Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention?
| Autor: | Mirosław Kowalski, Mateusz Śpiewak, Ewa Piotrowicz, Aneta Fronczak, Marcin Demkow, Witold Rużyłło, Magdalena Mazgaj, Piotr Hoffman, Krzysztof Weroński, Ryszard Piotrowicz, Elżbieta Katarzyna Biernacka |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Heart Defects Congenital Male medicine.medical_specialty Cardiac Catheterization Time Factors Adolescent medicine.medical_treatment Hemodynamics Young Adult Oxygen Consumption Double outlet right ventricle Predictive Value of Tests Internal medicine medicine Humans Cardiac Surgical Procedures Tetralogy of Fallot Retrospective Studies Heart Valve Prosthesis Implantation Pulmonary Valve Ejection fraction Exercise Tolerance business.industry Ross procedure Patient Selection General Medicine Recovery of Function medicine.disease Magnetic Resonance Imaging Pulmonary Valve Insufficiency Pulmonary Valve Stenosis medicine.anatomical_structure Treatment Outcome Great arteries Echocardiography Pulmonary valve Cardiology Exercise Test Female Cardiology and Cardiovascular Medicine Pulmonary atresia business |
| Zdroj: | Cardiology journal. 22(3) |
| ISSN: | 1898-018X |
| Popis: | Background: The aim of the study was to evaluate the role of cardiopulmonary exercise testing (CPET) parameters in assessing exercise capacity improvement after percutaneous pulmonary valve implantation (PPVI). Additionally, it aimed to determine if there are any baseline characteristics influencing that change. Methods and results: The study comprised 32 patients (mean age 26 ± 9); 53% males; diagnosis: tetralogy of Fallot (n = 18), pulmonary atresia (n = 6), Ross procedure (n = 4), other (transposition of great arteries, pulmonary stenosis, double outlet right ventricle, common arterial trunk type II — n = 4) who underwent successful PPVI due to right ventricular outflow tract dysfunction (predominant pulmonary regurgitation — n = 17, predominant pulmonary stenosis — n = 15). Treadmill CPET was performed before and a year after PPVI along with clinical evaluation, cardiac magnetic resonance and transthoracic echocardiography. Twelve months post successful PPVI (pulmonary valve competence restoration and pulmonary gradient reduction from 58.8 ± 47.1 to 26.6 ± 10.8 mm Hg) there was a significant decrease in the ventilatory equivalent for CO2 at peak exercise (EQCO 2 ) (25.3 ± 3.3 to 24.3 ± 3.0, p = 0.04) and oxygen consumption at peak exercise (pVO2) (20.4 ± 5.0 to 22.6 ± 5.3 mL/kg/min, p = 0.04). Improved EQCO2 correlated with an increase in right and left ventricular ejection fraction (respectively R = –0.57, p = 0.002; R = –0.56, p = 0.002). In this study, no baseline factors that might affect improvement in exercise function were found. Conclusions: Successful PPVI leads to an improvement in exercise capacity and hemodynamic response to exercise. The correlation between the improvement in EQCO2 or peak VO2 and baseline characteristics was too weak to reliably identify the group of patients that will benefit from the procedure |
| Databáze: | OpenAIRE |
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