Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin
Autor(a) principal: | |
---|---|
Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/3107 |
Resumo: | AIM: The aim of the study was to compare functional capacity in different types of congenital heart disease (CHD), as assessed by cardiopulmonary exercise testing (CPET). METHODS: A retrospective analysis was performed of adult patients with CHD who had undergone CPET in a single tertiary center. Diagnoses were divided into repaired tetralogy of Fallot, transposition of the great arteries (TGA) after Senning or Mustard procedures or congenitally corrected TGA, complex defects, shunts, left heart valve disease and right ventricular outflow tract obstruction. RESULTS: We analyzed 154 CPET cases. There were significant differences between groups, with the lowest peak oxygen consumption (VO2) values seen in patients with cardiac shunts (39% with Eisenmenger physiology) (17.2±7.1ml/kg/min, compared to 26.2±7.0ml/kg/min in tetralogy of Fallot patients; p<0.001), the lowest percentage of predicted peak VO2 in complex heart defects (50.1±13.0%) and the highest minute ventilation/carbon dioxide production slope in cardiac shunts (38.4±13.4). Chronotropism was impaired in patients with complex defects. Eisenmenger syndrome (n=17) was associated with the lowest peak VO2 (16.9±4.8 vs. 23.6±7.8ml/kg/min; p=0.001) and the highest minute ventilation/carbon dioxide production slope (44.8±14.7 vs. 31.0± 8.5; p=0.002). Age, cyanosis, CPET duration, peak systolic blood pressure, time to anaerobic threshold and heart rate at anaerobic threshold were predictors of the combined outcome of all-cause mortality and hospitalization for cardiac cause. CONCLUSION: Across the spectrum of CHD, cardiac shunts (particularly in those with Eisenmenger syndrome) and complex defects were associated with lower functional capacity and attenuated chronotropic response to exercise. |
id |
RCAP_4ac7777ef151ee2b439029599d29c8c8 |
---|---|
oai_identifier_str |
oai:repositorio.chlc.min-saude.pt:10400.17/3107 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise TestinCardiopatia Congénita em Adultos: Avaliação da Capacidade Funcional por Prova de Esforço CardiorrespiratóriaHSM CARHSM CAR PEDExercise TestHeart Defects, Congenital/diagnosisHeart Defects, Congenital/physiopathologyHeart Diseases/congenitalHeart Diseases/diagnosisHeart Diseases/physiopathologyRetrospective StudiesAIM: The aim of the study was to compare functional capacity in different types of congenital heart disease (CHD), as assessed by cardiopulmonary exercise testing (CPET). METHODS: A retrospective analysis was performed of adult patients with CHD who had undergone CPET in a single tertiary center. Diagnoses were divided into repaired tetralogy of Fallot, transposition of the great arteries (TGA) after Senning or Mustard procedures or congenitally corrected TGA, complex defects, shunts, left heart valve disease and right ventricular outflow tract obstruction. RESULTS: We analyzed 154 CPET cases. There were significant differences between groups, with the lowest peak oxygen consumption (VO2) values seen in patients with cardiac shunts (39% with Eisenmenger physiology) (17.2±7.1ml/kg/min, compared to 26.2±7.0ml/kg/min in tetralogy of Fallot patients; p<0.001), the lowest percentage of predicted peak VO2 in complex heart defects (50.1±13.0%) and the highest minute ventilation/carbon dioxide production slope in cardiac shunts (38.4±13.4). Chronotropism was impaired in patients with complex defects. Eisenmenger syndrome (n=17) was associated with the lowest peak VO2 (16.9±4.8 vs. 23.6±7.8ml/kg/min; p=0.001) and the highest minute ventilation/carbon dioxide production slope (44.8±14.7 vs. 31.0± 8.5; p=0.002). Age, cyanosis, CPET duration, peak systolic blood pressure, time to anaerobic threshold and heart rate at anaerobic threshold were predictors of the combined outcome of all-cause mortality and hospitalization for cardiac cause. CONCLUSION: Across the spectrum of CHD, cardiac shunts (particularly in those with Eisenmenger syndrome) and complex defects were associated with lower functional capacity and attenuated chronotropic response to exercise.Sociedade Portuguesa de CardiologiaRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEAguiar Rosa, SAgapito, ASoares, RMSousa, LOliveira, JAAbreu, ASilva, ASAlves, SAidos, HPinto, MFCruz Ferreira, R2018-11-29T13:13:48Z2018-052018-05-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3107engRev Port Cardiol. 2018 May;37(5):399-405.10.1016/j.repc.2017.09.020info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:41:17Zoai:repositorio.chlc.min-saude.pt:10400.17/3107Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:26.684311Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin Cardiopatia Congénita em Adultos: Avaliação da Capacidade Funcional por Prova de Esforço Cardiorrespiratória |
