頁籤選單縮合
題名 | Assessing Late Cardiopulmonary Function in Patients with Repaired Tetralogy of Fallot Using Exercise Cardiopulmonary Function Test and Cardiac Magnetic Resonance= |
---|---|
作者 | Yang, Ming-chun; Chen, Chun-an; Chiu, Hsin-hui; Chen, Ssu-yuan; Wang, Jou-kou; Lin, Ming-tai; Chiu, Shuenn-nan; Lu, Chun-wei; Huang, Shu-chien; Wu, Mei-hwan; |
期刊 | Acta Cardiologica Sinica |
出版日期 | 20151100 |
卷期 | 31:6 2015.11[民104.11] |
頁次 | 頁478-484 |
分類號 | 415.315 |
語文 | eng |
關鍵詞 | Cardiac magnetic resonance; Cardiopulmonary exercise function; Pulmonary regurgitation; Surgical age; Tetralogy of Fallot; |
英文摘要 | Background: Patients with repaired tetralogy of Fallot (TOF) usually experience progressive right ventricle (RV) dysfunction due to pulmonary regurgitation (PR). This could further worsen the cardiopulmonary function. This study aimed to compare the changes in patient exercise cardiopulmonary test and cardiac magnetic resonance imaging, and consider the implication of these changes. Methods: Our study examined repaired TOF patients who underwent cardiopulmonary exercise test (CPET) to obtain maximal (peak oxygen consumption, peak VO2) and submaximal parameters (oxygen uptake efficiency plateau, oxygen uptake efficiency plateau (OUEP), and ratio of minute ventilation to carbon dioxide production, VE/VCO2 slope). Additionally, the hemodynamic status was assessed by using cardiac magnetic resonance. Criteria for exclusion included TOF patients with pulmonary atresia, atrioventricular septal defect, or absence of pulmonary valve syndrome. Results: We enrolled 158 patients whose mean age at repair was 7.8 9.1 years (range 0.1-49.2 years) and the mean patient age at CPET was 29.5 12.2 years (range 7.0-57.0 years). Severe PR (PR fraction 40%) in 53 patients, moderate in 55, and mild (PR fraction < 20%) in 50 patients were noted. The mean RV end-diastolic volume index (RVEDVi) was 113 35 ml/m2 , with 7 patients observed to have a RVEDVi > 163 ml/m2 . The mean left ventricular ejection fraction (LVEF) was 63 8%, left ventricular end-diastolic volume index (LVEDVi) was 65 12 ml/m2 , and LVESVi was 25 14 ml/m2 . CPET revealed significantly decreased peak VO2 (68.5 14.4% of predicted), and fair OUEP (90.3 14.1% of predicted) and VE/VCO2 slope (27.1 5.3). PR fraction and age at repair were negatively correlated with maximal and submaximal exercise indicators (peak VO2 and OUEP). Left ventricular (LV) function and size were positively correlated with peak VO2 and OUEP. Conclusions: The results of CPET showed that patients with repaired TOF had a low maximal exercise capacity (peak VO2), but a fair submaximal exercise capacity (OUEP and VE/VCO2 slope), suggesting limited exercise capability in high intensity circumstances. PR, LV function and age at total repair were the most important determinants of CPET performance. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。