Document Detail


Exercise capacity after complete repair of tetralogy of Fallot: deleterious effects of residual pulmonary regurgitation.
MedLine Citation:
PMID:  1622697     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effects of residual pulmonary regurgitation on exercise tolerance after complete repair of tetralogy of Fallot. DESIGN: Prospective study of symptom free patients more than five years after complete repair. Graded exercise performance was measured with standard Bruce protocol. Maximal oxygen uptake and ventilatory anaerobic threshold were measured by respiratory mass spectrometry. Measurement of pulmonary regurgitant fraction was from pressure-volume loops constructed from measurements of right ventricular volume obtained from biplane angiograms and simultaneous pressures measured with a micromanometer. SETTING: Tertiary referral centre. PATIENTS: 16 patients were studied. Two patients had been excluded because of residual cardiac lesions or inadequate data from cardiac catheterisation. Four were later excluded because they failed to reach a respiratory quotient of greater than 1.0 during graded exercise. RESULTS: There was a significant negative correlation between the degree of residual regurgitation and both total duration of exercise and maximal heart rate achieved. Maximal heart rate and total duration of exercise were significantly lower in the patients than in normal controls. Patients with an abnormal maximal oxygen uptake (less than 85% of the predicted normal value) had significantly greater residual pulmonary regurgitation than those in whom oxygen uptake was normal. CONCLUSIONS: Impaired exercise capacity after complete repair of tetralogy of Fallot is directly related to the degree of residual pulmonary regurgitation. These data should be taken into account when deciding the optimal timing and nature of corrective surgery.
Authors:
J S Carvalho; E A Shinebourne; C Busst; M L Rigby; A N Redington
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  67     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-08-13     Completed Date:  1992-08-13     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  470-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Cardiology, Royal Brompton and National Heart and Lung Hospital, London.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Pressure / physiology
Child
Exercise / physiology*
Heart Rate / physiology
Humans
Oxygen Consumption / physiology
Postoperative Complications / physiopathology*
Prospective Studies
Pulmonary Valve Insufficiency / etiology,  physiopathology*
Tetralogy of Fallot / surgery*
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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