@Article{CHD.2021.016031,
AUTHOR = {Lukas Minder, Markus Schwerzmann, Thomas Radtke, Hugo Saner, Prisca Eser, Matthias Wilhelm, Jean-Paul Schmid},
TITLE = {Cardiopulmonary Response to Exercise at High Altitude in Adolescents with Congenital Heart Disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {16},
YEAR = {2021},
NUMBER = {6},
PAGES = {597--608},
URL = {http://www.techscience.com/schd/v16n6/43068},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective: </b>To extend our knowledge on tolerance of acute high-altitude exposure and hemodynamic response to
exercise in adolescents with congenital heart disease (AscCHD) without meaningful clinical or functional restriction. <b>Methods: </b>A symptom limited cardiopulmonary exercise stress test and a non-invasive cardiac output measurement during steady state exercise were performed at 540 m and at 3454 m a.s.l. Symptoms of acute mountain
sickness were noted. <b>Results: </b>We recruited 21 healthy controls and 16 AscCHD (59% male, mean age 14.7 ±
1.1 years). Three subjects (2 controls, 1 AscCHD) presented light symptoms of acute mountain sickness (dizziness
and headache). During the symptom limited exercise test at lowland, control subjects showed a significantly higher power to weight index (3.5 ± 0.6 W/kg vs. 3.0 ± 0.7 W/kg, <i>p</i> < 0.001), heart rate (188.8 ± 10.4 1/min vs. 179.4 ±
13.1 1/min, <i>p</i> < 0.050) and ventilation (92.8 ± 22.9 l/min <i>vs.</i> 75.4 ± 18.6 l/min, <0.050). At altitude, power to
weight index only remained significantly higher in the control group (2.8 ± 0.6 W/kg <i>vs.</i> 2.6 ± 0.6 W/kg,
<i>p</i> < 0.001). Pulmonary blood flow (PBF) at lowland showed no difference between the control and the AscCHD
group, neither at rest (5.4 ± 0.8 l/min <i>vs.</i> 5.1 ± 0.9 l/min, <i>p</i> = 0.308), nor during the steady state test (10.6 ±
2.4 l/min <i>vs.</i> 10.5 ± 2.0 l/min, <i>p</i> = 0.825). At high altitude, PBF increased by 110% and 112%, respectively (12.8 ±
2.32 l/min <i>vs.</i> 12.5 ± 3.0 l/min; intergroup difference: <i>p</i> = 0.986). <b>Conclusions:</b> High altitude exposure was well
tolerated in an unselected group of AscCHD. No significant difference in the cardio-pulmonary adaptation to a
control group was noted during a steady state exercise. Symptoms of minor acute mountain sickness did occur, which
should however not be misinterpreted as signs of hemodynamic maladaptation.},
DOI = {10.32604/CHD.2021.016031}
}