Author + information
- Shivani M. Bhatt,
- Elizabeth Goldmuntz,
- Okan Elci,
- Michael McBride,
- Stephen Paridon and
- Laura Mercer-Rosa
Background: Pulmonary insufficiency (PI) and right ventricular (RV) dysfunction are long-term complications in repaired tetralogy of Fallot (rTOF). We sought to investigate changes in PI and RV function that occur with exercise in this patient population.
Methods: Subjects with rTOF presenting for cardiopulmonary exercise test underwent rest and peak exercise echocardiograms. RV contractile reserve was defined as the change in RV global longitudinal strain from rest to peak exercise. PI was assessed with the diastolic to systolic time velocity integral ratio (DSTVI) from Doppler interrogation in the pulmonary artery. Exercise measures included the percent-predicted maximal oxygen consumption (%mVO2), maximum work, and oxygen pulse.
Results: We enrolled 32 patients (age 16.4 ± 4.9 years, 66% male). RV strain was diminished at rest and decreased further at peak exercise (reduced contractile reserve). At peak exercise, the DSTVI decreased, indicating an improvement in PI. This decrease was associated with better maximum work and greater oxygen pulse. A decrease in the diastolic/systolic velocity ratio correlated with better %mVO2. Contractile reserve was not associated with exercise parameters. (Table)
Conclusions: Patients with rTOF have abnormal response to exercise with reduced contractile reserve. The association of reduced PI with superior exercise performance, independent of contractile reserve, warrants further study to understand the diastolic contribution to exercise in rTOF.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Heart Disease: New Diagnostic Approaches in Congenital Heart Disease
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1231-016
- 2017 American College of Cardiology Foundation