Congenital Heart Disease and utility of Cardiopulmonary Exercise Testing

Introduction The number of patients with congenital heart disease reaching adulthood has progressively increased due to advances in technology and treatment. The cardiopulmonary exercise testing (CPET) is an essential tool, allowing a broad assessment of functional capacity and facilitating the evaluation of the need for therapeutic interventions.

Methodology Descriptive and observational study of 4 years duration with 49 cases under follow-up for patients who were referred for the performance of CPET. General, anthropometric, functional and test results data were collected.

Results Mean age 31.37±11.65 years (49% women), mean BMI 25.11 ± 4.38. The most frequent cardiopathies were: 14 Tetralogy of Fallot, 6 transposition of great vessels, 6 pulmonary atresia, 3 Ebstein's anomaly, 3 single ventricle and 17 miscellaneous. 49% presented dyspnea, 42.9% were asymptomatic. Spirometric data: FEV1 2,751±847ml (73.74±15.78%), FVC 3,316 ± 1,016ml (72.67±13.98%); FEV1/FVC 83.10±7.49%. TLco was 7.98±2.38 (80.41±18.4%). The mean duration of exercise was 6.40±2.32 minutes, stopping in 81.6% due to dyspnea. The results obtained are shown in Table. Limited aerobic capacity was observed in 93.9% of cases, low anaerobic threshold in 73.5% and decreased mechanical efficiency in 73.5%. 85% of patients failed to exhaust cardiac reserve, with reduced O2 pulse in 65.3%. After being reviewed in Cardiology: 78.72% did not undergo a change of treatment, 3 cases were reintervened, 2 are waiting for cardiac transplantation and 5 are awaiting a definitive decision ([Tab. 1]).

Conclusions CPET allows an objective assessment of functional capacity in addition to providing parameters that correlate with morbidity and mortality, which makes it a very useful test in the follow-up. Most of the patients present limited aerobic capacity, low anaerobic threshold, mechanical efficiency and a VE/VCO2 slope with mild alteration without presenting ventilatory reserve affectation.

Publication History

Article published online:
09 March 2023