Cross-sectional studies
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Arvidsson, 20092424 Arvidsson D, Slinde F, Hulthen L, Sunnegardh J. Physical activity, sports participation and aerobic fitness in children who have undergone surgery for congenital heart defects. Acta Paediatr. 2009;98(9):1475-82.
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Surgically corrected patients (54 patients had undergone biventricular repair), including: AoS, ASD, CoA, DORV, HLV, HRHS, MA, PA, PAPVC, TAPVC, PS, TGV, IVC. NYHA functional class II. |
79 |
9 - 11 years14 - 16 years |
37 |
Not reported |
Cardiopulmonary exercise test with cycloergometer; ramp protocol, duration 8-12 minutes and recovery. The patient was instructed to maintain a pedal rate of 60 rpm during the whole exercise test. |
Mean and standard deviation of VO2max = 42.28 ± 8.8 ml/Kg/min |
Giordano, 20032525 Giordano U, Giannico S, Turchetta A, Hammad F, Calzolari F, Calzolari A. The influence of different surgical procedures on hypertension after repair of coarctation. Cardiol Young. 2005;15(5):477-80.
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Surgically corrected aortic coarctation patients. There were 3 end-to-end anastomoses, 10 patch angioplasties, and 7 left subclavian flap repairs. |
20 |
13.7 ± 4.2 |
8 |
No antihypertensive medication. |
Maximal stress test with treadmill; Bruce protocol. Mean of the time of exercise test = 10.5 ± 2 minutes. |
Mean and standard deviation of heart rate = 171 ± 17 bpm |
Goldstein, 20112626 Goldstein BH, Golbus JR, Sandelin AM, Warnke N, Gooding L, King KK, et al. Usefulness of peripheral vascular function to predict functional health status in patients with Fontan circulation. Am J Cardiol. 2011;108(3):428-34.
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Participants with Fontan's procedure, excluding patients with pacemaker dependence, severe hypoxemia (oxygen saturation <80% at rest), atrial arrhythmia or several ventricular dysfunction. NYHA functional class I (94%). |
51 |
15 (10.9 -17.8) |
20 |
Not reported |
Cardiopulmonary exercise test with treadmill; Bruce protocol. |
Median and range of VO2max = 28.8 (25.6-33.2) |
Grant, 19912727 Grant GP, Garofano RP, Mansell AL, Leopold HB, Gersony WM. Ventilatory response to exercise after intracardiac repair of tetralogy of Fallot. Am Rev Respir Dis. 1991;144(4):833-6.
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Surgically corrected T4F patients NYHA functional class I. |
13 |
14.1 ± 3 |
7 |
Not reported |
Cardiopulmonary exercise test with cycloergometer; Godfrey protocol. |
Mean and standard deviation of VO2max = 28.7 ± 6.6 ml/Kg/min |
Groen, 20092828 Groen WG, Hulzebos HJ, Helders PJ, Takken T. Oxygen uptake to work rate slope in children with a heart, lung or muscle disease. Int J Sports Med. 2010;31(3):202-6.
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Surgically corrected T4F patients and Fontan's procedure. |
13 |
14 ± 2.8 |
6 |
Not reported |
Cardiopulmonary exercise test with cycloergometer; Godfrey protocol. |
Mean and standard deviation of VO2max = 33.7 ± 8.9 ml/Kg/min |
Hjortdal, 20081111 Hjortdal VE, Christensen TD, Larsen SH, Emmertsen K, Pedersen EM. Caval blood flow during supine exercise in normal and Fontan patients. Ann Thorac Surg. 2008;85(2):599-603.
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Participants with Fontan's procedure. NYHA functional class I and II. |
14 |
9.1 ± 5.2 |
6 |
Not reported |
Submaximal stress test (up to 1 W/kg) with cycloergometer. |
Mean and standard deviation of heart rate = 111.5 ± 64.2 bpm |
Ishi, 20052929 Ishii H, Harada K, Toyono M, Tamura M, Takada G. Usefulness of exercise-induced changes in plasma levels of brain natriuretic peptide in predicting right ventricular contractile reserve after repair of tetralogy of Fallot. Am J Cardiol. 2005;95(11):1338-43.
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Surgically corrected T4F patients. |
26 |
9.6 ± 3.3 |
Nonspecific |
Not reported |
Maximal stress test with cycloergometer; ramp protocol. |
Mean and standard deviation of heart rate = 143 ± 11 bpm |
Marcuccio, 20121313 Marcuccio E, Arora G, Quivers E, Yurchak MK, McCaffrey F. Noninvasive measurement of cardiac output during exercise in children with tetralogy of Fallot. Pediatr Cardiol. 2012;33(7):1165-70.
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Surgically corrected T4F patients |
21 |
15 (11-17) |
Nonspecific |
Not reported |
Submaximal stress test with treadmill. Bruce protocol. |
Median and range of VO2max = 35.8 (23.8-47.8) |
Moalla, 20083030 Moalla W, Dupont G, Temfemo A, Maingourd Y, Weston M, Ahmaidi S. Assessment of exercise capacity and respiratory muscle oxygenation in healthy children and children with congenital heart diseases. Appl Physiol Nutr Metab. 2008;33(3):434-40.
