Role of Right Ventricular and Pulmonary Functional Abnormalities in Limiting Exercise Capacity in Adults With Congenital Heart Disease

Adults with Ebstein's anomaly—Cardiopulmonary exercise testing and BNP levels

“…Additionally, Daliento et al [26] have proven the presence of fibrosis of the right and left ventricular myocardium observed in histopathological study performed as early as in neonatal age. The maximum heart rate in our group of patients was lower than in controls, which may indicate, according to some other authors, the impairment of chronotropic reaction in Ebstein's anomaly [22,24,30,31]. The limited chronotropic response that may result from sinus node dysfunction, right bundle branch conduction disorders or sympathetic tone changes [32,33], was also noted in patients presenting with other congenital heart anomalies [30,32,34 -36].…”

Congenital Heart Disease in the Older Adult

“…[165][166][167][168][169] In 475 adult patients with various forms of CHD, spirometry revealed that in most patients, the forced vital capacity was significantly lower than predicted for healthy subjects (P<0.0001), a finding that is highly suggestive of abnormal pulmonary mechanics. 166 Significantly reduced forced vital capacity and forced expiratory volume in 1 second (FEV 1 ) was also found in 335 adults with various forms of CHD.…”

“…Exercise intolerance is common in this population [165][166][167][168][169] and is associated with an increased risk for hospitalization and death. 168,176 Reduced exercise capacity is often attributed to an underlying cardiac pathogenesis, including abnormal heart rate response to exercise and cardiac dysfunction.…”

Abnormal Spirometry in Congenital Heart Disease

“…6,7 Although the present report includes a large number of patients, available pulmonary function data are limited to simple spirometry without information on lung volumes or diffusing capacity, which limits mechanistic inference. Previous reports demonstrated that the pattern of pulmonary function abnormalities and underlying mechanisms may vary between defects and at different stages of disease and repair.…”