title: Exercise Performance in Children and Young Adults After Complete and Incomplete Repair of Congenital Heart Disease.
abstract: Few previous studies have addressed exercise capacity in patients with corrected congenital heart disease (CHD) and significant anatomical residua. The aim of this study was to determine the aerobic fitness and peak cardiac function of patients with corrected CHD with complete or incomplete repairs, as determined by resting echocardiography. Children, adolescents and young adults (<40 years) with CHD from both sexes, who had previously undergone biventricular corrective therapeutic interventions (n = 73), and non-CHD control participants (n = 76) underwent cardiopulmonary exercise testing. The CHD group was further divided according to the absence/presence of significant anatomical residua on a resting echocardiogram ("complete"/"incomplete" repair groups). Aerobic fitness and cardiac function were compared between groups using linear regression and analysis of covariance. Peak oxygen consumption, O2 pulse and ventilatory threshold were significantly lower in CHD patients compared with controls (all p < 0.01). Compared with the complete repair group, the incomplete repair group had a significantly lower mean peak work rate, age-adjusted O2 pulse (expressed as % predicted) and a higher VE/VCO2 ratio (all p ≤ 0.05). Peak oxygen consumption was comparable between the subgroups. Patients after corrected CHD have lower peak and submaximal exercise parameters. Patients with incomplete repair of their heart defect had decreased aerobic fitness, with evidence of impaired peak cardiac function and lower pulmonary perfusion. Patients that had undergone a complete repair had decreased aerobic fitness attributed only to deconditioning. These newly identified differences explain why in previous studies, the lowest fitness was seen in patients with the most hemodynamically significant heart malformations.
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Omer
authors.initials: O
authors.lastname: Rosenblum
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Edmond J. Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Uriel
authors.initials: U
authors.lastname: Katz
authors.affiliation: Edmond J. Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Ronen
authors.initials: R
authors.lastname: Reuveny
authors.affiliation: Children's Health and Exercise Research Center, Sport and Health Sciences, University of Exeter, Exeter, UK.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Williams
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. gal.dubnov-raz@sheba.health.gov.il.|Exercise, Nutrition and Lifestyle Clinic, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel. gal.dubnov-raz@sheba.health.gov.il.
authors.forename: Gal
authors.identifier: http://orcid.org/0000-0003-1469-8043
authors.initials: G
authors.lastname: Dubnov-Raz
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D016022:Case-Control Studies; D002648:Child; D004452:Echocardiography; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D016014:Linear Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Cardiac; Congenital; Fitness; Heart; Malformation