Novaković Marko, Prokšelj Katja, Jug Borut
University Medical Centre Ljubljana, Division of Internal Medicine, Department of Vascular Diseases, Ljubljana, Slovenia.
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.
Int J Cardiol Congenit Heart Dis. 2022 Jan 15;7:100327. doi: 10.1016/j.ijcchd.2022.100327. eCollection 2022 Mar.
Exercise capacity and endothelial function are impaired in adults with repaired tetralogy of Fallot (ToF). This may be related to pathophysiological determinants, such as cardiac and endothelial impairment, or to a more sedentary lifestyle. Therefore, we sought to assess if cardiac and endothelial function are associated with exercise capacity in adults with repaired ToF.
In a case-control study, we compared adults with repaired ToF and controls in terms of exercise workload, peak oxygen consumption (VO2peak) and flow-mediated dilation (FMD). Additionally, we determined associations of natriuretic peptide levels, echocardiographic parameters of size, function and systolic pressure with exercise capacity.
A total of 26 patients (mean age 38 ± 10 years, 46% males) and 10 controls were included. Patients with repaired ToF had reduced VO2peak (25.0 vs. 36.3 ml/kg/min, p < 0.001) and FMD (7.6 vs. 10.8%, p = 0.007) compared to controls. Exercise workload was moderately associated with FMD (r = 0.428, p = 0.029) and right ventricular parameters, while VO2peak was moderately associated with natriuretic peptide levels (r = -0.523, p = 0.006).
Adults with repaired ToF have impaired exercise capacity and endothelial function as compared to healthy controls. Natriuretic peptide levels and FMD are moderately associated with exercise capacity in adults with repaired ToF.
法洛四联症（ToF）修复术后的成年人运动能力和内皮功能受损。这可能与病理生理决定因素有关，如心脏和内皮功能损害，或与久坐不动的生活方式有关。因此，我们试图评估心脏和内皮功能是否与ToF修复术后成年人的运动能力相关。
在一项病例对照研究中，我们比较了ToF修复术后的成年人与对照组在运动负荷、峰值耗氧量（VO2peak）和血流介导的血管舒张（FMD）方面的情况。此外，我们还确定了利钠肽水平、大小、功能和收缩压的超声心动图参数与运动能力之间的关联。
共纳入26例患者（平均年龄38±10岁，46%为男性）和10例对照组。与对照组相比，ToF修复术后的患者VO2peak降低（25.0 vs. 36.3 ml/kg/min，p<0.001），FMD降低（7.6 vs. 10.8%，p = 0.007）。运动负荷与FMD（r = 0.428，p = 0.029）和右心室参数中度相关，而VO2peak与利钠肽水平中度相关（r = -0.523，p = 0.006）。
与健康对照组相比，ToF修复术后的成年人运动能力和内皮功能受损。利钠肽水平和FMD与ToF修复术后成年人的运动能力中度相关。