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Surgically corrected patients including T4F, TGA, IAC, PA. NYHA functional class II and III. |
12 |
13.0 ± 1.2 |
Nonspecific |
Diuretics, cardiotonics, ACE inhibitors. |
Cardiopulmonary exercise test with cycloergometer; Wasserman protocol. |
Mean and standard deviation of VO2max = 30.2 ± 6.1 ml/Kg/min |
Mocelin, 19993131 Mocellin R, Gildein P. Velocity of oxygen uptake response at the onset of exercise: a comparison between children after cardiac surgery and healthy boys. Pediatr Cardiol. 1999;20(1):17-20.
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Patients corrected for: TGA, IVC, PA, T4F. |
35 |
10.8 ± 2.2 |
12 |
Not reported |
Cardiopulmonary exercise test with treadmill, constant-load protocol. |
Mean and standard deviation of VO2max = 42.6 ± 8.6 ml/Kg/min |
Page, 19961515 Page E, Perrault H, Flore P, Rossignol AM, Pironneau S, Rocca C, et al. Cardiac output response to dynamic exercise after atrial switch repair for transposition of the great arteries. Am J Cardiol. 1996;77(10):892-5.
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Participants with corrected D-TGA. |
7 |
10.4 ± 1.2 |
4 |
Not reported |
Cardiopulmonary exercise test with treadmill; ramp protocol. |
Mean and standard deviation of VO2max = 37.6 ± 1.4 ml/Kg/min |
Reybrouk, 2000 1212 Reybrouck T, Mertens L, Brusselle S, Weymans M, Eyskens B, Defoor J, et al. Oxygen uptake versus exercise intensity: a new concept in assessing cardiovascular exercise function in patients with congenital heart disease. Heart. 2000;84(1):46-52.
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Participants corrected for TGA e T4F. |
59 |
11.2 ± 7.6 |
24 |
Not reported |
Submaximal exercise test (up to 170 bpm) with treadmill. |
Mean of VO2max = 40 ml/Kg/min |
Sarubbi, 20003232 Sarubbi B, Pacileo G, Pisacane C, Ducceschi V, Iacono C, Russo MG, et al. Exercise capacity in young patients after total repair of Tetralogy of Fallot. Pediatr Cardiol. 2000;21(3):211-5.
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Surgically corrected T4F patients. |
41 |
11.2 ± 3.9 |
12 |
No diuretic of cardiotonic medication. |
Maximal stress test with cycloergometer. |
Mean and standard deviation of heart rate = 167.5 ± 17.4 bpm |
Tomassoni, 19913333 Tomassoni TL, Galioto FM Jr, Vaccaro P. Cardiopulmonary exercise testing in children following surgery for tetralogy of Fallot. Am J Dis Child. 1991;145(11):1290-3.
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Surgically corrected T4F patients. |
20 |
9.9 ± 2.8 |
9 |
Not reported |
Cardiopulmonary exercise test with treadmill; Bruce protocol for >8 years-old and modified Bruce protocol for <8 years-old. |
Mean and standard deviation of VO2max = 34.1 ± 2.9 ml/Kg/min |
Van Beck, 20093434 van Beek E, Binkhorst M, de Hoog M, de Groot P, van Dijk A, Schokking M, et al. Exercise performance and activity level in children with transposition of the great arteries treated by the arterial switch operation. Am J Cardiol. 2010;105(3):398-403.
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Participants with corrected TGV. NYHA functional class I. |
17 |
12.2 ± 2 |
5 |
Not reported |
Cardiopulmonary exercise test with cycloergometer; ramp protocol. |
Mean and standard deviation of VO2max = 41.1 ± 6.6 ml/Kg/min |
Muller, 20123535 Muller J, Bohm B, Semsch S, Oberhoffer R, Hess J, Hager A. Currently, children with congenital heart disease are not limited in their submaximal exercise performance. Eur J Cardiothorac Surg. 2013;43(6):1096-100.
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Participants with PS, IVC, IAC, T4F, aortic coarctation, valve stenosis/regurgitation after surgery, Ebstein anomaly, univentricular heart, TGV and TAC. NYHA functional class I and II. |
88 |
12.7 (12.0-13.3) |
36 |
Not reported |
Cardiopulmonary exercise test and submaximal exercise test with cycloergometer. |
Median and interquartil of VO2max = 35.5 (31.3-41.0) |
Su, 20133636 Su CT, Sung TY, Lin KL, Wang JL, Yang AL. Lower exercise capacity in children with asymptomatic atrial septal defect associated with circulatory impairment. Chin J Physiol. 2013;56(2):110-6.
