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01-01-2012 | Original Article

Near Infrared Spectroscopy Describes Physiologic Payback Associated With Excess Postexercise Oxygen Consumption in Healthy Controls and Children With Complex Congenital Heart Disease

Authors: Michael J. Danduran, Jennifer E. Dixon, Rohit P. Rao

Published in: Pediatric Cardiology | Issue 1/2012

Abstract

Exercise creates a physiologic burden with recovery from such effort crucial to adaptation. Excess postexercise oxygen consumption (EPOC) refers to the body’s increased metabolic need after work. This investigation was designed to determine the role of near infrared spectroscopy (NIRS) in the description of exercise recovery in healthy controls (NL) and children with congenital heart disease (CHD). Subjects were recruited with exercise testing performed to exhaustion. Exercise time (EXT), heart rate (HR), and oxygen consumption (VO₂) were measured. Four-site NIRS (brain, kidney, deltoid, and vastus lateralis) were measured during exercise and into recovery to establish trends. Fifty individuals were recruited for each group (NL = 26 boys and 24 girls; CHD = 33 boys and 17 girls). Significant differences existed between EXT, VO₂, and peak HR (P < 0.01). NIRS values were examined at four distinct intervals: rest, peak work, and 2 and 5 min after exercise. Significant cerebral hyperemia was seen in children with CHD post exercise when compared to normal individuals in whom redistribution patterns were directed to somatic muscles. These identified trends support an immediate compensation of organ systems to re-establish homeostasis in peripheral beds through enhanced perfusion. Noninvasive NIRS monitoring helps delineate patterns of redistribution associated with EPOC in healthy adolescents and children with CHD.

Albouaini K, Egred M, Alahmar A, Wright DJ (2007) Cardiopulmonary exercise testing and its application. Postgrad Med J 83:675–682PubMedCrossRef

Anderson PAW, Sleeper LA, Mahony L, Colan SD, Atz AM, Breitbart RE et al (2008) Contemporary outcomes after the Fontan procedure. A pediatric heart network multicenter study. J Am Coll Cardiol 52:85–98PubMedCrossRef

Belardinelli R, Barstow TJ, Porszasz J, Wasserman K (1995) Changes in skeletal muscle oxygenation during incremental exercise measured with near infrared spectroscopy. Eur J Appl Physiol Occup Physiol 70:487–492PubMedCrossRef

Bhambhani Y, Malik R, Mookerjee S (2007) Cerebral oxygenation decreases at exercise intensities above the respiratory compensation threshold. Respir Physiol Neurobiol 156:196–202PubMedCrossRef

Brassard P, Bedard E, Jobin J, Rodes-Cabau J, Poirier P (2006) Exercise capacity and impact of exercise testing in patients after a Fontan procedure: a review. Can J Cardiol 22(6):489–495PubMedCrossRef

Bruce RA (1971) Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation. Ann Clin Res 3:323–332PubMed

Costes F, Denis C, Roche F, Prieur F, Enjolras F, Barthelemy JC (1999) Age associated alteration of muscle oxygenation measured by near infrared spectroscopy during exercise. Arch Physiol Biochem 107:159–167PubMedCrossRef

Danduran MJ, Rao RP, Frommelt PC, Ghanayem NS, Hoffman GM (2009) Near infrared spectroscopy monitoring during cardiopulmonary exercise testing in children with and without heart disease: Emerging new tool for investigation cardiovascular physiology in pediatric cardiology [abstr]. Cardiology, 12th annual update on pediatric and congenital cardiovascular disease: strategies to improve care through a multidisciplinary approach. Cardiol Young 19(Suppl S2):122–162

DeLorey DS, Kowalchuck JM, Paterson DH (2003) Relationship between pulmonary O₂ uptake kinetics and muscle deoxygenation during moderate intensity exercise. J Appl Physiol 95:113–120PubMed

10.

Durongpisitkul K, Driscoll DJ, Mahoney DW, Wollen PC, Mottram CD, Puga FJ et al (1997) Cardiorespiratory response to exercise after modified Fontan operation: determinants of performance. J Am Coll Cardiol 29(4):785–790PubMedCrossRef

11.

