Exercise capacity following pediatric heart transplantation: A systematic review
Corresponding Author
Sara Peterson
Division of Pediatric Rehabilitation Medicine, Physical Therapy, Children's Hospital Los Angeles, Los Angeles, CA, USA
Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
Correspondence
Sara Peterson, Division of Pediatric Rehabilitation Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Email: [email protected]
Search for more papers by this authorJennifer A. Su
Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
Search for more papers by this authorJacqueline R. Szmuszkovicz
Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
Search for more papers by this authorRobert Johnson
Norris Medical Library, University of Southern California, Los Angeles, CA, USA
Search for more papers by this authorBarbara Sargent
Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
Search for more papers by this authorCorresponding Author
Sara Peterson
Division of Pediatric Rehabilitation Medicine, Physical Therapy, Children's Hospital Los Angeles, Los Angeles, CA, USA
Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
Correspondence
Sara Peterson, Division of Pediatric Rehabilitation Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Email: [email protected]
Search for more papers by this authorJennifer A. Su
Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
Search for more papers by this authorJacqueline R. Szmuszkovicz
Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
Search for more papers by this authorRobert Johnson
Norris Medical Library, University of Southern California, Los Angeles, CA, USA
Search for more papers by this authorBarbara Sargent
Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
Search for more papers by this authorAbstract
Pediatric HTs account for 13% of all HTs with >60% of recipients surviving at least 10 years post-HT. The purpose of this systematic review is to synthesize the literature on exercise capacity of pediatric HT recipients to improve understanding of the mechanisms that may explain the decreased exercise capacity. Six databases were searched for studies that compared the exercise capacity of HT recipients ≤21 years old with a control group or normative data. Sixteen studies were included. Pediatric HT recipients, as compared to controls or normative data, exhibit significantly higher resting HR, and at peak exercise exhibit significantly decreased HR, VO2, power, work, minute ventilation, and exercise duration. Peak VO2 appears to improve within the first 2.5 years post-HT; peak work remains constant; and there is inconclusive evidence that peak HR, HR recovery, and HR reserve improve with time since HT. These results are discussed in the context of the mechanisms that may explain the impaired exercise capacity of pediatric HT recipients, including chronotropic incompetence, graft dysfunction, side effects of immunosuppression therapy, and deconditioning. In addition, the limited literature on rehabilitation after pediatric HT is summarized.
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