RT Journal Article
SR Electronic
T1 Exercise capacity in patients with repaired Tetralogy of Fallot aged 6 to 63 years
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2020-318928
DO 10.1136/heartjnl-2020-318928
A1 Graziella Eshuis
A1 Julia Hock
A1 Gideon Marchie du Sarvaas
A1 Hiske van Duinen
A1 Rhoia Neidenbach
A1 Freek van den Heuvel
A1 Hans Hillege
A1 Rolf MF Berger
A1 Alfred Hager
YR 2021
UL http://heart.bmj.com/content/early/2021/05/13/heartjnl-2020-318928.abstract
AB Objectives This study aimed to provide a perspective for the interpretation of exercise capacity (peakVO2) in patients with repaired Tetralogy of Fallot (patients with rTOF) by describing the course of peakVO2 from patients aged 6–63 years.Methods A retrospective study was performed between September 2001 and December 2016 in the German Heart Centre Munich, Germany, and in the University Medical Centre Groningen, the Netherlands. A total of 1175 cardiopulmonary exercise tests (CPETs) were collected from 586 patients with rTOF, 46% female. Maximal exertion was verified using a respiratory exchange ratio ≥1.00. PeakVO2 was modelled using time-dependent multilevel models for repeated measurements (n=889 in 300 patients), and compared with subject-specific reference values calculated by the models of Bongers et al and Mylius et al.Results The peakVO2 of patients with rTOF was reduced at all ages. At the age of 6, the peakVO2 was 614 mL/min (70% of predicted (95% CI 67 to 73)). The reduced increase in peakVO2 during adolescence resulted in a significant lower maximum peakVO2 of 1209 mL/min at 25 years (65% predicted, p<0.001). A linear decline after 25 years was observed in patients and references, although patients showed an accelerated decline, with a -0.24% point of predicted (95% CI 0.11 to 0.38) per year without differences between sexes (p=0.263).Conclusions This study provides a context for peakVO2 across ages in patients with rTOF under contemporary treatment strategies. It showed that the reduction in peakVO2 originates from childhood and declines over time. Sex differences in patients with rTOF were similar to natural existing sex differences.Data are available on reasonable request. Please contact the corresponding author for questions about the availability of the data.