS, Ackerman MJ, Kovacs RJ, Myerburg RJ, Estes III NM. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 9: arrhythmias and conduction defects: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 2015;132(22):e315-e25.
Referanslar
Ginsburg KR, Child CoPAo, Health F. The importance of play in promoting healthy child development and maintaining strong parent-child bonds. Pediatrics. 2007;119(1):182-91.
Timmons BW, Naylor P-J, Pfeiffer KA. Physical activity for preschool children—how much and how? Applied Physiology, Nutrition, and Metabolism. 2007;32(S2E):S122-S34.
Ramanan N, Lee S, Maharajh G, Webster R, Longmuir PE. Preventing sedentary lifestyles among young children born with congenital heart defects: A feasibility study of physical activity rehabilitation after surgical or catheterization intervention. Plos one. 2023;18(8):e0284946.
Van Hare GF, Ackerman MJ, Evangelista J-aK, Kovacs RJ, Myerburg RJ, Shafer KM, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 4: congenital heart disease: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 2015;132(22):e281-e91.
Kempny A, Dimopoulos K, Uebing A, Moceri P, Swan L, Gatzoulis MA, et al. Reference values for exercise limitations among adults with congenital heart disease. Relation to activities of daily life—single centre experience and review of published data. European Heart Journal. 2011;33(11):1386-96.
Koyak Z, Harris L, de Groot JR, Silversides CK, Oechslin EN, Bouma BJ, et al. Sudden cardiac death in adult congenital heart disease. Circulation. 2012;126(16):1944-54.
Tran D, Maiorana A, Ayer J, Lubans DR, Davis GM, Celermajer DS, et al. Recommendations for exercise in adolescents and adults with congenital heart disease. Progress in cardiovascular diseases. 2020;63(3):350-66.
Inuzuka R, Diller G-P, Borgia F, Benson L, Tay EL, Alonso-Gonzalez R, et al. Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term. Circulation. 2012;125(2):250-9.
Marcuccio E, Arora G, Quivers E, Yurchak MK, McCaffrey F. Noninvasive measurement of cardiac output during exercise in children with tetralogy of Fallot. Pediatric cardiology. 2012;33:1165-70.
Alonso-Gonzalez R, Borgia F, Diller G-P, Inuzuka R, Kempny A, Martinez-Naharro A, et al. Abnormal lung function in adults with congenital heart disease: prevalence, relation to cardiac anatomy, and association with survival. Circulation. 2013;127(8):882-90.
Schuermans A, Boerma M, Sansoni GA, Van den Eynde J, Takkenberg JJ, Helbing WA, et al. Exercise in patients with repaired tetralogy of Fallot: a systematic review and meta-analysis. Heart. 2023;109(13):984-91.
Gallego P, Gonzalez AE, Sanchez-Recalde A, Peinado R, Polo L, Gomez-Rubin C, et al. Incidence and predictors of sudden cardiac arrest in adults with congenital heart defects repaired before adult life. The American journal of cardiology. 2012;110(1):109-17.
Lange Rd, Hörer Jr, Kostolny M, Cleuziou J, Vogt M, Busch R, et al. Presence of a ventricular septal defect and the Mustard operation are risk factors for late mortality after the atrial switch operation: thirty years of follow-up in 417 patients at a single center. Circulation. 2006;114(18):1905-13.
Schwerzmann M, Salehian O, Harris L, Siu SC, Williams WG, Webb GD, et al. Ventricular arrhythmias and sudden death in adults after a Mustard operation for transposition of the great arteries. European heart journal. 2009;30(15):1873-9.
Kammeraad JA, Van Deurzen CH, Sreeram N, Bink-Boelkens MTE, Ottenkamp J, Helbing WA, et al. Predictors of sudden cardiac death after Mustard or Senning repair for transposition of the great arteries. Journal of the American College of Cardiology. 2004;44(5):1095-102.
Winter MM, van der Bom T, de Vries LC, Balducci A, Bouma BJ, Pieper PG, et al. Exercise training improves exercise capacity in adult patients with a systemic right ventricle: a randomized clinical trial. European heart journal. 2012;33(11):1378-85.
Legendre A, Losay J, Touchot-Kone A, Serraf A, Belli E, Piot J, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation. 2003;108(10_suppl_1):II-186-II-90.
Rog B, Salapa K, Okolska M, Dluzniewska N, Werynski P, Podolec P, et al. Clinical evaluation of exercise capacity in adults with systemic right ventricle. Texas Heart Institute Journal. 2019;46(1):14-20.
Graham TP, Bernard YD, Mellen BG, Celermajer D, Baumgartner H, Cetta F, et al. Long-term outcome in congenitally corrected transposition of the great arteries: a multi-institutional study. Journal of the American College of Cardiology. 2000;36(1):255-61.
Grewal J, Crean A, Garceau P, Wald R, Woo A, Rakowski H, et al. Subaortic right ventricular characteristics and relationship to exercise capacity in congenitally corrected transposition of the great arteries. Journal of the American Society of Echocardiography. 2012;25(11):1215-21.
van der Bom T, Winter MM, Knaake JL, Cervi E, de Vries LS, Balducci A, et al. Long-term benefits of exercise training in patients with a systemic right ventricle. International journal of cardiology. 2015;179:105-11.
Polat MG. Pulmoner rehabilitasyon açılımı: kavramlar ve uygulama modelleri. Bulletin of Thoracic Surgery/Toraks Cerrahisi Bülteni. 2015;6(1).
Diller G-P, Giardini A, Dimopoulos K, Gargiulo G, Müller J, Derrick G, et al. Predictors of morbidity and mortality in contemporary Fontan patients: results from a multicenter study including cardiopulmonary exercise testing in 321 patients. European heart journal. 2010;31(24):3073-83.
Cordina RL, O'Meagher S, Karmali A, Rae CL, Liess C, Kemp GJ, et al. Resistance training improves cardiac output, exercise capacity and tolerance to positive airway pressure in Fontan physiology. International journal of cardiology. 2013;168(2):780-8.
Mahendran AK, Katz D, Opotowsky AR, Lubert AM. Exercise pathophysiology and testing in individuals with a Fontan circulation. CJC Pediatric and Congenital Heart Disease. 2023.
Zipes DP, Link MS, Ackerman MJ, Kovacs RJ, Myerburg RJ, Estes III NM. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 9: arrhythmias and conduction defects: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 2015;132(22):e315-e25.
