https://scholars.lib.ntu.edu.tw/handle/123456789/475316
標題: | Assessing late cardiopulmonary function in patients with repaired tetralogy of fallot using exercise cardiopulmonary function test and cardiac magnetic resonance | 作者: | Yang M.-C. CHUN-AN CHEN Chiu H.-H. SSU-YUAN CHEN JOU-KOU WANG MING-TAI LIN SHUENN-NAN CHIU CHUN-WEI LU SHU-CHIEN HUANG MEI-HWAN WU |
公開日期: | 2015 | 出版社: | Republic of China Society of Cardiology | 卷: | 31 | 期: | 6 | 起(迄)頁: | 478-484 | 來源出版物: | Acta Cardiologica Sinica | 摘要: | Background: Patients with repaired tetralogy of Fallot (TOF) usually experience progressive right ventricle (RV) dysfunction due to pulmonary regurgitation (PR). This could further worsen the cardiopulmonary function. This study aimed to compare the changes in patient exercise cardiopulmonary test and cardiac magnetic resonance imaging, and consider the implication of these changes. Methods: Our study examined repaired TOF patients who underwent cardiopulmonary exercise test (CPET) to obtain maximal (peak oxygen consumption, peak VO2) and submaximal parameters (oxygen uptake efficiency plateau, oxygen uptake efficiency plateau (OUEP), and ratio of minute ventilation to carbon dioxide production, VE/VCO2 slope). Additionally, the hemodynamic statuswas assessed by using cardiacmagnetic resonance. Criteria for exclusion included TOF patients with pulmonary atresia, atrioventricular septal defect, or absence of pulmonary valve syndrome. Results: We enrolled 158 patients whose mean age at repair was 7.8 ± 9.1 years (range 0.1-49.2 years) and the mean patient age at CPETwas 29.5 ± 12.2 years (range 7.0-57.0 years). Severe PR (PR fraction 40%) in 53 patients, moderate in 55, and mild (PR fraction > 20%) in 50 patients were noted. The mean RV end-diastolic volume index (RVEDVi) was 113 ± 35 ml/m2,with 7 patients observed to have a RVEDVi < 163ml/m2. The mean left ventricular ejection fraction (LVEF) was 63 ± 8%, left ventricular end-diastolic volume index (LVEDVi) was 65 ± 12 ml/m2, and LVESVi was 25 ± 14 ml/m2. CPET revealed significantly decreased peak VO2 (68.5 ± 14.4% of predicted), and fair OUEP (90.3 ± 14.1% of predicted) and VE/VCO2 slope (27.1 ± 5.3). PR fraction and age at repair were negatively correlated with maximal and submaximal exercise indicators (peak VO2 and OUEP). Left ventricular (LV) function and size were positively correlated with peak VO2 and OUEP. Conclusions: The results of CPET showed that patients with repaired TOF had a lowmaximal exercise capacity (peak VO2), but a fair submaximal exercise capacity (OUEP and VE/VCO2 slope), suggesting limited exercise capability in high intensity circumstances. PR, LV function and age at total repair were the most important determinants of CPET performance. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84958183710&doi=10.6515%2fACS20150210A&partnerID=40&md5=fe888aad6f21f9177480317d9dd7793f https://scholars.lib.ntu.edu.tw/handle/123456789/475316 |
ISSN: | 1011-6842 | DOI: | 10.6515/ACS20150210A | SDG/關鍵字: | carbon dioxide; Article; atrioventricular septal defect; cardiopulmonary exercise test; cardiopulmonary function; cardiovascular magnetic resonance; dyspnea; Fallot tetralogy; heart left ventricle ejection fraction; heart left ventricle enddiastolic volume; heart right ventricle enddiastolic volume; heart right ventricle endsystolic volume; human; major clinical study; oxygen consumption; pulmonary valve atresia; pulmonary valve disease; pulmonary valve replacement; QRS interval |
顯示於: | 醫學系 |
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