title: Exercise performance in Ebstein's anomaly in the course of time - Deterioration in native patients and preserved function after tricuspid valve surgery.
abstract: OBJECTIVE
  The purpose of this study was to assess the longitudinal follow-up of exercise performance in patients with native Ebstein anomaly and patients who had received previous tricuspid valve surgery.
  
  
  METHODS
  We identified 59 patients with Ebstein anomaly who had performed at least two cardiopulmonary exercise tests within a minimum of 6months. 22 patients (15 female, 29.0±13.4years) with native conditions, 37 patients (21 female, 32.1±15.3years) had undergone surgery of their tricuspid valve before baseline testing.
  
  
  RESULTS
  In the non-operated group peak workload (2.58±0.7 to 2.38±0.7W/kg, p=.019) declined during a mean follow-up of 4.6±2.6years, whereas peak workload remained stable in the surgical group (2.02±0.6 to 2.06±0.7W/kg, p=.229) throughout the follow-up of 3.4±2.3years. In the 18 patients who had their surgery less than one year prior to the first CPET the exercise performance even increased during the follow-up. Peak blood pressure as a marker of cardiac adaption to exercise increased in the follow-up examination only in the surgical group (159±23 vs. 171±30mmHg, p=.007). In the non-operated group blood pressure remained unchanged at follow-up (161±26 vs. 166±29, p=.358).
  
  
  CONCLUSIONS
  Exercise performance deteriorates in non-operated patients with Ebstein anomaly in contrast to patients after tricuspid valve surgery where exercise performance remains stable. These facts promote a surgical intervention latest at the time when exercise performance decreases.
authors.affiliation: Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany; Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. Electronic address: j.mueller@tum.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Müller
authors.affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kühn
authors.affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tropschuh
authors.affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Alfred
authors.initials: A
authors.lastname: Hager
authors.affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.affiliation: Department of Cardiac Surgery, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schreiber
authors.affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Kinderherz-Praxis, Leopoldstr. 27, 80802 Munich, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Vogt
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004437:Ebstein Anomaly / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D005080:Exercise Test / Q000379:methods / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014261:Tricuspid Valve / Q000002:abnormalities / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult
keywords: Ebstein anomaly; Exercise capacity; Longitudinal follow-up