| Comprehensive Use of Cardiopulmonary Exercise Testing Identifies Adults with Congenital Heart Disease at Increased Mortality Risk in the Medium Term. | |
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MedLine Citation:
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PMID: 22147905 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Parameters of cardiopulmonary exercise testing (CPX) were recently identified as strong predictors of mortality in adults with congenital heart disease (ACHD). We hypothesized that combinations of CPX parameters may provide optimal prognostic information on mid-term survival in this population. METHODS AND RESULTS: 1,375 consecutive ACHD patients (age 33±13 years) underwent CPX at a single center over a period of 10 years. Peak oxygen consumption (peak VO(2)), ventilation per unit of carbon dioxide production (VE/VCO(2) slope) and heart rate reserve (HRR) were measured. During a median follow-up of 5.8 years, 117 patients died. Peak VO(2), HRR and VE/VCO(2) slope were related to mid-term survival in ACHD patients. Risk of death increased with lower peak VO(2) and HRR. A higher VE/VCO(2) slope was also related to increased risk of death in non-cyanotic patients, while VE/VCO(2) slope was not predictive of mortality in cyanotic patients. The combination of peak VO(2) and HRR provided the greatest predictive information after adjusting for clinical parameters, such as negative chronotropic agents, age and presence of cyanosis. However, the incremental value of these exercise parameters was reduced in patients with peak respiratory exchange ratio below 1.0. CONCLUSIONS: CPX provides strong prognostic information in patients with ACHD. Prognostication should be approached differently depending on the presence of cyanosis, the use of rate lowering medications and achieved level of exercise. We provide 5-year survival prospects based on CPX parameters in this growing population. |
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Authors:
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Ryo Inuzuka; Gerhard-Paul Diller; Francesco Borgia; Leah Benson; Edgar L W Tay; Rafael Alonso-Gonzalez; Margarida Silva; Menelaos Charalambides; Lorna Swan; Konstantinos Dimopoulos; Michael A Gatzoulis |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-6 |
Journal Detail:
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Title: Circulation Volume: - ISSN: 1524-4539 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Brompton Hospital & Imperial College School of Medicine, London, United Kingdom; |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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