Characteristics of exercise intolerance in different subgroups of pulmonary arterial hypertension associated with congenital heart disease.
Int J Cardiol
; 375: 29-35, 2023 03 15.
Article
em En
| MEDLINE
| ID: mdl-36565957
ABSTRACT
BACKGROUND:
Exercise intolerance is a major manifestation of pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). We aimed to investigate the characteristics of exercise intolerance in different subgroups of PAH-CHD.METHODS:
We retrospectively enrolled 171 adult patients with PAH-CHD and 30 age and sex-matched healthy subjects and performed cardiopulmonary exercise testing. Gas exchange parameters, including peak oxygen uptake (peak VÌo2), anaerobic threshold, and the slope of ventilatory equivalent for carbon dioxide (VÌe/VÌco2 slope), were recorded.RESULTS:
The median age of patients at enrollment was 27.8 years, and 131 (76.6%) were female. Peak VÌo2 was reduced in patients compared to healthy controls (median, 14.8 ml/kg/min versus 26.9 ml/kg/min, p < 0.001). Of all 171 patients, 60 (35.1%) had Eisenmenger syndrome, 35 (20.5%) had PAH associated with systemic-to-pulmonary shunts (PAH-SP), 39 (22.8%) had PAH with small defects (PAH-SD), and 37 (21.6%) had PAH after cardiac defect correction (PAH-CD). Patients with Eisenmenger syndrome had the lowest peak VÌo2 (p = 0.003) and the highest VÌe/VÌco2 slope (p = 0.012), compared with other patients, representing the worst exercise capacity and ventilatory efficiency. Patients with PAH-SP had the best exercise capacity among the four groups, indicated by the highest peak VÌo2 (p = 0.003) compared with other patients. Peak VÌo2 was negatively correlated with pulmonary vascular resistance (r = -0.411, p < 0.001).CONCLUSIONS:
Exercise capacity was severely reduced in patients with PAH-CHD. Among the four subgroups, patients with Eisenmenger syndrome had the worst exercise capacity and ventilatory efficiency.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complexo de Eisenmenger
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Hipertensão Arterial Pulmonar
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Cardiopatias Congênitas
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Insuficiência Cardíaca
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
China