Research Centre for Cardiovascular and Respiratory Rehabilitation, Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101 bus 1501, 3001 Heverlee, Belgium.
Int J Cardiol. 2011 Nov 17;153(1):26-30. doi: 10.1016/j.ijcard.2010.08.030. Epub 2010 Sep 16.
Exercise capacity in grown-ups with congenital heart disease (GUCH) is mostly reported by peak oxygen consumption (peak VO(2)). Our aim was to evaluate the maximal character of exercise tests, and to investigate submaximal measures of exercise capacity.
Adults with Coarctation of the Aorta (COA, n=155), Tetralogy of Fallot (TOF, n=98), dextro-Transposition of the Great Arteries (dTGA, n=68) and Univentricular Heart (UVH, n=10), and 122 healthy adults performed cardiopulmonary exercise testing until exhaustion. Gas exchange was measured breath by breath. The maximal performance of the test was evaluated by respiratory exchange ratio (RER), ventilatory equivalent for oxygen and Borg scale. Oxygen uptake efficiency slope (OUES), VE/VCO(2) slope and VO(2)/WR slope were calculated and ventilatory anaerobic threshold (VAT) was defined. Correlations of these measures with peak VO(2) were calculated.
GUCH showed significantly lower peak VO(2) than controls (p<0.001), declining from 80% in COA, 74% in TOF, 64% in dTGA, to 55% in UVH. Compared to suggested criteria, mean peak RER and median Borg scale indicated a maximal effort in GUCH, however these results were significantly lower than controls (p<0.05). OUES, VO(2)/WR slope and VAT were significantly lower in patients compared to controls. OUES (r=0.853) and VAT (r=0.840) correlated best with peak VO(2); VO(2)/WR slope (r=0.551) and VE/VCO(2) slope (r=-0.421) correlated to a lesser degree (p<0.001).
The investigated GUCH show reduced exercise tolerance compared to controls, related to the underlying heart defect. Different expressions of exercise tolerance clearly reveal the same differences in exercise capacity across groups of GUCH.
成人先天性心脏病（GUCH）患者的运动能力主要通过峰值耗氧量（peak VO(2)）来报告。我们的目的是评估运动试验的最大特征，并研究运动能力的次最大指标。
155 例主动脉缩窄（COA）、98 例法洛四联症（TOF）、68 例右位-大动脉转位（dTGA）和 10 例单心室心脏（UVH）的成年人以及 122 例健康成年人进行心肺运动测试直至力竭。气体交换通过呼吸进行测量。通过呼吸交换比（RER）、氧通气当量和 Borg 量表评估测试的最大性能。计算摄氧量效率斜率（OUES）、VE/VCO(2)斜率和 VO(2)/WR 斜率，并定义通气无氧阈（VAT）。计算这些指标与峰值 VO(2)的相关性。
GUCH 的峰值 VO(2)明显低于对照组（p<0.001），从 COA 的 80%、TOF 的 74%、dTGA 的 64%下降到 UVH 的 55%。与建议的标准相比，平均峰值 RER 和中位数 Borg 量表表明 GUCH 达到了最大努力，但这些结果明显低于对照组（p<0.05）。与对照组相比，OUES、VO(2)/WR 斜率和 VAT 在患者中明显降低。OUES（r=0.853）和 VAT（r=0.840）与峰值 VO(2)相关性最好；VO(2)/WR 斜率（r=0.551）和 VE/VCO(2)斜率（r=-0.421）相关性稍差（p<0.001）。
与对照组相比，所研究的 GUCH 患者的运动耐量降低，这与潜在的心脏缺陷有关。不同的运动耐量表现清楚地揭示了 GUCH 各组之间运动能力的相同差异。
