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Tony Reybrouck

Publications and source records attributed to Tony Reybrouck.

10 recordsLinked to original sources
PubMed2006

Recommendations for participation in competitive and leisure sports in patients with congenital heart disease: a consensus document.

BACKGROUND: Physical activity is important for patients with congenital heart disease. The aim of this paper is to provide a consensus document for participation in competitive or leisure sport activity in children and adults with congenital heart disease. METHODS: The recommendations are based on expert consensus meetings, personal experience of the contributing authors and an updated review of the literature regarding exercise performance and risk stratification in patients with congenital heart disease. RESULTS: Physical performance and exercise tolerance is close to normal in patients with simple lesions with successful repair or no need for therapy. Most patients with complex lesions have some degree of residual disease, making them less suitable for participation in competitive sport. CONCLUSION: Regular exercise at recommended levels can be performed and should be encouraged in all patients with congenital heart disease. Many can attend sports with no restrictions. Special concern should be given to those patients with a significant ventricular dysfunction or recent history or risk of arrhythmia.

Adult↗
PubMed2006

Tilt training: a new challenge in the treatment of neurally mediated syncope.

Clinical experience with repeated tilt testing and standing training has shown that this procedure can be used as a new therapy for the restoration of abnormal autonomic orthostatic reflexes. The introduction of tilt training therapy for neurally mediated syncope is a new and effective treatment. This new therapy has been used recently in several centres with excellent results. Since syncope is a severe social handicap for the patient, successful therapy will normalise the functional status and restore self-confidence. The use of tilt training can be considered as first-line therapy in this disorder. In the majority of the studies on tilt training, patients remain free of syncope during active treatment with this therapy. In about 50% of the patients with neurally mediated syncope already the second consecutive tilt test became negative. This therapeutic effect of in-hospital repeated tilt tests is sustained by continued standing training at home.

Autonomic Nervous System↗
PubMed2005

Repeated tilt testing in patients with tilt-positive neurally mediated syncope.

In this study we have included 222 patients with apparent neurally mediated syncope and with a positive diagnostic tilt test. The mean age was 33.4+/-21.2 years (median 25.3): there were 107 men (median age 25.3) and 115 women (median age 22.6). The age difference between males and females was statistically significant (P = 0.002). The response to the diagnostic tilt test was: type 1 (mixed) in 74 patients; type 2A (cardioinhibitory and bradycardia) in 6; type 2B (cardioinhibitory and asystole) in 61; type 3 (vasodepressor) in 81. In all 222 patients the diagnostic tilt test was positive after 19+/-11 min (mean+/-SD), median time: 18 min. For the four types of syncope, the duration in minutes of the diagnostic tilt test was: type 1 (mixed) 19.5+/-11.4; type 2A (cardioinhibitory) 24.8+/-13.6; type 2B (cardioinhibitory and asystole) 14.7+/-10.2; type 3 (vasodepressor) 21.6+/-11.1. A significant difference was found between type 2B and type 3 responses (P = 0.002). Between males and females no significant differences in the duration of the diagnostic tilt test were found, neither for all responses, nor for the four subtypes. A type 2B (cardioinhibitory and asystole) response occurred in 61 patients. The duration of asystole was 12.8+/-10.6s (mean+/-SD; median 9, minimum 3, maximum 60). The head-up tilt test was repeated day after day: one session per day. The response became negative at the second session in 119 patients (54%); at session 3 in 47 (21%); at session 4 in 30 (13%); at session 5 in 15 (7%); at session 6 in 6 (3%); at session 7 in 2 (1%); at session 8 in 3 (1%). For all 222 patients the mean number of sessions in order to obtain a negative tilt test was 2.9 (SD 1.3; median 2). Only 25% of patients remained tilt-positive for three or more sessions. A negative tilt test was ultimately obtained in every patient. Follow-up data are available for 202/222 patients. The time span between the first and last tilt test was 11.1+/-10 months (median 8.8). Of these 202 patients, 163 remained free of any event (80.7%).

Adult↗
PubMed2005

A mitochondrial tRNA aspartate mutation causing isolated mitochondrial myopathy.

Several mutations in mitochondrial transfer RNA (tRNA) genes can cause mitochondrial myopathy. We describe a young girl who presented with pronounced exercise intolerance. The anaerobic threshold and the maximal oxygen consumption were decreased. She had decreased complex I and IV enzyme activity and ragged red fibers on muscle biopsy. An A to G transition at nucleotide position 7526 in tRNA Aspartate (tRNA(Asp)) gene was heteroplasmic in several of the patient's tissues. We were unable to detect the mutation in muscle tissue from the patient's mother. This case adds a new genetic etiology for mitochondrial myopathy. It also illustrates for patients with combined deficiency of the complex I and IV enzyme activity the value of sequencing in the affected tissue muscle, and not only in blood, all mitochondrial tRNA genes including those not commonly affected, such as in this case mt tRNA(Asp).

