Exercise MRI to Evaluate Cardiorespiratory Fitness in Children With Heart Disease
Utilizing Exercise Cardiovascular and Skeletal Magnetic Resonance Imaging to Evaluate Factors Associated With Cardiorespiratory Fitness in Children With Acquired and Congenital Heart Disease
University of Alberta
20 participants
Jan 20, 2025
OBSERVATIONAL
Conditions
Summary
There are many barriers to heart-healthy lifestyles in pediatric patients with acquired and congenital heart disease. Investigators want to further understand how participants heart and skeletal muscles work together during exercise and evaluate the impact on cardiac function. To do this, the investigators will use magnetic resonance imaging (MRI) to scan the heart and skeletal muscles during exercises to assess blood flow, oxygenation and function.
Eligibility
Inclusion Criteria3
- year olds followed at the Stollery Children's Hospital
- Heart transplant recipients ≥6 months post-transplant
- Have a moderate-complex congenital heart disease diagnosis
Exclusion Criteria15
- Non-English speaking
- Exercise restricted by the patient's clinical cardiologist
- Clinical antibody- or cellular-mediated rejection within 3-months of the assessment or during the study period (for HTRs)
- Previous involvement in a CR or exercise intervention program
- Previous exercise stress test demonstrating sustained arrhythmias, ST segment elevation or depression greater than 3mm, an inappropriate rise in blood pressure (BP) (\<20 mmHg) or a systolic BP \>200 mmHg, or symptoms of chest pain or syncope
- Resting arterial saturation \<85% or oxygen requirements
- Moderate ventricular systolic dysfunction (or worse) at the most recent echocardiogram
- History of chest pain on exertion; unrepaired/unpalliated CHD
- Arrhythmias in the last year (including supraventricular tachycardia, ventricular tachycardia, atrioventricular block or history of (Mobitz II or worse))
- New York Heart Association class II or worse symptoms
- Active medical inter-current illness limiting ability to participate
- Cognitive impairment limiting the communication needed for the exercise MRI
- Research MRI contraindications (e.g. any type of pacemaker), or any orthopedic limitation preventing exercise testing
- Extracardiac or congenital abnormality limiting the participant's functional ability to exercise
- Pregnant
Interventions
Participants will undergo a standard cardiac MRI to assess resting ventricular structure and function then complete an exercise cardiac MRI assessment using an MRI-compatible stepping ergometer.
Cardiopulmonary exercise testing will be performed using a cycle ergometer. Consistent with standard guidelines, workload will progressively increase (10W ramp protocol) such that peak oxygen consumption (VO2peak) is achieved within 8-12 minutes. VO2peak, VO2 at anaerobic threshold, peak power output (PPO), ventilation/carbon dioxide production (VE/VCO2) slope, peak heart rate (HR), and HR recovery at 1- and 3-minutes will be recorded. VO2peak will be converted to age-, weight, and sex-specific norms and a %predicted value.
Locations(1)
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NCT06325280