title: Exercise capacity and ventricular function in patients treated for isolated pulmonary valve stenosis or tetralogy of Fallot.
abstract: BACKGROUND
  We hypothesized 1) that long-term ventricular outcome and exercise capacity would be better in patients with isolated pulmonary valve stenosis (PS) treated with balloon pulmonary valvuloplasty (BPV) than in patients operated for tetralogy of Fallot (TOF), and 2) that ventricular outcome and exercise capacity would not be different in PS patients and healthy controls.
  
  
  METHODS
  We included 21 PS patients after BPV (16.2 ± 5.2 years) and 21 patients operated for TOF (16.6 ± 5.6 years), matching them for gender, age at treatment, and age at study. Patients underwent cardiovascular magnetic resonance (CMR) imaging, exercise testing, 12-lead ECG and 24-hour Holter monitoring for assessment of right ventricular (RV) size and function, pulmonary regurgitation (PR), exercise capacity and electrocardiographic status. Healthy controls for CMR imaging and exercise testing were matched for gender and age at study.
  
  
  RESULTS
  RV volumes and PR percentage were significantly larger in TOF patients than in PS patients; biventricular ejection fraction (EF) was not different. PR was mild in most PS patients. RV end-systolic volume was significantly larger in PS patients than in healthy controls; RVEF was significantly lower. Both patient groups had similar exercise test results. Peak workload and VO(2) max. were significantly lower in PS patients than in healthy controls.
  
  
  CONCLUSIONS
  Longstanding mild PR in PS patients can lead to an enlarged RV, reduced RV function and reduced exercise capacity. Despite more PR and larger RV volumes in TOF patients, exercise capacity and biventricular function are similar in both patient groups.
authors.affiliation: Department of Pediatrics, Division of Cardiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Saskia E
authors.initials: SE
authors.lastname: Luijnenburg
authors.forename: Wilfred B
authors.initials: WB
authors.lastname: de Koning
authors.forename: Soha
authors.initials: S
authors.lastname: Romeih
authors.forename: Jochem
authors.initials: J
authors.lastname: van den Berg
authors.forename: Hubert W
authors.initials: HW
authors.lastname: Vliegen
authors.forename: Barbara J M
authors.initials: BJ
authors.lastname: Mulder
authors.forename: Willem A
authors.initials: WA
authors.lastname: Helbing
mesh_terms: D000293:Adolescent; D063126:Balloon Valvuloplasty; D002648:Child; D004562:Electrocardiography; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D011666:Pulmonary Valve Stenosis / Q000503:physiopathology* / Q000601:surgery; D013771:Tetralogy of Fallot / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult