Adults with a systemic right ventricle exhibited reduced cardiopulmonary fitness (mean VO2peak 20.0 ± 6.1 mL/kg/min), with a multivariable model explaining 64% of the variance in VO2peak.
Cohort (n=99)
Yes
In adults with a systemic right ventricle, cardiopulmonary fitness is moderately reduced and determined by a combination of clinical, echocardiographic, and patient-reported variables, highlighting potential modifiable targets for intervention.
Abstract Background Adults with a systemic right ventricle are at high risk of heart failure and functional decline, yet, data on determinants of exercise capacity in this population remain limited. We assessed cardiopulmonary fitness and identify factors associated with peak oxygen uptake (VO2peak) in a large multicenter cohort. Methods The prospective QUALISYSTEMIC study enrolled 99 adults with a systemic right ventricle (congenitally corrected transposition of the great arteries or dextro-transposition of the great arteries after atrial switch) across 13 European centers. Participants underwent standardized cardiopulmonary exercise test (CPET), echocardiography, and patient-reported outcome assessments. Multivariable regression, guided by a prespecified causal framework, was used to identify independent determinants of VO2peak. Results Mean age was 38.8 years; 52% were in NYHA functional class II. VO2peak was reduced (20.0 ± 6.1 mL/kg/min, corresponding to 62.4 ± 16.8% of the predicted value), together with impaired ventilatory efficiency (VE/VCO2 slope 34.1 ± 8.1). Independent predictors of lower VO2peak included female sex, higher NYHA class, severe systemic tricuspid regurgitation, pulmonary stenosis, pacemaker use, older age, higher BMI, lower ventilatory anaerobic threshold, and lower physical component score from the quality-of-life questionnaire. The final model explained 64% of the variance in VO2 peak. Conclusion Adults with a systemic right ventricle exhibit moderately reduced, but heterogeneous cardiopulmonary fitness. By integrating clinical, echocardiographic, and patient-reported variables, this study provides the most comprehensive explanatory model to date. Several determinants of cardiopulmonary fitness are modifiable, supporting a care pathway that combines correction of residual lesions, optimization of rhythm and device therapy, and CPET-guided rehabilitation programs.Cardiorespiratory parameters and NYHAFor image description, please refer to the figure legend and surrounding text.
Andrianoely et al. (Mon,) conducted a cohort in Systemic right ventricle (n=99). Clinical, echocardiographic, and patient-reported variables was evaluated on peak oxygen uptake (VO2peak). Adults with a systemic right ventricle exhibited reduced cardiopulmonary fitness (mean VO2peak 20.0 ± 6.1 mL/kg/min), with a multivariable model explaining 64% of the variance in VO2peak.
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