Document Detail

Exercise capacity and stroke volume are preserved late after tetralogy repair, despite severe right ventricular dilatation.
MedLine Citation:
PMID:  22869677     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To assess if exercise capacity and resting stroke volume are different in tetralogy of Fallot (TOF) repair survivors with indexed RV (right ventricle) end-diastolic volume (RVEDVi) more versus less than 150 ml/m(2), a currently suggested threshold for pulmonary valve replacement (PVR).
DESIGN: Cross-sectional study.
SETTING: Single-centre adult congenital heart disease unit.
PATIENTS: 55 consecutively eligible patients with repaired TOF (age at repair 2.3±1.9 years; age at evaluation 26.2±8.8 years; NYHA Class I or II).
INTERVENTIONS: Cardiovascular MRI (1.5T) and cardiopulmonary exercise test.
MAIN OUTCOME MEASURES: Biventricular volumes and function; exercise capacity.
RESULTS: 20 patients had RVEDVi below, and 35 had RVEDVi above 150 ml/m(2), at time of referral. In the >150 ml/m(2) group, fractional pulmonary regurgitation was higher (41±8 vs 31±8%, p<0.001). Although RV ejection fraction (EF) was lower (47±7 vs 54±6%, p=0.007), indexed RV stroke volume was higher (87±14 vs 64±10 ml/m(2), p<0.001) in the >150 ml/m(2) group. There were no significant differences in LVEF, indexed LV stroke volume or exercise capacity (% predicted peak work: 90±17 vs 89±11% and; % predicted VO(2) peak: 84±17 vs 87±12%).
CONCLUSIONS: Exercise capacity and stroke volume are maintained with RVEDVi above compared with below a commonly used cut-off for PVR surgery. Optimal timing for PVR, thus, remains unclear.
Shamus O'Meagher; Phillip A Munoz; Jennifer A Alison; Iven H Young; David J Tanous; David S Celermajer; Rajesh Puranik
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-06
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  98     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-22     Completed Date:  2013-01-08     Revised Date:  2014-01-07    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1595-9     Citation Subset:  AIM; IM    
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MeSH Terms
Cardiac Surgical Procedures / methods*
Cardiomyopathy, Dilated / diagnosis,  etiology*,  physiopathology
Exercise Tolerance / physiology*
Follow-Up Studies
Magnetic Resonance Imaging, Cine
Postoperative Complications
Pulmonary Valve Insufficiency / complications*,  diagnosis,  physiopathology
Retrospective Studies
Stroke Volume*
Tetralogy of Fallot / physiopathology,  surgery*
Ventricular Dysfunction, Right / diagnosis,  etiology*,  physiopathology
Young Adult
Comment In:
Heart. 2013 Dec;99(24):1875-6   [PMID:  23958759 ]
Heart. 2013 Dec;99(24):1875   [PMID:  23958760 ]

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