402 Dobutamine stress echocardiography is feasible, efficacious, and safe in the estimation of right ventricular reserve in patients with repaired Tetralogy of Fallot

Brili, Stella; Alexopoulos, Nikolaos; Chrysohoou, Christine; Barbetseas, John; Karamitros, J.; Massias, S; Stamatopoulos, Ilias; Stefanadis, C.

doi:10.1016/s1525-2167(06)60192-3

Cited by 2 publications

(1 citation statement)

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“…In line with the study by Bansal et al [41], early flattening of the O 2 pulse slope or a downward displacement at peak exercise in our series was associated with lower O 2 consumption. This was likely due to the Fontan circulation's inability to increase the pulmonary blood flow and ventricle preload during exercise, and as a consequence a limited capacity to increase the stroke volume with exertion [42][43][44][45][46]. Furthermore, we observed that those with flat or descending oxygen pulse kinetics had a lower functional capacity.…”

Section: Oxygen Pulse Kineticsmentioning

confidence: 71%

Respiratory Muscle Function and Exercise Performance in Adult Patients with Fontan Circulation

Ladrón-Abia,

Cejudo Ramos,

Valverde Pérez

et al. 2023

JCM

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At rest, a good Fontan circulation can provide a normal cardiac output (CO). However, as a consequence of its unique hemodynamic nature, the limitations of the Fontan circuit are exposed during exercise. We aimed to provide a comprehensive assessment of the pathophysiology of exercise in adult Fontan patients (FPs) and identify factors limiting their functional capacity (FC). In a single-center study conducted in 37 FPs aged ≥16 years and 19 healthy-controls (HCs) who underwent CPET on a cycle ergometer in February and March 2022, the mean peakVO2 was 21 ± 5.4 mL/kg/min, which was 55% of the predicted value. Morphologically, the left single ventricle showed a higher peakVO2% predicted value (57.4 ± 14.4% vs. 43.4 ± 8.1%, p = 0.045). The factors associated with low peakVO2 values were an early flattened or descending O2 pulse at maximal exertion (52 ± 14% vs. 62 ± 12.5, p = 0.04 and 47.6 ± 9% vs. 60 ± 14, p = 0.018, respectively) and chronotropic insufficiency (53 ± 12% vs. 69.8 ± 20%, p = 0.008). The OUES was found to be a useful parameter to assess the FC in FPs in maximal and submaximal exercise testing. A strong positive correlation was observed between the %OUES and peakVO2%predicted (r = 0.726, p > 0.001). The lung function was impaired in the FPs, mostly with a mild restrictive pattern (56.8%). The FPs showed lower inspiratory muscle strength compared to the HCs but it was not statistically associated with either the peakVO2 or VE/VCO2 slope. Regular intense physical activity improves one’s FC. Although FPs have inspiratory muscle weakness, its impact on their FC is unclear. The peakVO2% predicted grew progressively higher as the level of physical activity increased (low level 49.5 ± 14%, moderate level 55 ± 12%, intense level 69 ± 20%).

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Section: Oxygen Pulse Kineticsmentioning

confidence: 71%

Respiratory Muscle Function and Exercise Performance in Adult Patients with Fontan Circulation

Ladrón-Abia,

Cejudo Ramos,

Valverde Pérez

et al. 2023

JCM

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Respiratory Muscle Function and Submaximal Exercise Performance in Adult Patients With Fontan Circulation

Ladrón-Abia¹,

Valverde²,

Camacho³

et al. 2023

Preprint

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We aimed to provide a comprehensive assessment of exercise physiology of adult Fontan patients (FP) and factors limiting functional capacity (FC). A prospective single-centre study of 37 FP aged ≥16years and 19 healthy-controls (HC), who underwent CPET on cycle-ergometer in February-March 2022. Lung function was impaired in FP, mostly mild restrictive pattern (56.8%). Mean peakVO2 was 21±5.4ml/kg/min, 55% predicted. Morphologically left-single ventricle showed higher peakVO2%predicted (57.4±14.4% vs 43.4±8.1%, p=0.045). A lower peakVO2%predicted was observed in patients with an early flattened and/or descending O2 pulse at maximal exertion (52±14% vs 62±12.5, p=0.04 and 47.6±9% vs 60±14 respectively, p=0.018) and chronotropic insufficiency (53±12% vs 69.8±20%, p=0.008). Strong positive correlation was observed between %OUES and peakVO2%predicted (r=0.726, p>0.001). PeakVO2%predicted was progressively higher as the level of physical activity increased (low-level 49.5±14%, moderate-level 55±12%, intense-level 69±20%). FP showed lower inspiratory muscle strength compared to HC but it was no statistically associated with either peakVO2 or VE/VCO2 slope. In FP OUES is a useful submaximal parameter in those who fail to reach maximal exertion. Chronotropic insufficiency and early flattened or descending oxygen pulse slope were factors associated with low peakVO2. Regular intense physical activity improves FC. Although FP have inspiratory muscle weakness, its impact on FC is unclear.

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402 Dobutamine stress echocardiography is feasible, efficacious, and safe in the estimation of right ventricular reserve in patients with repaired Tetralogy of Fallot

Cited by 2 publications

References 0 publications

Respiratory Muscle Function and Exercise Performance in Adult Patients with Fontan Circulation

Respiratory Muscle Function and Exercise Performance in Adult Patients with Fontan Circulation

Respiratory Muscle Function and Submaximal Exercise Performance in Adult Patients With Fontan Circulation

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