Korean Circ J.  2007 Oct;37(10):489-496. 10.4070/kcj.2007.37.10.489.

Usefulness of the Cardiopulmonary Exercise Test in Congenital Heart Disease

• Kim GB
• Kwon BS
• Choi EY
• Bae EJ
• Noh CI
• Yun YS
• Kim WH
• Lee JR
• Kim YJ

• KMID: 2227050
• DOI: http://doi.org/10.4070/kcj.2007.37.10.489

Abstract

BACKGROUND AND OBJECTIVES: This study aimed to evaluate the usefulness of cardiopulmonary exercise test (CPET) in children with various congenital heart diseases (CHDs).
SUBJECTS AND METHODS
Forty-eight children and adolescents (18 girls and 30 boys; mean+/-SD age, 12.6+/-0.5 years) with CHD who had undergone corrective surgery performed CPET using a programmable treadmill. The participants were divided into 4 groups based on the surgery performed: Fontan operation (12 patients), total correction for tetralogy of Fallot (13 patients), repair for coarctation of aorta (11 patients), and corrective surgery for simple CHDs (12 patients). Patients with simple CHDs who had undergone an early surgery were selected as controls.
RESULTS
Progressive exercise time was the longest in the simple CHD group than in the other groups (10.6+/-2 versus 8.2-8.7 min, p=0.122). Absolute and predicted values of mean peak oxygen consumption were the lowest in the Fontan operation group (p=0.220 and 0.091, respectively). The coarctation of aorta group exhibited a prominent blood pressure response, that is, an elevation in the systolic blood pressure relative to that in the other groups at rest (131.7+/-18.8 versus 114.4-121.3 mmHg) and at peak exercise (196.5+/-41.5 versus 146.8-184.3 mmHg).
CONCLUSION
CPET can be a useful tool to clarify the exercise capacity and reflect the hemodynamic status of patients who have undergone surgery for various CHDs and other heart diseases.

Keyword

Exercise test; Congenital heart disease; Oxygen consumption

MeSH Terms

Adolescent
Aortic Coarctation
Blood Pressure
Child
Exercise Test*
Female
Fontan Procedure
Heart Defects, Congenital*
Heart Diseases
Hemodynamics
Humans
Oxygen Consumption
Tetralogy of Fallot

Figure

• 

  Fig. 1 Systolic blood pressure at rest (base) and peak exercise (max) in the various postoperative patients. Compared to the other groups, the CoA group exhibited a prominent blood pressure response, that is, a relatively elevated SBP at rest and peak exercise. The peak SBP responses in the Fontan operation group was relatively lower than that in the other groups. TOF: tetralogy of Fallot, CoA: coarctation of aorta, SBP: systolic blood pressure.

• 

  Fig. 2 Peak VO2 at peak exercise in the various post-operative patients. The absolute (A) and predicted (B) mean values of peak VO2 were the lowest in the Fontan operation group (p=0.22 and 0.091, respectively). VO2: oxygen consumption, TOF: tetralogy of Fallot, CoA: coarctation of aorta.

• 

  Fig. 3 VE/VCO2 and VE/VO2 at peak exercise in various post-operative patients. TOF: tetralogy of Fallot, CoA: coarctation of aorta. Ventilatory equivalents for CO2 (VE/VCO2) (A) and for O2 (VE/VO2) (B) at peak exercise were significantly increased in the group with Fontan operation compared with the other groups (p<0.001, respectively).

• 

  Fig. 4 SPO2 at rest (base) and peak exercise (max) in the various postoperative patients. The values depicted by the pulse oximeter were significantly more decreased in the Fontan operation group than in the other groups at rest and, in particular, at peak exercise (p<0.001 for both). TOF: tetralogy of Fallot, CoA: coarctation of aorta, SpO2: saturation by pulse oximeter.

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