Key result
Adults with repaired tetralogy of Fallot had significantly reduced peak oxygen consumption (25.0 vs. 36.3 ml/kg/min) and flow-mediated dilation (7.6% vs. 10.8%) compared to healthy controls.
Why the study?
It was unclear whether impaired exercise capacity in adults with repaired tetralogy of Fallot relates to cardiac and endothelial impairment or to a more sedentary lifestyle.
Are cardiac and endothelial function associated with exercise capacity in adults with repaired tetralogy of Fallot compared to healthy controls?
Case-Control (n=36)
No
Are cardiac and endothelial function associated with exercise capacity in adults with repaired tetralogy of Fallot compared to healthy controls?
Absolute Event Rate: 25% vs 36.3%
p-value: p=<0.001
Adults with repaired tetralogy of Fallot exhibit impaired exercise capacity and endothelial function, which are moderately associated with each other and with natriuretic peptide levels.
Impaired fitness and endothelial function in repaired tetralogy of Fallot may prompt surveillance; leaves open mechanisms and interventions for prospective study.
Background: 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. Methods: 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. Results: 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). Conclusions: 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.
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Novakovic et al. (2022) conducted a case-control in Repaired tetralogy of Fallot (n=36). Repaired tetralogy of Fallot vs. Healthy controls was evaluated on Peak oxygen consumption (VO2peak) (p=<0.001). Adults with repaired tetralogy of Fallot had significantly reduced peak oxygen consumption (25.0 vs. 36.3 ml/kg/min) and flow-mediated dilation (7.6% vs. 10.8%) compared to healthy controls.
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