Key result
Submaximal exercise parameters, including OUES (AUC 0.781, P=0.018) and V˙E/V˙CO2 slope (AUC 0.714, P=0.04), were significantly associated with 2-year cardiac morbidity in Fontan patients.
Why the study?
Do submaximal exercise parameters predict cardiac morbidity better than maximal exercise parameters in Fontan patients?
Cohort (n=52)
Do submaximal exercise parameters predict cardiac morbidity better than maximal exercise parameters in Fontan patients?
Effect estimate: AUC for OUES 0.781, AUC for V˙E/V˙CO2 slope 0.714
p-value: p=0.018 for OUES, 0.04 for V˙E/V˙CO2 slope
Submaximal exercise parameters, specifically OUES and V˙E/V˙CO2 slope, provide superior prognostic information compared to maximal exercise data for predicting cardiac morbidity in Fontan patients.
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May support submaximal testing for Fontan risk stratification; hypothesis-generating and needs prospective validation before practice change.
Chen et al. (2013) conducted a cohort in Fontan circulation (n=52). Submaximal exercise parameters (OUES and V˙E/V˙CO2 slope) vs. Maximal exercise parameters (peak V˙O2 and HR reserve) was evaluated on 2-yr cardiac morbidity (cardiac-related hospitalization) (AUC for OUES 0.781, AUC for V˙E/V˙CO2 slope 0.714, p=0.018 for OUES, 0.04 for V˙E/V˙CO2 slope). Submaximal exercise parameters, including OUES (AUC 0.781, P=0.018) and V˙E/V˙CO2 slope (AUC 0.714, P=0.04), were significantly associated with 2-year cardiac morbidity in Fontan patients.