Exercise capacity in adult patients with tetralogy of Fallot

Background: On a group level, patients with repaired tetralogy of Fallot have impaired exercise capacity. Since exercise capacity is related to prognosis, and more patients survive into higher age, it is important to know the expected exercise capacity at different ages. Furthermore, factors associa...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Anette Sandström, Anna Wikner, Daniel Rinnström, Camilla Sandberg, Christina Christersson, Mikael Dellborg, Niels Erik Nielsen, Peder Sörensson, Ulf Thilén, Bengt Johansson
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Adult congenital heart disease Tetralogy of Fallot Exercise test Exercise capacity Register Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/22f1742bdf514e38b930e644a0004324
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:22f1742bdf514e38b930e644a0004324
record_format	dspace
spelling	oai:doaj.org-article:22f1742bdf514e38b930e644a00043242021-11-06T04:37:46ZExercise capacity in adult patients with tetralogy of Fallot2666-668510.1016/j.ijcchd.2021.100204https://doaj.org/article/22f1742bdf514e38b930e644a00043242021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666668521001282https://doaj.org/toc/2666-6685Background: On a group level, patients with repaired tetralogy of Fallot have impaired exercise capacity. Since exercise capacity is related to prognosis, and more patients survive into higher age, it is important to know the expected exercise capacity at different ages. Furthermore, factors associated with exercise capacity and the relation between exercise capacity and mortality need further evaluation. Methods: The national register of congenital heart disease was searched for exercise tests in adults with repaired tetralogy of Fallot. The results from exercise tests were compared with national reference data. Results: 314 patients were identified (median age 33.2 [IQR 24.8–44.7], 40.8% women). The mean percent of predicted workload was 74.8 (±19.6) % without change across ages. In multivariable analysis, NYHA class I (odds ratio [OR]4.2, 95% confidence interval [CI]1.7–10.0) and higher physical activity level (>3 h/week) (OR 3.6, 95%CI 1.8–7.3) were positively associated with higher exercise capacity, while ongoing cardiovascular therapy (OR 0.4, 95%CI 0.2–0.7) and male sex (OR 0.3, 95%CI 0.2–0.6) were negatively associated with higher exercise capacity. Both exercise capacity (HR 0.96, 95%CI 0.93–0.98) and heart rate reserve (HR 0.96, 95%CI 0.94–0.98) were associated with mortality. Conclusions: In patients with repaired tetralogy of Fallot the exercise capacity was approximately 75% of expected, regardless of age. Patients with better NYHA class and high physical activity level had a higher exercise capacity. Low exercise capacity and low heart rate reserve were associated with higher mortality. Therefore, evaluating exercise capacity as part of follow up is of importance.Anette SandströmAnna WiknerDaniel RinnströmCamilla SandbergChristina ChristerssonMikael DellborgNiels Erik NielsenPeder SörenssonUlf ThilénBengt JohanssonElsevierarticleAdult congenital heart diseaseTetralogy of FallotExercise testExercise capacityRegisterDiseases of the circulatory (Cardiovascular) systemRC666-701ENInternational Journal of Cardiology Congenital Heart Disease, Vol 5, Iss , Pp 100204- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Adult congenital heart disease Tetralogy of Fallot Exercise test Exercise capacity Register Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Adult congenital heart disease Tetralogy of Fallot Exercise test Exercise capacity Register Diseases of the circulatory (Cardiovascular) system RC666-701 Anette Sandström Anna Wikner Daniel Rinnström Camilla Sandberg Christina Christersson Mikael Dellborg Niels Erik Nielsen Peder Sörensson Ulf Thilén Bengt Johansson Exercise capacity in adult patients with tetralogy of Fallot
description	Background: On a group level, patients with repaired tetralogy of Fallot have impaired exercise capacity. Since exercise capacity is related to prognosis, and more patients survive into higher age, it is important to know the expected exercise capacity at different ages. Furthermore, factors associated with exercise capacity and the relation between exercise capacity and mortality need further evaluation. Methods: The national register of congenital heart disease was searched for exercise tests in adults with repaired tetralogy of Fallot. The results from exercise tests were compared with national reference data. Results: 314 patients were identified (median age 33.2 [IQR 24.8–44.7], 40.8% women). The mean percent of predicted workload was 74.8 (±19.6) % without change across ages. In multivariable analysis, NYHA class I (odds ratio [OR]4.2, 95% confidence interval [CI]1.7–10.0) and higher physical activity level (>3 h/week) (OR 3.6, 95%CI 1.8–7.3) were positively associated with higher exercise capacity, while ongoing cardiovascular therapy (OR 0.4, 95%CI 0.2–0.7) and male sex (OR 0.3, 95%CI 0.2–0.6) were negatively associated with higher exercise capacity. Both exercise capacity (HR 0.96, 95%CI 0.93–0.98) and heart rate reserve (HR 0.96, 95%CI 0.94–0.98) were associated with mortality. Conclusions: In patients with repaired tetralogy of Fallot the exercise capacity was approximately 75% of expected, regardless of age. Patients with better NYHA class and high physical activity level had a higher exercise capacity. Low exercise capacity and low heart rate reserve were associated with higher mortality. Therefore, evaluating exercise capacity as part of follow up is of importance.
format	article
author	Anette Sandström Anna Wikner Daniel Rinnström Camilla Sandberg Christina Christersson Mikael Dellborg Niels Erik Nielsen Peder Sörensson Ulf Thilén Bengt Johansson
author_facet	Anette Sandström Anna Wikner Daniel Rinnström Camilla Sandberg Christina Christersson Mikael Dellborg Niels Erik Nielsen Peder Sörensson Ulf Thilén Bengt Johansson
author_sort	Anette Sandström
title	Exercise capacity in adult patients with tetralogy of Fallot
title_short	Exercise capacity in adult patients with tetralogy of Fallot
title_full	Exercise capacity in adult patients with tetralogy of Fallot
title_fullStr	Exercise capacity in adult patients with tetralogy of Fallot
title_full_unstemmed	Exercise capacity in adult patients with tetralogy of Fallot
title_sort	exercise capacity in adult patients with tetralogy of fallot
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/22f1742bdf514e38b930e644a0004324
work_keys_str_mv	AT anettesandstrom exercisecapacityinadultpatientswithtetralogyoffallot AT annawikner exercisecapacityinadultpatientswithtetralogyoffallot AT danielrinnstrom exercisecapacityinadultpatientswithtetralogyoffallot AT camillasandberg exercisecapacityinadultpatientswithtetralogyoffallot AT christinachristersson exercisecapacityinadultpatientswithtetralogyoffallot AT mikaeldellborg exercisecapacityinadultpatientswithtetralogyoffallot AT nielseriknielsen exercisecapacityinadultpatientswithtetralogyoffallot AT pedersorensson exercisecapacityinadultpatientswithtetralogyoffallot AT ulfthilen exercisecapacityinadultpatientswithtetralogyoffallot AT bengtjohansson exercisecapacityinadultpatientswithtetralogyoffallot
_version_	1718443840888635392

Exercise capacity in adult patients with tetralogy of Fallot

Ejemplares similares