these patients results in reduced heart rates and im-
proved cardiovascular efficiency during usual daily
activities.
This is only the second report providing a system-
atic evaluation of the effects of programmed training
on aerobic capacity after the Fontan operation. Mi-
namisawa et al
20
reported on a 2- to 3-month exercise
training program (walking or jogging) held 2 or 3
times a week for 20 to 30 minutes in 19 teens and
young adults after the Fontan operation. The exercise
training in these patients resulted in an increase in
maximal oxygen consumption (7%) and exercise time
(4%). They also observed that heart rate tended to
decrease during small workloads after training and
oxygen pulse tended to increase. Our findings are
similar but of greater magnitude, probably because the
training period was longer. Further, we found definite
improvement in cardiovascular efficiency at small
workloads. In addition to the longer training program,
these differences may be due to the personalized pre-
scription of the exercise program, including a specific
target heart rate range.
Acknowledgment: We gratefully acknowledge
Francesca Forner, Francesca Gasbarro, and Professor
Giorgio Andreaggi for their excellent assistance dur-
ing the exercise training session and Cecilia Giron,
MD, for the statistical analysis.
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Values of High-Sensitivity C-Reactive Protein in Each
Month of the Year in Apparently Healthy Individuals
Ori Rogowski, MD, Sharon Toker, MSc, Itzhak Shapira, MD, Samuel Melamed, PhD,
Arie Shirom, PhD, David Zeltser, MD, MPH, and Shlomo Berliner, MD, PhD
The serum levels of high-sensitivity C-reactive protein
were determined during a 12-month period. No sea-
sonal variation was found in a group of 1,677 ap-
parently healthy patients in whom the presence of
clinically evident infection or inflammation was ex-
cluded by an appropriate questionnaire. 2005 by
Excerpta Medica Inc.
(Am J Cardiol 2005;95:152–155)
I
t has been repeatedly shown that high-sensitivity C-
reactive protein (hs-CRP) is a useful marker for the
presence of low-grade inflammation in apparently
healthy patients.
1
The determination of hs-CRP in these
patients has been shown to have significant prognostic
implications in terms of future cardiovascular events.
2
In
this regard, it is important to determine whether the
concentration of this protein changes during the winter
season, when respiratory tract infections are more prevalent
and could have an influence on the results of hs-CRP.
From the Department of Medicine “D” and Institute for Special Medical
Examinations (MALRAM), Tel Aviv Sourasky Medical Center, Tel Aviv;
and the National Institute of Occupational & Environmental Health,
Raanana, Israel. Dr. Berliner’s address is: Department of Internal
Medicine “D,” Tel-Aviv Sourasky Medical Center, 6 Weizman Street,
Tel Aviv 64239, Israel. E-mail: shapiraiz@tasmc.health.gov.il. Manu-
script received April 14, 2004; revised manuscript received and
accepted August 16, 2004.
152 ©2005 by Excerpta Medica Inc. All rights reserved. 0002-9149/05/$–see front matter
The American Journal of Cardiology Vol. 95 January 1, 2005 doi:10.1016/j.amjcard.2004.08.086