Functional Characterization of Children with Chronic Venous Thromboembolic Disease

项目总结 静脉血栓形成影响大约200名住院儿童中的1名。深部后重要症状 累及下肢的静脉血栓形成(DVT)和肺栓塞(PE)包括 呼吸和运动不耐受导致生活质量下降。这些症状的发生机制 都是未知的。尽管静脉血栓形成合并手术不耐受和劳力性呼吸困难的患者 我们的初步数据通常被认为是非条件的，但它挑战了这一传统观点。因此，它是 目前尚不清楚运动不耐受或劳力性呼吸困难是由心血管、肺或四肢引起的- 肌肉功能障碍以及后天获得性风险因素，如去条件反射或肥胖是否导致这些 有问题。如果我们发现解除条件导致或使运动不耐受或呼吸困难复杂化的证据， 运动训练将是非常有益的；对于与肥胖相关的呼吸力学变化， 在可以忍受运动训练之前，积极的减肥措施可能是必要的。在这 应用，我们将利用最先进的措施，包括7特斯拉磁共振成像，休息和 在运动期间，研究这些常见症状的中枢和外周机制。目标1将 描述心脏限制；目标2，肺和目标3，下列骨骼肌代谢异常 儿科患者诊断后3个月和12个月的DVT和PE。我们的长期合作 目的是提供新的和临床相关的结果，可能改变预防的方法 以及治疗运动不耐受和呼吸困难，并提高VTE儿童患者的生活质量。

PROJECT SUMMARY Venous thrombosis affects approximately 1 in 200 hospitalized children. Important symptoms after deep venous thrombosis (DVT) involving lower extremities and pulmonary embolism (PE) include shortness of breath and exercise intolerance resulting in a decreased quality of life. The mechanisms of these symptoms are unknown. Although patients with venous thrombosis with excise intolerance and exertional dyspnea are generally considered to be deconditioned, our preliminary data challenge this conventional wisdom. Thus, it is presently unclear if exercise intolerance or exertional dyspnea are due to cardiovascular, pulmonary, or limb- muscle dysfunction and whether acquired risk-factors such as deconditioning or obesity contribute to these problems. If we find evidence of deconditioning causing or complicating exercise intolerance or dyspnea, exercise training would be dramatically beneficial; for obesity-related changes in respiratory mechanics, aggressive weight loss measures may be necessary before exercise training can be tolerated. In this application, we will utilize state-of-the-art measures, including 7 Tesla magnetic resonance imaging, at rest and during exercise to investigate central and peripheral mechanisms of these common symptoms. Aim 1 will characterize cardiac limitations; Aim 2, pulmonary and Aim 3, skeletal muscle metabolic aberrations following DVT and PE at 3 and 12 months post-diagnosis in pediatric patients following diagnosis. Our long-term objective is to provide novel and clinically relevant results that could potentially alter approaches for preventing and treating exercise intolerance and dyspnea and improving the quality of life for pediatric patients with VTE.