Adult↗
PubMed2005

A Java software for calculating mean breath-by-breath variability in gas exchange parameters: application in young cardiac patients with exercise-related periodic breathing.

Oscillatory changes in parameters of gas exchange have been reported during rest and exercise in cardiac patients with severely depressed left ventricular function. As a result of the growing interest in this oscillatory phenomenon, several methods for assessment of this ventilatory response have been presented in cardiovascular research. Nowadays, objective measurement becomes more important. Therefore, the software reported in this study is based on calculating the mean breath-by-breath variability in respiratory variables and has the advantage that patients can be compared to normal controls. This Java-based software is available for public download under: http://www.perswww.kuleuven.ac.be/Steven_Vangesselen

Belgium↗
PubMed2005

Physical performance and physical activity in grown-up congenital heart disease.

AIM: To review exercise performance and exercise habits in patients with congenital heart disease (CHD). BACKGROUND AND METHODS: Physical exercise and physical activity has shown beneficial effects on the physical, psychological and social level in adult patients with cardiovascular disease. Favourable effects have also been documented in children with CHD. Exercise testing is preferentially performed on a treadmill in children, with the measurement of gas exchange. RESULTS: An overview of the literature showed that formal exercise testing has frequently documented reduced or suboptimal values for aerobic exercise performance in children with left-to-right shunts (atrial septal defect, ventricular septal defect), valvular heart disease and obstructive anomalies (aortic stenosis, pulmonary stenosis, coarctation of the aorta). Subnormal values for exercise tolerance have also been observed in patients with successfully repaired cyanotic heart disease (tetraology of Fallot, transposition of the great arteries, Fontan operation). An important contributing factor to the impaired exercise performance is the hypoactive lifestyle, as often observed in patients with CHD. This frequently results from parental or environmental overprotection. CONCLUSION: These patients should be stimulated to be physically active, unless medical restriction is imposed. Fortunately, this represents only a small fraction of the total number of congenital heart defects for which sports participation is allowed.

Adult↗
PubMed2003

Influence of work rate on the determinants of oxygen deficit during short-term submaximal exercise: implications for clinical research.

OBJECTIVE: The effect of increasing work rate was studied on the determinants of the oxygen deficit. METHODS: Exercise testing was performed on a treadmill and gas exchange was measured on a breath-by-breath basis. Eleven healthy subjects, aged 18-25 years, performed three square wave exercise tests of different intensity. Before exercise, gas exchange was measured at rest in the standing position for 3 min, followed by a 6-min square wave exercise test, randomly assigned at 4, 8 or 12% inclination. Immediately after exercise the recovery gas exchange was determined for 3 min. To calculate oxygen deficit, the oxygen uptake (O2) values at onset of exercise were subtracted from the steady-state value, the differences were cumulated and expressed as a percentage of the total oxygen cost for the 6-min exercise. RESULTS: The oxygen deficit increased significantly (P<0.001) with increasing work rate (6.1 +/- 1.4% for 4%, 8.4 +/- 2.1% for 8% and 9.4 +/- 1.7% at 12% inclination). This resulted from a somewhat slower increase of O2 at the onset of exercise at the highest work rate, reflected by a significantly higher time constant for O2 at 8 and 12% (24.6 +/- 7.3 s at 8% and 24.1 +/- 6.3 s at 12% versus 20.2 +/- 8.1 s at 4%). More importantly a significantly higher steady-state value for O2 was found at the highest exercise level, compared with the other exercise intensities. CONCLUSION: The higher oxygen deficit at the highest level of exercise is determined by a slower time constant and a higher asymptote value for O2.

Adult↗
PubMed2002

Long-term follow-up results of tilt training therapy in patients with recurrent neurocardiogenic syncope.

Tilt twining therapy is considered as a first choice treatment for neurocardiogenic syncope in the Department of Cardiology, University of Leuven. However, long-term compliance to therapy may be difficult when patients become asymptomatic. In a single center uncontrolled study, the long-term clinical outcome of 38 patients was studied after a follow-up period of 43 +/- 7.8 months. At the time of assessment 29 patients had abandoned tilt twining therapy, while 9 still continued on a regular basis. In this series, 31 (82%) of 38 patients were free from syncope and 25 (66%) of 38 were completely asymptomatic. During follow-up, seven patients reported the recurrence of at least one syncope. Of these seven patients, six had discontinued tilt training therapy. The number of syncopes after discontinuation was significantly lower as compared with the period before initiation of tilt twining. In only one patient syncope recurrence was observed during rather irregular tilt training therapy. Moreover, in 19 patients who abandoned tilt training after about 1 year, no syncope recurrence was reported during daily life, which suggests that the disturbed autonomic reflex activity in these patients may have been restored.

Adolescent↗