Author + information
- Markus Schwerzmann,
- Pascal Schmidheiny,
- Kerstin Wustmann,
- Andreas Wahl,
- Jean-Pierre Pfammatter and
- Alexander Kadner
: Histological structural abnormalities of the medial aorta are common in adults with conotruncal defects. Using cardiac magnetic resonance imaging (MRI), we documented a decreased distensibility of the ascending aorta in these repaired adults compared to controls. We hypothesize that impaired aortic distensibility increases the afterload burden for the subaortic ventricle and compromises cardiac output during exercise.
Exercise capacity was assessed by cardiopulmonary exercise testing in 26 adults with d-TGA and an atrial switch procedure, and 35 adults with repaired TOF, and analyzed in relation to the patients’ characteristics, the ejection fraction of the subaortic ventricle, and the ascending aortic distensibility.
The mean age of adults with repaired TOF was 29 ± 10.6 years, and 23.4 ± 7.4 years in adults with d-TGA (p=0.026). Absolute exercise capacity did not differ between both groups nor the percentage of predicted peakVO2 (76 ± 27% and 73 ± 20, p=0.638). In a multivariate regression analysis with age, gender, type of congenital defect, body surface area, subaortic ejection fraction and aortic distensibility as predictors of peakVO2, the only independent predictors of exercise capacity were gender and aortic distensibility (Table 1)
Impaired aortic distensibility predicts exercise capacity in adults with repaired conotruncal defects, independent of the subaortic ejection fraction.
Oral Contributions West, Room 3005
Sunday, March 10, 2013, Noon-12:15 p.m.
Session Title: Congenital Cardiology Solutions: Adult
Abstract Category: 12. Congenital Cardiology Solutions: Adult
Presentation Number: 924-8
- 2013 American College of Cardiology Foundation