Mechanisms of maintained exercise capacity in adults with repaired tetralogy of Fallot

O’Meagher, S.; Muñoz, Phillip A.; Muthurangu, Vivek; Robinson, Peter; Malitz, Nathan; Tanous, David; Celermajer, David S.; Puranik, Rajesh

doi:10.1016/j.ijcard.2014.09.008

Cited by 18 publications

(19 citation statements)

References 6 publications

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“…We found that exercise function, measured by% VO 2peak , was decreased (67.2 ± 16.7%) but not as low as that in the study of Fredriksen et al, 14 who reported% VO 2 peak of 51% predicted 14 . Our data are also similar to those in a recent study by O’Meagher et al, 15 which, together with our data, suggest that ToF patients have sufficient exercise cardiac response to maintain nearly normal exercise tolerance, despite a high prevalence of residual right sided-lesions 15 …”

Section: Discussionsupporting

confidence: 90%

Effect of ventricular function and volumes on exercise capacity in adults with repaired Tetralogy of Fallot

Dłużniewska¹,

Podolec²,

Miszalski−Jamka³

et al. 2018

Indian Heart Journal

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Section: Discussionsupporting

confidence: 90%

Effect of ventricular function and volumes on exercise capacity in adults with repaired Tetralogy of Fallot

Dłużniewska¹,

Podolec²,

Miszalski−Jamka³

et al. 2018

Indian Heart Journal

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“…Not surprisingly, an increased burden of thromboembolism and stroke is observed. 76 Exercise intolerance and reduced oxygen consumption is prevalent, especially in patients with complex forms of CHD, [77][78][79] and progressive hepatic fibrosis occurs in patients with elevated systemic venous pressures. 80,81 Not surprisingly, among adult women with CHD who become pregnant, adverse cardiovascular events occurring in pregnancy and childbirth are considerably more likely during admission for delivery than the general population, particularly among those with complex CHD or pulmonary hypertension.…”

Section: Adults With Chdmentioning

confidence: 99%

Trends in Congenital Heart Disease

2016

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“…Similar to our findings, PI regurgitant fraction (RF) decreased as exercise intensity and heart rate increased with resultant augmentation in net pulmonary artery forward flow. 38…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Contractile Reserve Is Impaired in Children and Adolescents With Repaired Tetralogy of Fallot: An Exercise Strain Imaging Study

Bhatt

Wang

Elci

et al. 2019

Journal of the American Society of Echocardiography

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Background: Pulmonary insufficiency (PI) and right ventricular (RV) dysfunction are long-term complications in rTOF. We sought to investigate RV contractile reserve and changes in PI that occur during exercise in patients with repaired tetralogy of Fallot (rTOF) and the association of these changes with exercise performance using stress echocardiography. Methods: Subjects with rTOF (n = 32) and healthy controls (n=10) were prospectively enrolled and underwent rest and peak exercise echocardiograms during standard CPET protocol on cycle ergometer or treadmill. RV contractile reserve was defined as the change in RV global longitudinal strain (RVGLS) from rest to peak exercise. PI was assessed with the diastolic systolic time velocity integral ratio (DSTVI) and diastolic/systolic velocity ratio (D/S Ratio) from pulmonary artery Doppler interrogation. Exercise measures included heart rate reserve, percent-predicted maximum oxygen consumption (%mVO2), percent-predicted maximum work (%mWork) and oxygen pulse. Results: Right ventricular contractile reserve was impaired in rTOF compared to controls with a significant drop in the absolute value of RVGLS from 17% (range 8-27) at rest to 13% (range 5-28) at peak exercise. Similarly, PI decreased at peak exercise, with a drop in DSTVI and D/S ratios. Reduction in PI was directly associated with %mVO2, %mWork, and greater oxygen pulse. Heart rate reserve was directly associated with %mVO2 and %mWork. RV contractile reserve was not associated with any exercise parameters. Conclusions: Patients with rTOF have an abnormal myocardial response to exercise with impaired RV contractile reserve compared to control subjects. Heart rate reserve and reduction in PI at peak exercise are associated with better exercise performance and appear to be significant contributors to exercise performance in rTOF. Measures to improve chronotropic health in rTOF should be explored.

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Mechanisms of maintained exercise capacity in adults with repaired tetralogy of Fallot

Cited by 18 publications

References 6 publications

Effect of ventricular function and volumes on exercise capacity in adults with repaired Tetralogy of Fallot

Effect of ventricular function and volumes on exercise capacity in adults with repaired Tetralogy of Fallot

Trends in Congenital Heart Disease

Right Ventricular Contractile Reserve Is Impaired in Children and Adolescents With Repaired Tetralogy of Fallot: An Exercise Strain Imaging Study

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