Title: Determinants of exercise tolerance in adults with congenital heart disease
Authors: Buys, Roselien
Budts, Werner
Van De Bruaene, Alexander
Delecluse, Christophe
Stevens, An
Vanhees, Luc #
Issue Date: 2010
Host Document: European Journal of Cardiovascular Prevention and Rehabilitation vol:17 issue:Suppl 2 pages:S19
Conference: EuroPrevent location:Prague date:5-7 May, 2010
Article number: 10312
Abstract: Determinants of exercise tolerance in adults with congenital heart disease
Purpose: Grown Up patients with Congenital Heart disease (GUCH) have a lower exercise tolerance compared to normal controls, but data concerning the predictive factors of exercise tolerance are scarce. Therefore this study focuses on the determinants of peak oxygen uptake (peak VO2) in adults with tetralogy of Fallot (TF), transposition of the great arteries (TGA) and coarctation of the aorta (COA).

Methods: 205 GUCH (98 COA, 57 TF, 50 TGA) who underwent echocardiography at rest followed by an exercise test until exhaustion, and who filled in questionnaires about physical activity and quality of life, were included in the study. Stepwise multiple regression analysis was used to assess the determinants of peak VO2. Following variables were included in the analysis: demographic data, pathology, age at correction, resting blood pressure, sports participation, SF-36 data and smoking. In subanalysis per patient group, echocardiographic-Doppler data and surgical correction data were also included.

Results: Peak VO2 averaged 79.8±14.8% of predicted normal values in COA, 72.4±15.1% in TF, and 64.4±13.8% in TGA. Gender, age, BMI, pathology and MET-hours of sports per week could explain 61,5% of the variance in peak VO2 in all patients. In TF, left ventricular mass index (LVMI), age at correction and perceived physical health were also related to peak VO2. The variance of peak VO2 in TGA was furthermore partly explained by perceived physical health, as well as the degree of right ventricular dilatation.

Conclusions: In GUCH, exercise tolerance is affected by the underlying heart defect, decreases with age, is positively related to BMI and physical activity, and male patients have a higher exercise tolerance. A higher LVMI and younger age at correction positively influence peak VO2 in TF. A decrease in right ventricular contractility in TGA negatively affects the exercise tolerance.
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Research Group for Cardiovascular and Respiratory Rehabilitation
Exercise Physiology Research Group
# (joint) last author

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