Cardiopulmonary exercise test in the evaluation of exercise capacity, arterial hypertension, and degree of descending aorta stenosis in adults after repair of coarctation of the aorta.
BACKGROUND
Despite effective repair of coarctation of the aorta (CoAo), arterial hypertension (AH) and early coronary artery disease that may result in heart failure. The aim of the study was to evaluate exercise capacity by a cardiopulmonary exercise test in patients after of CoAo repair, and to determine relations between these parameters and the presence of AH, residual stenosis of the descending aorta (AoD) and the patient's age at the time of the surgery.


METHODS
74 patients at mean age 31.2 +/- 9.8 years. The controls: 30 at mean age 32.2 +/- 6.6. Descending aorta (AoD) gradient was evaluated by echocardiography. The group with residual AoD stenosis: >/= 25 mm Hg (AoD+) 32 patients and AoD-: 41 patients. Subgroups without AH (AH-, n = 32), exercise-induced AH (AHex, n = 10), persistent AH (AH+, n = 32). The maximum exercise test was performed.


RESULTS
A comparison of the study and control groups: VO(2)max: p = 0.0001), VO(2)max%: p=0.0001 and VE/VCO(2): p = 0.001. Negative correlation: between VO(2)max and the age at the time of surgery: p = 0.004) and a positive: between VE/VCO(2) and age at surgery: p = 0.005. No differences were observed between the AoD+ and AoD- groups with respect to cardiopulmonary parameters. A comparison of the AH+ and AH- groups revealed: VO(2)max: p = 0.01, VO(2)max%: p = 0.02 and VE/VCO(2): p = 0.003. A comparison of the AHex and AH- groups showed VE/VCO(2): p = 0.01.


CONCLUSIONS
The exercise capacity of adults after surgical CoAo repair is reduced. This is more pronounced in patients with AH and those operated on at a more advanced age, but not in AoD+. (Cardiol J 2007; 14: 76-82).
Trojnarska
Olga
O
Gwizdała
Adrian
A
Katarzyńska
Agnieszka
A
Lanocha
Magdalena
M
Katarzyński
Sławomir
S
Oko-Sarnowska
Zofia
Z
Szyszka
Andrzej
A
Kramer
Lucyna
L