BACKGROUND: The identification of patients with adult congenital heart disease (ACHD) who are at higher risk of death is challenging. Peak circulatory power (CircP; expressed as peak exercise oxygen uptake multiplied for peak mean arterial blood pressure) is a strong predictor of death in adults with acquired heart disease. We sought to establish the distribution and the prognostic value of peak CircP across a wide spectrum of patients with ACHD. METHODS: Four hundred thirty-two consecutive patients with ACHD of varying diagnosis underwent cardiopulmonary exercise testing at a single laboratory between 1996 and 2005. Patient age was 32 +/- 10 years. RESULTS: A gradual variation in peak CircP was found across the spectrum of congenital heart defects (P < .0001 at analysis of variance). Reduced peak CircP values were associated with the presence of heart failure symptoms (P < .0001), absence of sinus rhythm (P = .010), and use of antiarrhythmic medications (P = .0013). At a follow-up of 4.4 +/- 2.4 years, 23 patients (5.3%) had died. Peak CircP was a strong predictor of mortality when univariate analysis was used and the strongest independent predictor of mortality among exercise parameters. A peak CircP < or = 1476 mm Hg mlO2 min(-1) kg(-2) was associated with a 15.4-fold increase in the 4-year risk of death. CONCLUSIONS: Peak CircP is abnormal across the spectrum of ACHD. Peak CircP appears as the strongest predictor of adverse outcome in ACHD.
BACKGROUND: The identification of patients with adult congenital heart disease (ACHD) who are at higher risk of death is challenging. Peak circulatory power (CircP; expressed as peak exercise oxygen uptake multiplied for peak mean arterial blood pressure) is a strong predictor of death in adults with acquired heart disease. We sought to establish the distribution and the prognostic value of peak CircP across a wide spectrum of patients with ACHD. METHODS: Four hundred thirty-two consecutive patients with ACHD of varying diagnosis underwent cardiopulmonary exercise testing at a single laboratory between 1996 and 2005. Patient age was 32 +/- 10 years. RESULTS: A gradual variation in peak CircP was found across the spectrum of congenital heart defects (P < .0001 at analysis of variance). Reduced peak CircP values were associated with the presence of heart failure symptoms (P < .0001), absence of sinus rhythm (P = .010), and use of antiarrhythmic medications (P = .0013). At a follow-up of 4.4 +/- 2.4 years, 23 patients (5.3%) had died. Peak CircP was a strong predictor of mortality when univariate analysis was used and the strongest independent predictor of mortality among exercise parameters. A peak CircP < or = 1476 mm Hg mlO2 min(-1) kg(-2) was associated with a 15.4-fold increase in the 4-year risk of death. CONCLUSIONS: Peak CircP is abnormal across the spectrum of ACHD. Peak CircP appears as the strongest predictor of adverse outcome in ACHD.
Authors: Olga Trojnarska; Adrian Gwizdała; Sławomir Katarzyński; Agnieszka Katarzyńska; Zofia Oko-Sarnowska; Piotr Bręborowicz; Stefan Grajek Journal: Arch Med Sci Date: 2010-04-30 Impact factor: 3.318
Authors: Polliana B Dos Santos; Rodrigo P Simões; Cássia da L Goulart; Meliza G Roscani; Renan S Marinho; Patrícia Faria Camargo; Renata F Arbex; Guilherme Casale; Cláudio R Oliveira; Renata G Mendes; Ross Arena; Audrey Borghi-Silva Journal: Int J Chron Obstruct Pulmon Dis Date: 2021-02-03
Authors: Janne Hulkkonen; Heikki Aatola; Kristiina Pälve; Terho Lehtimäki; Nina Hutri-Kähönen; Jorma Sa Viikari; Olli T Raitakari; Mika Kähönen Journal: BMC Cardiovasc Disord Date: 2014-03-13 Impact factor: 2.298
Authors: Derek L Tran; David S Celermajer; Julian Ayer; Leeanne Grigg; Carley Clendenning; Tim Hornung; Robert Justo; Glen M Davis; Yves d'Udekem; Rachael Cordina Journal: Front Cardiovasc Med Date: 2021-12-07