title |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin |
spellingShingle |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin Aguiar Rosa, S HSM CAR HSM CAR PED Exercise Test Heart Defects, Congenital/diagnosis Heart Defects, Congenital/physiopathology Heart Diseases/congenital Heart Diseases/diagnosis Heart Diseases/physiopathology Retrospective Studies |
title_short |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin |
title_full |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin |
title_fullStr |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin |
title_full_unstemmed |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin |
title_sort |
Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin |
author |
Aguiar Rosa, S |
author_facet |
Aguiar Rosa, S Agapito, A Soares, RM Sousa, L Oliveira, JA Abreu, A Silva, AS Alves, S Aidos, H Pinto, MF Cruz Ferreira, R |
author_role |
author |
author2 |
Agapito, A Soares, RM Sousa, L Oliveira, JA Abreu, A Silva, AS Alves, S Aidos, H Pinto, MF Cruz Ferreira, R |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Aguiar Rosa, S Agapito, A Soares, RM Sousa, L Oliveira, JA Abreu, A Silva, AS Alves, S Aidos, H Pinto, MF Cruz Ferreira, R |
dc.subject.por.fl_str_mv |
HSM CAR HSM CAR PED Exercise Test Heart Defects, Congenital/diagnosis Heart Defects, Congenital/physiopathology Heart Diseases/congenital Heart Diseases/diagnosis Heart Diseases/physiopathology Retrospective Studies |
topic |
HSM CAR HSM CAR PED Exercise Test Heart Defects, Congenital/diagnosis Heart Defects, Congenital/physiopathology Heart Diseases/congenital Heart Diseases/diagnosis Heart Diseases/physiopathology Retrospective Studies |
description |
AIM: The aim of the study was to compare functional capacity in different types of congenital heart disease (CHD), as assessed by cardiopulmonary exercise testing (CPET). METHODS: A retrospective analysis was performed of adult patients with CHD who had undergone CPET in a single tertiary center. Diagnoses were divided into repaired tetralogy of Fallot, transposition of the great arteries (TGA) after Senning or Mustard procedures or congenitally corrected TGA, complex defects, shunts, left heart valve disease and right ventricular outflow tract obstruction. RESULTS: We analyzed 154 CPET cases. There were significant differences between groups, with the lowest peak oxygen consumption (VO2) values seen in patients with cardiac shunts (39% with Eisenmenger physiology) (17.2±7.1ml/kg/min, compared to 26.2±7.0ml/kg/min in tetralogy of Fallot patients; p<0.001), the lowest percentage of predicted peak VO2 in complex heart defects (50.1±13.0%) and the highest minute ventilation/carbon dioxide production slope in cardiac shunts (38.4±13.4). Chronotropism was impaired in patients with complex defects. Eisenmenger syndrome (n=17) was associated with the lowest peak VO2 (16.9±4.8 vs. 23.6±7.8ml/kg/min; p=0.001) and the highest minute ventilation/carbon dioxide production slope (44.8±14.7 vs. 31.0± 8.5; p=0.002). Age, cyanosis, CPET duration, peak systolic blood pressure, time to anaerobic threshold and heart rate at anaerobic threshold were predictors of the combined outcome of all-cause mortality and hospitalization for cardiac cause. CONCLUSION: Across the spectrum of CHD, cardiac shunts (particularly in those with Eisenmenger syndrome) and complex defects were associated with lower functional capacity and attenuated chronotropic response to exercise. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-11-29T13:13:48Z 2018-05 2018-05-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/3107 |
url |
http://hdl.handle.net/10400.17/3107 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Rev Port Cardiol. 2018 May;37(5):399-405. 10.1016/j.repc.2017.09.020 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799131300647403520 |