title: Right ventricular systolic pressure response during exercise in adolescents born with atrial or ventricular septal defect.
abstract: Our study investigated the abnormal right ventricular systolic pressure response (RVPR) in young patients with isolated atrial septal defect (ASD) or ventricular septal defect (VSD). An abnormal RVPR >50 mm Hg during exercise has been identified as a precursor of pulmonary artery hypertension. The present study included a population-based selection of 44 patients (age 13 to 25 years) with either isolated VSD (n = 27) or ASD (n = 17) and without right ventricular outflow tract obstruction. Of the 44 defects, 28 had been surgically closed (17 ASDs and 11 VSDs); 16 minor VSDs were untreated. Cardiovascular exercise testing and echocardiography at rest and during exercise were performed for all patients and 88 healthy controls. The aerobic capacity was significantly reduced in all patient groups (open VSD, closed VSD, closed ASD). The measurements of right ventricular performance were significantly lower in patients with closed ASD or closed VSD compared to those of the controls and patients with open VSD. Finally, 5% of the controls, no patient with ASD, and 9 patients with VSD (33%), regardless of defect closure, had an abnormal RVPR during exercise. In conclusion, 1/3 of young patients with isolated VSD had an abnormal RVPR during exercise.
authors.affiliation: Department of Pediatrics, Vestfold Hospital Trust, Tønsberg, Norway. thomas.moller@siv.no
authors.forename: Thomas
authors.initials: T
authors.lastname: Möller
authors.forename: Henrik
authors.initials: H
authors.lastname: Brun
authors.forename: Per Morten
authors.initials: PM
authors.lastname: Fredriksen
authors.forename: Henrik
authors.initials: H
authors.lastname: Holmstrøm
authors.forename: Kari
authors.initials: K
authors.lastname: Peersen
authors.forename: Eirik
authors.initials: E
authors.lastname: Pettersen
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Grünig
authors.forename: Derliz
authors.initials: D
authors.lastname: Mereles
authors.forename: Erik
authors.initials: E
authors.lastname: Thaulow
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001794:Blood Pressure; D016022:Case-Control Studies; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D013599:Systole