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Participants corrected and non corrected IAC. |
50 |
11.2 ± 3.5 |
31 |
Not reported |
Cardiopulmonary exercise test with treadmill, Bruce protocol. |
Mean and standard deviation of VO2max = 31.8 ± 6.8ml/Kg/min |
Quasi-experimental studies
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Amiard, 20083737 Amiard V, Jullien H, Nassif D, Bach V, Maingourd Y, Ahmaidi S. Effects of home-based training at dyspnea threshold in children surgically repaired for congenital heart disease. Congenit Heart Dis. 2008;3(3):191-9.
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Surgically corrected patients including: single ventricle and PA, PA with intact sept, T4F, TGV, IAC. |
23 |
15 ± 1.4 |
10 |
ACE inhibitor; diuretics, anticoagulants, cardiotonics, imunosuppressors. |
Cardiopulmonary exercise test with cycloergometer; Wasserman protocol. |
Mean and standard deviation of VO2max = 34.4 ± 10.9ml/Kg/min |
Moalla, 20051010 Moalla W, Gauthier R, Maingourd Y, Ahmaidi S. Six-minute walking test to assess exercise tolerance and cardiorespiratory responses during training program in children with congenital heart disease. Int J Sports Med. 2005;26(9):756-62.
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Participants surgically corrected for: T4F, TGA, IAC, PA. Functional class NYHA II and III. |
17 |
12.9 ± 0.3 |
Nonspecific |
Diuretics, cardiotonics, ACE inhibitor, except for beta-blocker. |
Cardiopulmonary exercise test with cycloergometer; Wasserman protocol. Submaximal test with 6MWT. |
Mean and standard deviation of VO2max = 28.9 ± 1.7ml/Kg/min |
Rutenberg, 19833838 Ruttenberg HD, Adams TD, Orsmond GS, Conlee RK, Fisher AG. Effects of exercise training on aerobic fitness in children after open heart surgery. Pediatr Cardiol. 1983 Jan-Mar;4(1):19-24.
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Participants corrected for TGA, T4F, valve and aorta diseases. |
24 |
12.8 ± 3.4 |
8 |
Not reported |
Cardiopulmonary exercise test with treadmill; Bruce protocol. |
Mean and standard deviation of VO2max = 39.3 ± 8.8ml/Kg/min |
Cross-sectional studies with follow-up
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Binkhorst, 20083939 Binkhorst M, van de Belt T, de Hoog M, van Dijk A, Schokking M, Hopman M. Exercise capacity and participation of children with a ventricular septal defect. Am J Cardiol. 2008;102(8):1079-84.
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Participants with corrected and non‑corrected IVC. |
27 (13 post-correction IVC and 14 non-corrected), three were excluded from the analysis of functional capacity. |
Corrected group = 13 ± 2.5Non-corrected group = 12.5 ± 3 |
Corrected group = 6Non-corrected group = 8 |
Not reported |
Cardiopulmonary exercise test with cycloergometer, ramp protocol. |
Mean and standard deviation of VO2max = 45.5 ± 29.2 ml/Kg/min |
Carvalho, 19924040 Carvalho JS, Shinebourne EA, Busst C, Rigby ML, Redington AN. Exercise capacity after complete repair of tetralogy of Fallot: deleterious effects of residual pulmonary regurgitation. Br Heart J. 1992;67(6):470-3.
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Surgically corrected T4F patients. |
12 |
11.3 ± 2.7 |
Nonspecific |
Not reported |
Cardiopulmonary exercise test with treadmill; Bruce protocol. |
Mean and standard deviation of VO2max = 48.0 ± 8.8 ml/Kg/min |
Hovels-Gurich, 20034141 Hovels-Gurich HH, Kunz D, Seghaye M, Miskova M, Messmer BJ, von Bernuth G. Results of exercise testing at a mean age of 10 years after neonatal arterial switch operation. Acta Paediatr. 2003;92(2):190-6.
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Surgically corrected TGA patients. NYHA functional class I. |
56 |
10.5 ± 1.6 |
13 |
Not reported |
Maximal stress test with treadmill; Bruce protocol. |
Mean and standard deviation of heart rate = 191.1 ± 10.0 bpm |
Musewe, 19884242 Musewe NN, Reisman J, Benson LN, Wilkes D, Levison H, Freedom RM, et al. Cardiopulmonary adaptation at rest and during exercise 10 years after Mustard atrial repair for transposition of the great arteries. Circulation. 1988;77(5):1055-61.
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Surgically corrected TGA patients. NYHA class I. |
18 |
12.8 ± 1.6 |
7 |
Not reported |
Cardiopulmonary exercise test with cycloergometer; Jones and Campbell protocol. |
Mean and standard deviation of VO2max = 31.0 ± 7.0 ml/Kg/min |
Pfamatter, 2002 1414 Pfammatter JP, Zanolari M, Schibler A. Cardiopulmonary exercise parameters in children with atrial septal defect and increased pulmonary blood flow: short-term effects of defect closure. Acta Paediatr. 2002;91(1):65-70.
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Participants with corrected IAC. |
14 |
11.4 (6.8 - 16.1) |
9 |
Not reported |
Cardiopulmonary exercise test with treadmill; ramp protocol. |
Mean and standard deviation of VO2max = 37.8 ± 14.8 ml/Kg/min |