Sep 15, 2018

Exercise testing and spirometry as predictors of mortality in congenital heart disease: Contrasting Fontan physiology with repaired tetralogy of Fallot

Congenital Heart Disease
Keri M ShaferJonathan Rhodes

Abstract

Risk prediction using cardiopulmonary exercise testing (CPET) in complex congenital heart disease tends to either focus on single diagnoses or complete cohorts. We aimed to evaluate patients with two distinct anatomies cared for at a single institution over the same time period to determine CPET variables associated with mortality. All Fontan and tetralogy of Fallot (TOF) subjects with CPET between November 1, 2002 and December 31, 2014 and subsequently died were identified (cases). Cases were matched 1:3 to controls with similar age, underlying anatomy and timing of exercise test. Of the 42 cases, 27 had a Fontan circulation and 15 with TOF. All Fontan patients had a low peak VO2 but there was no significant difference between cases and controls (52.5 ± 14.7 v. 57.4% ± 13.5% predicted, P = .11). Spirometry values were significantly lower in Fontan cases than controls (eg, FVC 67.4 ± 19.1 v 77.6% ± 14.9% predicted, P = .007). Spirometry values were also lower in TOF cases than controls (% predicted FVC 62.8 ± 16.7 v 75 ± 14, P = .006). In contrast to the Fontan analysis, both %peak predicted VO2 and VE/VCO2 slope were worse in TOF cases than controls (50.1 ± 13.5 v. 68.5% ± 15.0% predicted VO2 , P = .0004; 33.9 ± 12.9 v 26.6 ± ...Continue Reading

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Mentioned in this Paper

Lung
Institution
Congenital Heart Disease
Congenital Disorders
Cardiopulmonary Exercise Test
Repair of Tetralogy of Fallot
Evaluation
Hemi-Fontan Procedure
Exercise Stress Test
Congenital Heart Defects

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