Vogel M, Smallhorn JF, Trusler GA, Freedom RM Echocardiographic analysis of regional left ventricular wall motion in children after the arterial switch operation for complete transposition of the great arteries J Am Coll Cardiol 1990;15:1417–1423 This study evaluated the effectiveness of echocardiographic evaluation of regional wall motion in 21 patients an average of 2 years after the arterial switch operation for transposition A strong correlation was found between wall motion abnormalities on stress echocardiography and myocardial perfusion defects using the tracer thallium 201 Gewillig MH, Lundstrom UR, Bull C, et al Exercise responses in patients with congenital heart disease after Fontan repair: patterns and determinants of performance J Am Coll Cardiol 1990;15:1424–1432 This study evaluated the exercise responses of 42 patients with Fontan physiology to that of 28 age-matched controls during supine cycle ergometry Results indicated that impairment in ventricular filling is more predictive of exercise performance than the heart rate responses Davis JA, McBride MG, Chrisant MA, et al Longitudinal assessment of cardiovascular exercise performance after paediatric heart transplantation J Heart Lung Transplant 2006;25:626–633 Serial longitudinal exercise performance was evaluated in 28 children following cardiac transplantation Results indicated that exercise performance is impaired and, despite an initial improvement, declines over time The deterioration in exercise performance correlated with increasing diastolic dysfunction, a finding also frequently cited in adult studies in this population of patients References Williams CL, Hayman LL, Daniels SR, et al Cardiovascular health in childhood: a statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association Circulation 2002;106:143– 160 Rychik J, Wernovsky G Hypoplastic Left Heart Syndrome Kluwer Academic Publishers: Norwell, MA; 2003 Wasserman K, Hansen JE, Sue DY, et al Exercise Testing and Interpretation: An Overview Principles of Exercise Testing and Interpretation 2nd ed Lea & Febiger: Philadelphia; 1994:1–8 Wasserman K, Hansen JE, Sue DY, et al Physiology of Exercise Principles of Exercise Testing and Interpretation 2nd ed Lea & Febiger: Philadelphia; 1994:9–51 Astrand P, Rodahl K, Dahl H, Stromme SB The Muscle and Its Contraction Textbook of Work Physiology: Physiological Bases of Exercise 3rd ed McGraw-Hill: New York; 1986:12–208