Key result
Patients with a single or systemic right ventricle demonstrated markedly reduced exercise capacity, with a VO2max of 21.7 ml/kg/min compared to 34.2 ml/kg/min in healthy controls.
Why the study?
Do adult patients with single or systemic right ventricles have reduced exercise capacity and elevated BNP levels compared to healthy controls?
Cross-Sectional (n=62)
Single-blind
No
Do adult patients with single or systemic right ventricles have reduced exercise capacity and elevated BNP levels compared to healthy controls?
Absolute Event Rate: 21.7% vs 34.2%
p-value: p=0.00001
Adult patients with a systemic right ventricle or Fontan physiology have markedly reduced exercise capacity and elevated BNP levels compared to healthy controls, though these two markers do not correlate with each other.
Supports CpET and BNP evaluation in systemic right ventricle patients; hypothesis-generating for risk stratification in congenital heart disease.
INTRODUCTION: The aim of the study was to evaluate exercise capacity using cardiopulmonary exercise test (CpET) and serum B-type natriuretic peptide (BNP) levels in patients with single or systemic right ventricles. MATERIAL AND METHODS: The study group included 40 patients (16 males) - 17 with transposition of the great arteries after Senning operation, 13 with corrected transposition of the great arteries and 10 with single ventricle after Fontan operation, aged 19-55 years (mean 28.8 ±9.5 years). The control group included 22 healthy individuals (10 males) aged 23-49 years (mean 30.6 ±6.1 years). RESULTS: The majority of patients reported good exercise tolerance - accordingly 27 were classified in NYHA class I (67.5%), 12 (30%) in class II, and only 1 (0.5%) in class III. Cardiopulmonary exercise test revealed significantly lower exercise capacity in study patients than in control subjects. In the study vs. control group VO(2max) was 21.7 ±5.9 vs. 34.2 ±7.4 ml/kg/min (p = 0.00001), maximum heart rate at peak exercise (HRmax) 152.5 ±32.3 vs. 187.2 ±15.6 bpm (p = 0.00001), VE/VCO(2) slope 34.8 ±7.1 vs. 25.7 ±3.2 (p = 0.00001), forced vital capacity (FVC) 3.7 ±0.9l vs. 4.6 ±0.3 (p = 0.03), forced expiratory volume in 1 s (FEV(1)) 3.0 ±0.7 vs. 3.7 ±0.9l (p = 0.0002) respectively. Serum BNP concentrations were higher in study patients than in control subjects; 71.8 ±74.4 vs. 10.7 ±8.1 (pg/ml) respectively (p = 0.00001). No significant correlations between BNP levels and CpET parameters were found. CONCLUSIONS: Patients with a morphological right ventricle serving the systemic circulation and those with common ventricle physiology after Fontan operation show markedly reduced exercise capacity. They are also characterized by higher serum BNP concentrations, which do not however correlate with CpET parameters.
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Trojnarska et al. (2010) conducted a cross-sectional in Single or systemic right ventricles (n=62). Single or systemic right ventricle vs. Healthy controls was evaluated on Peak oxygen consumption (VO2max) (p=0.00001). Patients with a single or systemic right ventricle demonstrated markedly reduced exercise capacity, with a VO2max of 21.7 ml/kg/min compared to 34.2 ml/kg/min in healthy controls.
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