title: Long-term benefits of exercise training in patients with a systemic right ventricle.
abstract: OBJECTIVE
  The aim of the present study is to determine the long-term effects of a ten-week exercise training program in adult patients with a systemic right ventricle.
  
  
  METHODS
  All patients who participated in a 2009 randomized controlled trial were approached. At approximately three years of follow-up from initial baseline, patients underwent cardiopulmonary exercise testing, filled out two quality of life questionnaires, and NT proBNP levels were measured. All examinations were performed according to the protocols of the 2009 trial. In addition, patients were asked about their current sports habits.
  
  
  RESULTS
  Of the 54 patients who were randomized in the 2009-trial 40 participated in the current re-evaluation (male 50%, ccTGA 35%, age 36 ± 10 years, intervention group n=22, control group n=18). After three years, no persistent effect of exercise training on V'O₂peak training remained (-2% of predicted, 95% CI -3% to 5%; p=.56). However, patients who already participated in regular sports or exercise at baseline (n=23/40 (58%)) showed higher V'O₂peak of 13% of predicted (95% CI 4% to 23%; p>.01) and a decrease of 62% in plasma NT-proBNP (95% CI -115% to -10%; p>.03) during follow-up, when compared to patients who did not. Moreover, sports were associated with a lower incidence of clinical events (p=.032).
  
  
  CONCLUSIONS
  Short-term beneficial effects of exercise training did not persist over a three-year follow-up period. However, sports participation at baseline was associated with better exercise capacity, lower neurohormone levels, and increased event-free survival.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: van der Bom
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Michiel M
authors.initials: MM
authors.lastname: Winter
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Knaake
authors.affiliation: Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Cervi
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Leonie S C
authors.initials: LS
authors.lastname: de Vries
authors.affiliation: Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Balducci
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Paola G
authors.initials: PG
authors.lastname: Meregalli
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Petronella G
authors.initials: PG
authors.lastname: Pieper
authors.affiliation: Department of Cardiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Arie P J
authors.initials: AP
authors.lastname: van Dijk
authors.affiliation: Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bonvicini
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
authors.forename: Barbara J M
authors.initials: BJ
authors.lastname: Mulder
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: b.j.bouma@amc.uva.nl.
authors.forename: Berto J
authors.initials: BJ
authors.lastname: Bouma
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011788:Quality of Life; D013177:Sports; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014188:Transposition of Great Vessels / Q000150:complications; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Congenital heart disease; Exercise; Sports; Systemic right ventricle; Transposition of the great arteries