Fortune PM, Wagstaff M, Petros AJ (2001) Cerebro-splanchnic oxygenation ration (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischemia in neonates. Intensive Care Med 27:1401–1407PubMedCrossRef

12.

Golstein BH, Connor CE, Gooding L, Rocchini AP (2010) Relation of systemic venous return, pulmonary vascular resistance, and diastolic dysfunction to exercise capacity in patients with single ventricle receiving Fontan palliation. Am J Cardiol 105:1169–1175CrossRef

13.

Hayashida M, Kin N, Tomioka T, Orii R, Sekiyama H, Usui H et al (2004) Cerebral ischemia during cardiac surgery in children detected by combined monitoring of BIS and near infrared spectroscopy. Br J Anaesth 92:662–669PubMedCrossRef

14.

Hoffman GM, Stuth EA, Jaquiss RD, Vanderwal PL, Staudt SR, Troshynski TJ et al (2004) Changes in cerebral and somatic oxygenation during stage 1 palliation of hypoplastic left heart syndrome using continuous regional cerebral perfusion. J Thorac Cardiovasc Surg 127:223–233PubMedCrossRef

15.

Khairy P, Poirier N, Mercier LA (2007) Univentricular heart. Circulation 115:800–812PubMedCrossRef

16.

Koike A, Nagayama O, Hoshimoto-Iwamoto M, Suzuki T, Tajima A, Uejima T et al (2008) Clinical significance of cerebral oxygenation during exercise in patients with coronary artery disease. Circ J 72(11):1852–1858PubMedCrossRef

17.

Madsen PL, Nielsen HB, Christiansen P (2000) Well being and cerebral oxygen saturation during acute heart failure in humans. Clin Physiol 20(2):158–164PubMedCrossRef

18.

Margaria R, Edwards HT, Hill DB (1933) The possible mechanism of contracting and paying the oxygen debt and the role of lactic acid in muscular contraction. Am J Physiol 106:687–714

19.

McArdle WD, Katch FL, Katch VL (1991) Energy transfer in exercise. In: Exercise physiology: energy, nutrition and human performance, 3rd edn. Lea and Febiger, Philadelphia, pp 133–139

20.

Nagdyman N, Fleck T, Barth S, Abdul-Khaliq H, Stiller B, Ewert P et al (2004) Relation of cerebral tissue oxygenation index to central venous oxygen saturation in children. Intensive Care Med 30:468–471PubMedCrossRef

21.

Nollert G, Mohnle P, Tassani-Prell P, Uttner I, Borasio GD, Schmoeckel M et al (1995) Postoperative neuropsychological dysfunction and cerebral oxygenation during cardiac surgery. Thorac Cardiovasc Surg 43:260–264PubMedCrossRef

22.

Nollert G, Jonas RA, Reichart B (2000) Optimizing cerebral oxygenation during cardiac surgery: a review of experimental and clinical investigations with near infrared spectrophotometry. Thorac Cardiovasc Surg 48:247–253PubMedCrossRef

23.

Ohuchi H, Hamamichi Y, Hayashi T, Watanabe T, Yamada O, Yagihara T et al (2005) Post exercise heart rate, blood pressure and oxygen uptake dynamics in pediatric patients with Fontan circulation. Comparison with patients after right ventricular outflow tract reconstruction. Int J Cardiol 101:129–136PubMedCrossRef

24.

Ohuchi H, Hayashi T, Yamada O, Echigo S (2006) Change in plasma volume during peak exercise in patients with cyanotic congenital heart disease after definitive operation. Int J Cardiol 108:216–223PubMedCrossRef

25.

Owen-Reece H, Smith M, Elwell CE, Goldstone JC (1990) Near infrared spectroscopy. Br J Anaesth 82:418–426

26.

Paquet C, Deschamps A, Denault AY, Couture P, Carrier M, Babin D et al (2008) Baseline regional cerebral oxygen saturation correlates with left ventricular systolic and diastolic function. J Cardiothorac Vasc Anesth 22(6):840–846PubMedCrossRef

27.

Paridon SM, Alpert BS, Boas SR, Cabrera ME, Caldarera LL, Daniels SR et al (2007) American Heart Association Council on Cardiovascular Disease in the Young. Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young. Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Circulation 113:1905–1920CrossRef

28.

