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Congenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testin

2018-05Journal article Open access
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dc.contributor.authorAguiar Rosa, S
dc.contributor.authorAgapito, A
dc.contributor.authorSoares, RM
dc.contributor.authorSousa, L
dc.contributor.authorOliveira, JA
dc.contributor.authorAbreu, A
dc.contributor.authorSilva, AS
dc.contributor.authorAlves, S
dc.contributor.authorAidos, H
dc.contributor.authorPinto, MF
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2018-11-29T13:13:48Z
dc.date.available2018-11-29T13:13:48Z
dc.date.issued2018-05
dc.description.abstractAIM: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2018 May;37(5):399-405.pt_PT
dc.identifier.doi10.1016/j.repc.2017.09.020pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3107
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Cardiologiapt_PT
dc.subjectHSM CARpt_PT
dc.subjectHSM CAR PEDpt_PT
dc.subjectExercise Testpt_PT
dc.subjectHeart Defects, Congenital/diagnosispt_PT
dc.subjectHeart Defects, Congenital/physiopathologypt_PT
dc.subjectHeart Diseases/congenital
dc.subjectHeart Diseases/diagnosis
dc.subjectHeart Diseases/physiopathology
dc.subjectRetrospective Studies
dc.titleCongenital Heart Disease in Adults: Assessment of Functional Capacity Using Cardiopulmonary Exercise Testinpt_PT
dc.title.alternativeCardiopatia Congénita em Adultos: Avaliação da Capacidade Funcional por Prova de Esforço Cardiorrespiratóriapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage405pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage399pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume37pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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