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Determinants of exercise capacity after arterial switch operation for transposition of the great arteries
- Source :
- The American journal of cardiology. 104(7)
- Publication Year :
- 2009
-
Abstract
- Patients who undergo the arterial switch operation for transposition of the great arteries (TGA) are at risk of reduced exercise capacity, with most reports focusing on chronotropic incompetence as the cause. Residual right ventricular outflow tract (RVOT) obstruction is relatively common after the arterial switch operation, but its effect on exercise capacity is unknown. We studied 60 patients (44 males, age 13.3 +/- 3.4 years) who had undergone a neonatal arterial switch operation using the cardiopulmonary exercise test and transthoracic echocardiography. The peak exercise oxygen uptake (VO(2)), and heart rate were recorded and are expressed as the percentage of predicted values. The greatest velocity detected by echocardiography across the pulmonary valve, pulmonary trunk, or pulmonary branches was used in the analysis as an index of RVOT obstruction. The peak VO(2)% was 84 +/- 15%, and the peak heart rate percentage was 97 +/- 8%. Of the 60 patients, 29 had an abnormal peak VO(2)% (or =84%) and 3 (5%) had an abnormal peak heart rate percentage (or =85%). The maximal RVOT velocity was 2.3 +/- 0.6 m/s, and it correlated with the peak VO(2)% (r = -0.392, p = 0.004). On multivariate analysis, the presence of residual RVOT obstruction (p = 0.0007) was the only variable associated with a reduced peak VO(2)%. Patients with a RVOT maximal velocityor =2.5 m/s had a lower peak VO(2)% than those with lower velocities (p0.0001). No relation was found between age at testing and the peak VO(2)%. In conclusion, a reduced exercise capacity is relatively common in children and young adults who have undergone an arterial switch operation, but it does not decrease with age. The presence of residual RVOT obstruction seems to have an effect on exercise capacity.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Heart disease
Adolescent
Transposition of Great Vessels
Vital Capacity
Physical exercise
Risk Assessment
Ventricular Outflow Obstruction
Cohort Studies
Young Adult
Oxygen Consumption
Postoperative Complications
Heart Rate
Predictive Value of Tests
Internal medicine
Heart rate
Medicine
Ventricular outflow tract
Humans
Cardiac Surgical Procedures
Child
Retrospective Studies
Analysis of Variance
Exercise Tolerance
business.industry
Incidence
Age Factors
Transposition of the great vessels
medicine.disease
medicine.anatomical_structure
Treatment Outcome
Great arteries
Echocardiography
Pulmonary valve
Child, Preschool
Circulatory system
Multivariate Analysis
Cardiology
Exercise Test
Female
Cardiology and Cardiovascular Medicine
business
Blood Flow Velocity
Follow-Up Studies
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 104
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....8151f0e98213507edafce3787ca65f6f