Paridon AM, Mitchell PD, Colan SD, Williams RV, Blaufox A, Li JS et al (2008) A cross sectional study of exercise performance during the first two decades of life after the Fontan operation. J Am Coll Cardiol 52:99–107PubMedCrossRef

29.

Petros AJ, Heys R, Tasker RC, Fortune PM, Roberts I, Kiely E (1999) Near infrared spectroscopy can detect changes in splanchnic oxygen delivery in neonates during apnoeic episodes. Eur J Pediatr 158:173–174PubMedCrossRef

30.

Polgar G, Promadhat V (1971) Standards in pulmonary function tests. In: Polgar G (ed) Pulmonary function testing in children; techniques and standard. Saunders, Philadelphia, pp 254–260

31.

Rao RP, Danduran MJ, Frommelt PC, Ghanayem NS, Berger S, Simpson PM et al (2009) Measurement of regional tissue bed venous weighted oximetric trends during exercise by near infrared spectroscopy. Pediatr Cardiol 30:465–471PubMedCrossRef

32.

Rao RP, Danduran MJ, Dixon JE, Frommelt PC, Berger S, Zangwill SD (2010) Near infrared spectroscopy: guided tilt table testing for syncope. Pediatr Cardiol 31(5):674–679PubMedCrossRef

33.

Rao RP, Danduran MJ, Hoffman GM, Ghanayem NS, Berger S, Frommelt PC (2010) Cerebral hemodynamics in the presence of decreased systemic venous compliance in patients with Fontan physiology may limit anaerobic exercise capacity. Pediatr Cardiol 31(2):208–214PubMedCrossRef

34.

Schulz G, Weiss M, Bauersfeld U, Teller J, Haensse D, Bucher HU et al (2002) Liver tissue oxygenation as measured by near-infrared spectroscopy in the critically ill child in correlation with central venous oxygen saturation. Intensive Care Med 28:184–189PubMedCrossRef

35.

Task ERS, Palange FP, Ward SA, Carlsen KH, Casaburi R, Gallagher CG et al (2007) Recommendations on the use of exercise testing in clinical practice. Eur Respir J 29:185–209

36.

Tsuji M, Saul JP, du Plessis A, Eichenwald E, Sobh J, Crocker R et al (2000) Cerebral intravascular oxygenation correlates with mean arterial pressure in critically ill premature infants. Pediatrics 106:625–632PubMedCrossRef

37.

Watzman HM, Kurth CD, Montenegro LM, Rome J, Steven JM, Nicolson SC (2000) Arterial and venous contributions to near-infrared cerebral oximetry. Anesthesiology 93:947–953PubMedCrossRef

38.

Weiss M, Dullenkopf A, Kolarova A, Schulz G, Frey B, Baenziger O (2005) Near-infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation. Paediatr Anaesth 15:102–109PubMedCrossRef

39.

Wyatt JS, Cope M, Delpy DT, Wray S, Reynolds EO (1986) Quantification of cerebral oxygenation and haemodynamics in sick newborn infants by near infrared spectrophotometry. Lancet 2(8515):1063–1066PubMedCrossRef

40.

Yoshitani K, Kawaguchi M, Iwata M, Sasaoka N, Inoue S, Kurumatani N et al (2005) Comparison of changes in jugular venous bulb oxygen saturation and cerebral oxygen saturation during variations of haemoglobin concentration under propofol and sevoflurane anaesthesia. Br J Anaesth 94:341–346PubMedCrossRef

Title: Near Infrared Spectroscopy Describes Physiologic Payback Associated With Excess Postexercise Oxygen Consumption in Healthy Controls and Children With Complex Congenital Heart Disease
Authors: Michael J. Danduran
Jennifer E. Dixon
Rohit P. Rao
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: Pediatric Cardiology / Issue 1/2012
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI: https://doi.org/10.1007/s00246-011-0097-3

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Near Infrared Spectroscopy Describes Physiologic Payback Associated With Excess Postexercise Oxygen Consumption in Healthy Controls and Children With Complex Congenital Heart Disease

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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