Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise
BackgroundThe Fontan circulation is a unique palliation procedure for several congenital heart defects. Impaired exercise capacity has previously been demonstrated in these patients and also a higher risk for cardiopulmonary mortality. Hemorheology was shown to affect cardiopulmonary capacity and in...
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| Format: | Article |
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Frontiers Media S.A.
2019-11-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2019.01443/full |
| _version_ | 1818453159883833344 |
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| author | Julian Alexander Härtel Julian Alexander Härtel Nicole Müller Ulrike Herberg Johannes Breuer Daniel Alexander Bizjak Wilhelm Bloch Marijke Grau |
| author_facet | Julian Alexander Härtel Julian Alexander Härtel Nicole Müller Ulrike Herberg Johannes Breuer Daniel Alexander Bizjak Wilhelm Bloch Marijke Grau |
| author_sort | Julian Alexander Härtel |
| collection | DOAJ |
| description | BackgroundThe Fontan circulation is a unique palliation procedure for several congenital heart defects. Impaired exercise capacity has previously been demonstrated in these patients and also a higher risk for cardiopulmonary mortality. Hemorheology was shown to affect cardiopulmonary capacity and in turn to be affected by regular exercise and hypoxia but none of these have been investigated in Fontan patients so far. The aim of this study was to detect general differences in hemorheology in normoxia as well as possible altered hemorheological responses to hypoxia exposure and hypoxic exercise between Fontan patients and healthy controls.Methods and Findings26 Fontan patients and 20 healthy controls performed an acute exercise test (AET) on a bicycle ergometer under hypoxia with ambient 15.2% oxygen saturation (sO2). Blood samples were taken at rest in normoxia (T0), at rest in hypoxia (T1), after maximum exhaustion in hypoxia (T2), and after 50 min recovery in normoxia (T3). Hemorheological and blood parameters were investigated. Additionally, arterial stiffness was tested at T0. Red blood cell (RBC) deformability, NOx, erythropoietin (EPO) concentration, RBC count, hemoglobin (Hb) concentration and hematocrit (hct) were significantly increased in Fontan patients compared to controls. Same was observed for arterial stiffness. No changes were observed for RBC aggregation, fibrinogen concentration, free radical levels and vascular endothelial growth factor (VEGF). Hypoxia exposure did not change parameters, whereas exercise in hypoxia increased aggregation and hct significantly in both groups. Fontan patients showed significantly increased aggregation-disaggregation balance compared to controls.ConclusionAcute hypoxia exposure and exercise under hypoxia might have similar impact on hemorheology in Fontan patients and controls and was clinically well tolerated. Nevertheless, exercise alters aggregation and possibly hemodynamics which requires special attention in Fontan patients. |
| first_indexed | 2024-12-14T21:34:34Z |
| format | Article |
| id | doaj.art-5e6643f6ad604017891e96c3b7c0053d |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-14T21:34:34Z |
| publishDate | 2019-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-5e6643f6ad604017891e96c3b7c0053d2022-12-21T22:46:36ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2019-11-011010.3389/fphys.2019.01443490704Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic ExerciseJulian Alexander Härtel0Julian Alexander Härtel1Nicole Müller2Ulrike Herberg3Johannes Breuer4Daniel Alexander Bizjak5Wilhelm Bloch6Marijke Grau7Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, GermanyDepartment for Pediatric Cardiology, University Hospital Bonn, Bonn, GermanyDepartment for Pediatric Cardiology, University Hospital Bonn, Bonn, GermanyDepartment for Pediatric Cardiology, University Hospital Bonn, Bonn, GermanyDepartment for Pediatric Cardiology, University Hospital Bonn, Bonn, GermanyDepartment of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, GermanyDepartment of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, GermanyDepartment of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, GermanyBackgroundThe Fontan circulation is a unique palliation procedure for several congenital heart defects. Impaired exercise capacity has previously been demonstrated in these patients and also a higher risk for cardiopulmonary mortality. Hemorheology was shown to affect cardiopulmonary capacity and in turn to be affected by regular exercise and hypoxia but none of these have been investigated in Fontan patients so far. The aim of this study was to detect general differences in hemorheology in normoxia as well as possible altered hemorheological responses to hypoxia exposure and hypoxic exercise between Fontan patients and healthy controls.Methods and Findings26 Fontan patients and 20 healthy controls performed an acute exercise test (AET) on a bicycle ergometer under hypoxia with ambient 15.2% oxygen saturation (sO2). Blood samples were taken at rest in normoxia (T0), at rest in hypoxia (T1), after maximum exhaustion in hypoxia (T2), and after 50 min recovery in normoxia (T3). Hemorheological and blood parameters were investigated. Additionally, arterial stiffness was tested at T0. Red blood cell (RBC) deformability, NOx, erythropoietin (EPO) concentration, RBC count, hemoglobin (Hb) concentration and hematocrit (hct) were significantly increased in Fontan patients compared to controls. Same was observed for arterial stiffness. No changes were observed for RBC aggregation, fibrinogen concentration, free radical levels and vascular endothelial growth factor (VEGF). Hypoxia exposure did not change parameters, whereas exercise in hypoxia increased aggregation and hct significantly in both groups. Fontan patients showed significantly increased aggregation-disaggregation balance compared to controls.ConclusionAcute hypoxia exposure and exercise under hypoxia might have similar impact on hemorheology in Fontan patients and controls and was clinically well tolerated. Nevertheless, exercise alters aggregation and possibly hemodynamics which requires special attention in Fontan patients.https://www.frontiersin.org/article/10.3389/fphys.2019.01443/fullexerciseFontan circulationhypoxiared blood cellsrheology |
| spellingShingle | Julian Alexander Härtel Julian Alexander Härtel Nicole Müller Ulrike Herberg Johannes Breuer Daniel Alexander Bizjak Wilhelm Bloch Marijke Grau Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise Frontiers in Physiology exercise Fontan circulation hypoxia red blood cells rheology |
| title | Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise |
| title_full | Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise |
| title_fullStr | Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise |
| title_full_unstemmed | Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise |
| title_short | Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise |
| title_sort | altered hemorheology in fontan patients in normoxia and after acute hypoxic exercise |
| topic | exercise Fontan circulation hypoxia red blood cells rheology |
| url | https://www.frontiersin.org/article/10.3389/fphys.2019.01443/full |
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